Li An, Wang Xiao-hong, Hao Feng-tong
The Affililate of Capitol University of Medicol Sciences, Beijing, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2013 Mar;31(3):212-4.
To investigate the current situation of treatment for acute chemical poisoning in the emergency departments and occupational disease departments of some general hospitals and to provide a basis for improving the ability of general hospital to deal with acute chemical poisoning.
Four hospitals from Shandong Province, Beijing City, and Shanxi Province, China were selected in the study. They included two first-class hospitals located in the downtown, where the patients with acute chemical poisoning from urban and suburban areas were admitted to the occupational disease departments, and two second-class hospitals located in the suburban area or county, where the patients with acute chemical poisoning from the suburban area were admitted to the emergency departments. A questionnaire survey was conducted in 141 medical workers (51 persons in the emergence department group and 90 persons in the occupational disease department group) that were engaged in the treatment of acute chemical poisoning in the four hospitals; 1999 medical records were analyzed. Individual in-depth interviews, questionnaire investigation, and field observation were used to compare the emergency department group and occupational disease department group in terms of the ability to deal with acute chemical poisoning and the training on treatment for acute chemical poisoning.
The emergency department group had significantly higher proportion of pesticide poisoning cases than the occupational disease department group (P<0.01). Thirty-seven of the patients in occupational disease department group died, with a fatality rate of 2.7%, and 14 of the patients in emergence department group died,with a fatality rate of 2.2%, so there was no significant difference between the two groups in this regard (P>0.05). There were significantly more cases treated without emergency plan in the emergency department group than in the occupational disease department group ( 37.3% vs. 10.0%, P <0.0 1). The occupational disease department group had significantly higher score of knowledge about the treatment for acute chemical poisoning than the emergence department group (7.2±1.3 vs. 5.2±0.9, P<0.01 ). There were significantly lower proportions of medical staff who had received training on the knowledge about acute chemical poisoning and on the emergency disposal of acute chemical poisoning in the emergency department group than in the occupational disease department group (P<0.05).
There is a lack of the knowledge about treatment for acute chemical poisoning and protective measures during treatment among the medical staff in general hospitals, and related training and emergency plan are needed.
调查部分综合医院急诊科和职业病科急性化学中毒的救治现状，为提高综合医院应对急性化学中毒的能力提供依据。
选取我国山东省、北京市和山西省的4所医院进行研究。其中包括2所位于市区的三级医院，来自城区和郊区的急性化学中毒患者被收治于职业病科；2所位于郊区或县的二级医院，来自郊区的急性化学中毒患者被收治于急诊科。对这4所医院从事急性化学中毒救治工作的141名医务人员（急诊科组51人，职业病科组90人）进行问卷调查；分析1999份病历。采用个人深入访谈、问卷调查和现场观察的方法，比较急诊科组和职业病科组在急性化学中毒救治能力及急性化学中毒治疗培训方面的情况。
急诊科组农药中毒病例比例显著高于职业病科组（P<0.01）。职业病科组有37例患者死亡，病死率为2.7%，急诊科组有14例患者死亡，病死率为2.2%，两组在这方面差异无统计学意义（P>0.05）。急诊科组无应急预案处理的病例显著多于职业病科组（37.3%对10.0%，P<0.01）。职业病科组急性化学中毒治疗知识得分显著高于急诊科组（7.2±1.3对5.2±0.9，P<0.01）。急诊科组接受急性化学中毒知识培训和急性化学中毒应急处置培训的医务人员比例显著低于职业病科组（P<0.05）。
综合医院医务人员缺乏急性化学中毒治疗知识及治疗过程中的防护措施，需要进行相关培训并制定应急预案。
