Department of Aviation Security, Polish Air Force Academy, 08-521 Dęblin, Poland.
Department of Emergency Medicine, Medical University of Lublin, 20-059, Lublin, Poland.
Int J Environ Res Public Health. 2020 Mar 9;17(5):1779. doi: 10.3390/ijerph17051779.
Medical facilities, while providing both essential and demanding health care to society's most vulnerable populations, also belong to the most demanding category of risk to human life if and when a crisis event occurs within its walls. The development of a safe evacuation plan for these facilities is extremely complicated, as the evacuation of medical facilities is much more complex than for other critical infrastructure. In this category, the evacuated patients constitute a specific risk group requiring specialized medical care. Hospitalized persons may be dependent on life-saving measures, are unconscious or immobile, are significantly restricted in movement or mentally unbalanced, being dependent on the continued assistance of trained third parties. Additionally, the medical transport of evacuated patients becomes more difficult due to the limited capacity of ambulances and available health care facilities to transport them to, which are increasingly limited due to their overcrowded census. The study aimed to analyze the requirements which are placed on hospitals in Poland to ensure the safety of patients in case of an evacuation. The research method used in the paper was retrospective analysis and evaluation of the media and literature. We have found, that Polish law imposes an obligation on the administrator of a medical facility to ensure the safety of both patients and employees. The regulations cover issues of technical conditions to be met by buildings and their location, prevention, and fire protection requirements, and the determination of which staff is responsible for the evacuation. However, available documents fail to describe what the hospital evacuation process itself should entail under emergency evacuation. Taking into account the complexity of the hospital evacuation process, health care facilities should have a well-developed plan of action that must be implemented at least once a year in the form of facility-wide training. Evacuation drills should not be avoided. Only trained procedures offer the possibility of later analysis to identify and eliminate errors and provide the opportunity to acquire skill sets and habits which promote the behaviors expected in real-life emergencies.
医疗设施在为社会中最脆弱的人群提供基本和急需的医疗保健的同时,如果其内部发生危机事件,也属于对人类生命要求最高的风险类别。为这些设施制定安全的疏散计划极其复杂,因为医疗设施的疏散比其他关键基础设施复杂得多。在这一类中,疏散的患者构成了一个特定的风险群体,需要专门的医疗护理。住院患者可能依赖救生措施,处于无意识或无法移动的状态,行动受限或精神失衡,依赖受过培训的第三方的持续帮助。此外,由于救护车的容量有限,以及可用于将患者转移到的医疗设施的容量有限,疏散患者的医疗运输变得更加困难,而这些设施的容量由于过度拥挤而越来越受到限制。本研究旨在分析波兰的医院在发生疏散时对确保患者安全的要求。本文采用的研究方法是对媒体和文献进行回顾性分析和评估。我们发现,波兰法律规定医疗设施的管理者有义务确保患者和员工的安全。法规涵盖建筑物及其位置应满足的技术条件、预防和防火要求以及负责疏散的员工的确定等问题。然而,现有文件未能描述紧急疏散情况下医院疏散过程本身应包含哪些内容。考虑到医院疏散过程的复杂性,医疗机构应该有一个完善的行动计划,该计划每年至少应通过全设施培训的形式实施一次。应避免避免疏散演习。只有经过培训的程序才能提供以后进行分析的可能性,以识别和消除错误,并提供机会获得技能和习惯,促进在现实紧急情况下预期的行为。