Department of Emergency Management and Disaster Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel.
Division of Emergency & Disaster Management, Ministry of Health, Tel Aviv 6744300, Israel.
Int J Environ Res Public Health. 2020 Mar 31;17(7):2385. doi: 10.3390/ijerph17072385.
A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs ( = 0.006), training and exercises ( = 0.003), and in the overall score ( = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals' geographical location (F = 3.0, = 0.056), proximity to other medical facilities (F = 10.0 = 0.005), and type of area (Urban vs. Periphery) (F = 13.1, = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.
大量人员伤亡事件（MCI）由毒理学/化学物质引起，构成了一种潜在但不常见的风险，可能造成巨大破坏。如果在医院中未立即识别出接触此类物质的伤员，可能会导致二次污染，从而导致急诊科功能失调。本研究考察了纵向评估过程对医院应对毒理学 MCI 的持续应急准备的影响，历时十余年。
在过去的十年中，定期评估所有以色列医院应对毒理学事件的应急准备情况。评估基于一个结构化的工具，旨在鼓励持续制定标准作业程序（SOP）、设备和基础设施、人员知识以及培训和演练。基准分发给所有医院，作为建立和改进应急准备的基础。对医院内部和医院之间的得分进行了比较。
在五次测量中，应急准备的总体平均得分从 88 分提高到 95 分。在 SOP（= 0.006）、培训和演练（= 0.003）以及总体得分（= 0.004）方面，T1（第一次评估）和 T5（最后一次评估）之间存在显著差异。在设备和基础设施以及知识方面未发现显著变化；在整个十年中，它们的得分一直很高。评估周期和医院地理位置（F = 3.0，= 0.056）、与其他医疗设施的接近程度（F = 10.0，= 0.005）和区域类型（城市与周边地区）（F = 13.1，= 0.002）之间存在交互效应。在 T5 时，所有医院的应急准备得分均达到相似的高水平。
使用可访问的基准，可以清楚地划定需要持续实施的内容，从而有助于持续维持有效的应急准备水平。由于这是针对不太常见的风险进行的演示，因此可以假设，实现和维持其他潜在风险的应急准备是可能且可行的。
