Environmental Health Center, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea.
Department of Emergency Medicine, Soonchunhyang University Hospital, Bucheon, 170, Jomaru-ro, Bucheon-si, Gyeonggi-do, 14584, Republic of Korea.
BMC Emerg Med. 2021 Mar 22;21(1):34. doi: 10.1186/s12873-021-00427-1.
This study analyzed the characteristics of hydrogen fluoride-exposed patients (HFEPs) treated in the emergency department (ED) of a local university hospital, and reviewed the hospital's disaster response according to space, staff, supplies, and systems (4Ss).
This retrospective observational chart review and descriptive study included 199 HFEPs among 2588 total ED patients who visited a local university emergency medical center for treatment between September 27, 2012 and October 20, 2012, following a hydrofluoric acid leak at the Hube Globe factory in Gumi City, Republic of Korea. Descriptive results concerning the 4Ss were obtained by interviewing ED specialist staff physicians on duty during the study period. In accordance with American Burn Association criteria, patients requiring burn center referral were assigned to the major burn group (MBG) as severe condition.
During the acute phase (within 8 h after leak initiation), there were 43 patients in the ED, which was staffed with 3 doctors and 3 nurses, without 4S resources. Of these 43 patients, there were 8 HFEPs (100%) in the MBG and 0 in the non-MBG (NMBG). During the subacute phase (24 h after the acute phase), there were 262 patients in the ED including 167 HFEPs, of whom 45 (26.95%) were in the MBG and 122 (73.05%) were in the NMBG. The ED was then staffed with 6 doctors (3 on day shift and 3 on night shift) and 10 nurses (3 on day shift, 4 on evening shift, and 3 on night shift), and no 4S resources were available. Throughout the study period, no 4Ss were available. First, there was no expansion of ED space or secured disaster reserve beds. Second, there was no increase in manpower with duty time adjustments or duty relocation for ED working personnel. Third, there was no logistics reinforcement (e.g., antidote or personal protective equipment). Fourth, there were no disaster-related measures for the administration department, decontamination zone setup, safety diagnostic testing, or designated disaster triage implementation.
The hospital's disaster response was insufficient for all aspects of the 4Ss. Detailed guidance concerning a hospital disaster management plan is required.
本研究分析了在当地一所大学医院急诊科接受治疗的氢氟酸暴露患者（HFEPs）的特征，并根据空间、人员、物资和系统（4Ss）对医院的灾害应对进行了回顾。
这是一项回顾性观察性图表回顾和描述性研究，纳入了 2012 年 9 月 27 日至 10 月 20 日期间，韩国固城 Hube Globe 工厂发生氢氟酸泄漏后，在当地大学急救医疗中心接受治疗的 2588 名急诊科患者中的 199 名 HFEPs。通过在研究期间采访急诊科专科医生，获得了有关 4Ss 的描述性结果。根据美国烧伤协会的标准，需要烧伤中心转诊的患者被分配到主要烧伤组（MBG）作为严重情况。
在急性阶段（泄漏发生后 8 小时内），急诊科有 43 名患者，配备了 3 名医生和 3 名护士，没有 4S 资源。在这 43 名患者中，有 8 名 HFEPs（100%）在 MBG 中，0 名在非 MBG（NMBG）中。在亚急性阶段（急性阶段后 24 小时），急诊科有 262 名患者，其中包括 167 名 HFEPs，其中 45 名（26.95%）在 MBG 中，122 名（73.05%）在 NMBG 中。急诊科配备了 6 名医生（3 名白班医生和 3 名夜班医生）和 10 名护士（3 名白班护士、4 名晚班护士和 3 名夜班护士），没有 4S 资源。在整个研究期间，都没有 4Ss 可用。首先，没有扩大急诊科空间或确保灾难储备床位。其次，没有通过调整医务人员的值班时间或重新分配医务人员的值班地点来增加人力。第三，没有后勤增援（例如解毒剂或个人防护设备）。第四，行政部门没有采取与灾害有关的措施，没有设置去污区，没有进行安全诊断测试，也没有实施指定的灾害分诊。
医院在 4Ss 的各个方面的灾害应对都不足。需要详细的医院灾难管理计划指导。
