Berk W A, Todd K
Department of Emergency Medicine, Detroit Receiving Hospital/University Health Center, MI 48201.
Am J Emerg Med. 1994 Jan;12(1):60-3. doi: 10.1016/0735-6757(94)90201-1.
Prevention of transmission of bloodborne pathogens to health care workers (HCWs) involved in resuscitation of critically injured patients presents special challenges. As a step toward creation of a standard, a telephone survey of the infection control practices in this setting of the 100 busiest EDs in the United States (US) was performed. Departmental staff who were knowledgeable about ED infection prevention protocols were questioned about general policy, barrier protection measures, sharps management, and educational programs directed to HCWs. Surveys were completed for 82 EDs. Of these, 56 (68%) either function as primary trauma care facilities for the local community, or are designated level 1 trauma centers by the American College of Surgeons. Specific infection control protocols for trauma resuscitation had been printed and posted by 18 EDs (22%), with the remaining 64 (78%) using the same universal precautions for care of the severely injured as for other patients. A specific policy relating to invasive procedures had been promulgated by 66 EDs (80%). Barrier protection was used by protocol or by custom for care of all critically injured patients by 43 EDs (52%). Impermeable gowns with sleeves were available in 63 EDs (77%). Eye or face protection included face shields by 74 EDs (90%), face masks by 76 EDs (93%), and goggles by 72 EDs (88%). Only 59 EDs (72%) reported that sharp containers were always within arm's reach of HCWs with material to discard. Specially adapted equipment included self-sheathing intravenous catheters (21, 26%) and needle/syringe combinations (16, 20%). Considerable variation exists in infection control practices in busy US EDs during resuscitation of critically injured patients.(ABSTRACT TRUNCATED AT 250 WORDS)
预防血源性病原体传播给参与重症受伤患者复苏的医护人员面临特殊挑战。作为制定标准的一步，对美国100家最繁忙急诊科在这种情况下的感染控制措施进行了电话调查。询问了了解急诊科感染预防方案的部门工作人员有关总体政策、屏障保护措施、锐器管理以及针对医护人员的教育项目。82家急诊科完成了调查。其中，56家（68%）要么是当地社区的主要创伤护理机构，要么被美国外科医师学会指定为一级创伤中心。18家急诊科（22%）已印制并张贴了创伤复苏的具体感染控制方案，其余64家（78%）对重伤患者的护理采用与其他患者相同的通用预防措施。66家急诊科（80%）颁布了与侵入性操作相关的具体政策。43家急诊科（52%）按照方案或惯例对所有重症受伤患者进行护理时使用屏障保护。63家急诊科（77%）备有带袖的不透水隔离衣。眼部或面部防护方面，74家急诊科（90%）包括面罩，76家急诊科（93%）包括口罩，72家急诊科（88%）包括护目镜。只有59家急诊科（72%）报告称锐器容器总是在医护人员伸手可及的范围内并有可丢弃的物品。特殊适配设备包括自护套静脉导管（21家，26%）和针/注射器组合（16家，20%）。在美国繁忙的急诊科对重症受伤患者进行复苏期间，感染控制措施存在很大差异。（摘要截取自250字）
