Mortelmans Luc J M, Gaakeer Menno I, Dieltiens Greet, Anseeuw Kurt, Sabbe Marc B
1Department of Emergency Medicine,ZNA Camp Stuivenberg,Antwerp,Belgium.
3Department of Emergency Medicine,Admiraal De Ruyter Hospital,The Netherlands.
Prehosp Disaster Med. 2017 Oct;32(5):483-491. doi: 10.1017/S1049023X17006513. Epub 2017 May 8.
Introduction Being one of Europe's most densely populated countries, and having multiple nuclear installations, a heavy petrochemical industry, and terrorist targets, the Netherlands is at-risk for chemical, biological, or radionuclear (CBRN) incidents. Recent world and continental events show that this threat is real and that authorities may be underprepared. Hypothesis The hypothesis of this study is that Dutch hospitals are underprepared to deal with these incidents.
A descriptive, cross-sectional study was performed. All 93 Dutch hospitals with an emergency department (ED) were sent a link to an online survey on different aspects of CBRN preparedness. Besides specific hospital information, information was obtained on the hospital's disaster planning; risk perception; and availability of decontamination units, personal protective equipment (PPE), antidotes, radiation detection, infectiologists, isolation measures, and staff training.
Response rate was 67%. Sixty-two percent of participating hospitals were estimated to be at-risk for CBRN incidents. Only 40% had decontamination facilities and 32% had appropriate PPE available for triage and decontamination teams. Atropine was available in high doses in all hospitals, but specific antidotes that could be used for treating victims of CBRN incidents, such as hydroxycobolamine, thiosulphate, Prussian blue, Diethylenetriaminepentaacetic acid (DTPA), or pralidoxime, were less frequently available (74%, 65%, 18%, 14%, and 42%, respectively). Six percent of hospitals had radioactive detection equipment with an alarm function and 22.5% had a nuclear specialist available 24/7 in case of disasters. Infectiologists were continuously available in 60% of the hospitals. Collective isolation facilities were present in 15% of the hospitals.
There is a serious lack of hospital preparedness for CBRN incidents in The Netherlands. Mortelmans LJM , Gaakeer MI , Dieltiens G , Anseeuw K , Sabbe MB . Are Dutch hospitals prepared for chemical, biological, or radionuclear incidents? A survey study. Prehosp Disaster Med. 2017;32(5):483-491.
引言 作为欧洲人口最密集的国家之一，拥有多个核设施、庞大的石化工业以及恐怖主义目标，荷兰面临化学、生物或放射性核素（CBRN）事件的风险。近期的全球和欧洲大陆事件表明，这种威胁是真实存在的，而且当局可能准备不足。假设 本研究的假设是荷兰医院在应对这些事件方面准备不足。
进行了一项描述性横断面研究。向荷兰所有93家设有急诊科（ED）的医院发送了一个在线调查问卷的链接，内容涉及CBRN准备工作的不同方面。除了特定的医院信息外，还获取了有关医院灾难规划、风险认知、去污设备的可用性、个人防护装备（PPE）、解毒剂、辐射检测、感染病专家、隔离措施以及人员培训等方面的信息。
回复率为67%。估计62%的参与医院面临CBRN事件的风险。只有40%的医院有去污设施，32%的医院有适用于分诊和去污团队的PPE。所有医院都有高剂量的阿托品，但可用于治疗CBRN事件受害者的特定解毒剂，如羟钴胺、硫代硫酸盐、普鲁士蓝、二乙烯三胺五乙酸（DTPA）或氯解磷定，其可用性较低（分别为74%、65%、18%、14%和42%）。6%的医院有具备警报功能的放射性检测设备，22.5%的医院在灾难发生时有核专家随时待命。60%的医院有感染病专家随时可用。15%的医院有集体隔离设施。
荷兰医院在应对CBRN事件方面严重缺乏准备。莫特尔曼斯LJM、加克MI、迪尔蒂恩斯G、安西厄K、萨贝MB。荷兰医院对化学、生物或放射性核素事件有准备吗？一项调查研究。院前灾难医学。2017；32（5）：483 - 491。
