Emergency Department, Frimley Park Hospital, Camberley, UK.
Clin Toxicol (Phila). 2010 Jul;48(6):522-7. doi: 10.3109/15563650.2010.491483.
Following a Chemical, Biological, Radiation, or Nuclear (CBRN) incident, the attending rescuers will be required to administer drugs while wearing the CBRN Personal Protective Equipment (CBRN-PPE). Little is known regarding the impact of the CBRN-PPE on the ability to speedily, safely, and accurately draw up drugs for subsequent administration.
A randomized control trial examining the ability of rescuers to draw up drugs from four different drug presentations (a Minijet prefilled syringe, an Aurum prefilled syringe, and glass and plastic ampoules with needle and syringe) was undertaken with participants wearing and not wearing the National Health Service (NHS) CBRN-PPE. Each participant underwent the procedure once in "normal clothes" and twice while wearing the CBRN-PPE. The speed and accuracy of each participant were measured as well as the participant's perceived risk of suit damage associated with the four different drug presentations.
The participants constituted a non-homogenous group of emergency nurses, nurse lecturers, paramedic lecturers, and student paramedics. A total of 81 participants were recruited; one participant withdrew due to claustrophobia. All participants had used all four drug preparations prior to being enrolled into the study.
Wearing the CBRN-PPE had a negative effect on drawing up drugs in the first attempt while wearing the CBRN-PPE, typically taking 63.8% longer time than without (95% confidence interval: 55.3-72.9%). Improvements were noted on second attempts. The choice of drug presentation had an effect on the time taken to draw up the drugs, with Aurum being overall the fastest and glass ampoules the slowest (p-values < 0.001). All participants rated the prefilled syringes as the easiest and the safest to use, and the glass ampoules with needles and syringes as the most difficult to use and the ones most likely to puncture the CBRN-PPE. During the drawing-up process, varying amounts of "drug" were lost, although in two-thirds of the attempts all 10 mL was drawn up. The lowest volume was lost from the prefilled syringes and the maximum volume of fluid was lost from the glass ampoules.
The NHS CBRN-PPE has a negative effect on the drawing up of drugs especially from glass ampoules. Glass ampoules represent a poor choice of drug preparation when considering speed, safety, and accuracy of drawing up of drugs while wearing protective clothing.
在发生化学、生物、辐射或核（CBRN）事故后，现场救援人员需要穿着 CBRN 个人防护设备（CBRN-PPE）给药。目前，关于 CBRN-PPE 对快速、安全和准确配药能力的影响知之甚少。
一项随机对照试验，考察了救援人员在穿着和不穿着国民保健服务（NHS）CBRN-PPE 时，从四种不同药物制剂（Minijet 预充注射器、Aurum 预充注射器以及带针和注射器的玻璃安瓿和塑料安瓿）中抽取药物的能力。每位参与者在“正常着装”和穿着 CBRN-PPE 的情况下各进行一次。测量每位参与者的速度和准确性，以及参与者对与四种不同药物制剂相关的套装损坏风险的感知。
参与者由急诊护士、护士讲师、护理讲师和学生护理人员组成，构成一个非同质群体。共招募了 81 名参与者，由于幽闭恐惧症，一名参与者退出了研究。所有参与者在被纳入研究之前都曾使用过所有四种药物制剂。
穿着 CBRN-PPE 会对第一次穿着 CBRN-PPE 配药产生负面影响，通常需要多花 63.8%的时间（95%置信区间：55.3-72.9%）。第二次尝试时有所改进。药物制剂的选择对抽取药物的时间有影响，Aurum 总体上最快，玻璃安瓿最慢（p 值<0.001）。所有参与者均将预充注射器评为最容易使用和最安全的药物制剂，将带针和注射器的玻璃安瓿评为最难使用和最容易刺破 CBRN-PPE 的药物制剂。在抽取过程中，会损失一定量的“药物”，尽管在三分之二的尝试中，所有 10 毫升都被抽取。预充注射器损失的体积最小，而玻璃安瓿损失的液体量最大。
NHS CBRN-PPE 对药物抽取有负面影响，尤其是从玻璃安瓿中抽取。当考虑在穿着防护服时药物的抽取速度、安全性和准确性时，玻璃安瓿是一种较差的药物制剂选择。
