Tullius Zoe, Helgesen Wanda, Mulla Zuber D, Chheda Sadhana
Paul L Foster School of Medicine, Department of Pediatrics, Division of Neonatology, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.
El Paso Children's Hospital, El Paso, TX, USA.
Disaster Med Public Health Prep. 2022 Aug 3;17:e244. doi: 10.1017/dmp.2022.158.
Evacuations of neonatal intensive care units (NICUs) in emergency situations pose specialized challenges given their population of critically-ill neonates. Most of the literature on this topic describes planned evacuations and simulations due to natural disasters, usually involving only NICU staff. This study examines a unique emergent NICU evacuation simulation involving multiple responders occurring on a citywide scale.
A simulated evacuation in response to a fire was conducted in 6 different NICUs in El Paso, Texas. The exercise utilized response from NICU staff and first responders. A standardized tool, by independent evaluators, was used to evaluate staff competencies while reactions were assessed using post-exercise surveys.
This city-wide multidisciplinary simulation improved NICU personnel skills in evacuation and also introduced first responders to this specialized patient population. Areas of strength across all NICUs included teamwork, knowledge of evacuation equipment, and patient tracking. Areas for improvement included lack of adequate equipment for post-evacuation care, understanding implications of smoke exposure, alternative evacuation routes, incident command structure, and unified communication.
This successful, citywide NICU evacuation simulation improved knowledge among participants, introduced first responders to a specialized patient population, and provided valuable lessons on neonate-specific themes that can be incorporated to improve citywide emergency preparedness.
鉴于新生儿重症监护病房（NICU）中有危重新生儿，在紧急情况下撤离该病房会带来特殊挑战。关于这一主题的大多数文献描述的是因自然灾害而进行的计划性撤离和模拟，通常只涉及NICU工作人员。本研究考察了一次在全市范围内进行的、涉及多个响应方的独特的NICU紧急撤离模拟。
在得克萨斯州埃尔帕索的6个不同的NICU中进行了一次针对火灾的模拟撤离。该演习动用了NICU工作人员和急救人员的响应力量。由独立评估人员使用标准化工具来评估工作人员的能力，同时通过演习后调查来评估反应情况。
这次全市范围的多学科模拟提高了NICU人员的撤离技能，还让急救人员了解了这一特殊患者群体。所有NICU的优势领域包括团队合作、撤离设备知识和患者追踪。有待改进的方面包括撤离后护理设备不足、对烟雾暴露影响的认识、替代撤离路线、 incident command structure（事件指挥结构，此处原文可能有误，推测应为指挥结构相关内容）以及统一通信。
这次成功的全市范围的NICU撤离模拟提高了参与者的知识水平，让急救人员了解了特殊患者群体，并提供了关于新生儿特定主题的宝贵经验教训，可用于改进全市范围的应急准备工作。
