Jama Timo J, Kuisma Markku J
1Centre for Prehospital Care and Emergency Medicine,Päijät-Häme Social and Healthcare Group,Lahti,Finland.
2Emergency Medical Services,Department of Emergency Medicine,Helsinki University Hospital,Finland.
Prehosp Disaster Med. 2016 Aug;31(4):392-6. doi: 10.1017/S1049023X16000546. Epub 2016 May 24.
Introduction The preparedness level of Finnish Emergency Medical Services (EMS) for treating chemical emergencies is unknown. The aim of this study was to survey the preparedness level of EMS systems for managing and handling mass-casualty chemical incidents in the prehospital phase in Finland. Hypothesis The study hypothesis was that university hospital districts would have better clinical capability to treat patients than would central hospital districts in terms of the number of patients treated in the field within one hour after dispatching as well as patients transported to hospital within one hour or two hours after dispatching.
This cross-sectional study was conducted as a Webropol (Wuppertal, Germany) survey. All hospital districts (n=20) in continental Finland were asked about their EMS preparedness level in terms of capability of treating and transporting chemically affected patients in the field. Their capability for decontamination of affected patients in the field was also inquired.
University hospital district-based EMS systems had at least 20% better absolute clinical capacity than central hospital-based EMS systems for treating chemically affected patients concerning all treatments inquired about, except the capacity for non-invasive ventilation (NIV)/continuous positive airway pressure (CPAP) treatment in the field. Overall, there was a good level of preparedness for treating chemical accident patients with supplemental oxygen, bronchodilators, and inhaled corticosteroids. Preparedness for providing antidote therapy in cases of cyanide gas exposure was, in general, low. The variation among the hospital districts was remarkable. Only nine of 15 central hospital district EMS had a mobile decontamination unit available, whereas four of five university hospital districts had one.
Emergency Medical Services capacity in Finland for treating chemically affected patients in the field needs to be improved, especially in terms of antidote therapy. Mobile decontamination units should be available in all hospital districts. Jama TJ , Kuisma MJ . Preparedness of Finnish Emergency Medical Services for chemical emergencies. Prehosp Disaster Med. 2016;31(4):392-396.
引言 芬兰紧急医疗服务(EMS)应对化学紧急情况的准备水平尚不清楚。本研究的目的是调查芬兰EMS系统在院前阶段管理和处理大规模伤亡化学事故的准备水平。假设 研究假设是,就派遣后一小时内在现场治疗的患者数量以及派遣后一小时或两小时内转运至医院的患者数量而言,大学医院区比中心医院区在治疗患者方面具有更好的临床能力。
本横断面研究以Webropol(德国伍珀塔尔)调查的形式进行。向芬兰大陆的所有医院区(n = 20)询问了其在现场治疗和转运化学中毒患者的能力方面的EMS准备水平。还询问了他们在现场对受影响患者进行去污的能力。
对于所询问的所有治疗方法,除了现场无创通气(NIV)/持续气道正压通气(CPAP)治疗能力外,基于大学医院区的EMS系统在治疗化学中毒患者方面的绝对临床能力比基于中心医院的EMS系统至少高20%。总体而言,在使用补充氧气、支气管扩张剂和吸入性皮质类固醇治疗化学事故患者方面有良好的准备水平。在氰化氢气体暴露情况下提供解毒治疗的准备水平总体较低。医院区之间的差异显著。15个中心医院区的EMS中只有9个有移动去污单元,而5个大学医院区中有4个有。
芬兰紧急医疗服务在现场治疗化学中毒患者的能力需要提高,特别是在解毒治疗方面。所有医院区都应配备移动去污单元。Jama TJ,Kuisma MJ。芬兰紧急医疗服务对化学紧急情况的准备。院前灾难医学。2016;31(4):392 - 396。