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急诊科及医护人员面临的二次化学污染威胁:一个罕见但反复出现的问题。

Threat of Secondary Chemical Contamination of Emergency Departments and Personnel: An Uncommon but Recurrent Problem.

作者信息

Larson Theodore C, Orr Maureen F, Auf der Heide Erik, Wu Jennifer, Mukhopadhyay Sutapa, Horton D Kevin

机构信息

1Division of Toxicology and Human Health Sciences,Agency for Toxic Substances and Disease Registry,Atlanta,Georgia.

2Communicable and Environmental Diseases and Emergency Preparedness,Tennessee Department of Health,Nashville,Tennessee.

出版信息

Disaster Med Public Health Prep. 2016 Apr;10(2):199-202. doi: 10.1017/dmp.2015.127. Epub 2015 Nov 10.

Abstract

OBJECTIVE

To analyze acute hazardous substance release surveillance data for events involving secondary contamination of hospital emergency departments (EDs). Secondary contamination of EDs may occur when a patient exposed to a hazardous chemical is not decontaminated before arrival at the ED and when ED staff are not wearing appropriate personal protective equipment. This can result in adverse health outcomes among department personnel, other patients, and visitors. Even events without actual secondary contamination risk can be real in their consequences and require the decontamination of the ED or its occupants, evacuation, or temporary shutdown of the ED.

METHODS

Events involving secondary contamination were identified by using the Hazardous Substances Emergency Events Surveillance system and the National Toxic Substance Incidents Program from 2007 to 2013.

RESULTS

Five incidents involving the threat of secondary contamination (0.02% of all events reported to the surveillance systems [n=33,001]) were detected and are described. Four incidents involved suspected secondary contamination in which the facility was evacuated or shut down.

CONCLUSIONS

These results suggest that although rare, incidents involving secondary contamination continue to present a hazard for emergency departments. Suggested best practices to avoid secondary contamination have been described. Hospitals should be made aware of the risks associated with secondary contamination and the need to proactively train and equip staff to perform decontamination.

摘要

目的

分析医院急诊科(ED)发生二次污染事件的急性有害物质释放监测数据。当接触有害化学物质的患者在抵达急诊科之前未进行去污处理,以及急诊科工作人员未穿戴适当的个人防护装备时,可能会发生急诊科的二次污染。这可能会导致科室人员、其他患者和访客出现不良健康后果。即使是没有实际二次污染风险的事件,其后果也可能很严重,可能需要对急诊科或其人员进行去污处理、疏散或临时关闭急诊科。

方法

利用有害物质应急事件监测系统和国家有毒物质事件计划,确定2007年至2013年期间涉及二次污染的事件。

结果

检测到5起涉及二次污染威胁的事件(占向监测系统报告的所有事件的0.02%[n = 33,001])并进行了描述。4起事件涉及疑似二次污染,相关设施被疏散或关闭。

结论

这些结果表明,虽然涉及二次污染的事件很少见,但仍继续对急诊科构成危害。已描述了避免二次污染的建议最佳做法。应让医院了解与二次污染相关的风险以及积极培训和装备工作人员进行去污处理的必要性。

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