Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study
Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study
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DOI：
10.1017/s1049023x17006513
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发表时间：
2017-10-01
影响因子：
2.2
通讯作者：
Sabbe, Marc B.
中科院分区：
文献类型：
--
作者：
Mortelmans, Luc J. M.;Gaakeer, Menno I.;Sabbe, Marc B.
简介：作为欧洲人口最稠密的国家之一，拥有多个核设施，重型石化工业和恐怖主义目标，荷兰面临化学，生物或辐射（CBRN）事件的风险。最近的世界和大陆的事件表明，这种威胁是真实的，当局可能准备不足。假设：本研究的假设是，荷兰医院准备不足，以处理这些incidents.Methods：一个描述性的，横断面研究进行。所有93家设有急诊科（艾德）的荷兰医院都收到了一个关于CBRN准备工作不同方面的在线调查链接。除了具体的医院信息，信息获得医院的灾难规划;风险认知;和可用性的去污单位，个人防护设备（PPE），解毒剂，辐射检测，感染学家，隔离措施，和员工training.Results：响应率为67%。据估计，62%的参与医院面临CBRN事件的风险。只有40%有去污设施，32%有适当的个人防护装备可供分诊和去污小组使用。所有医院都有高剂量的阿托品，但可用于治疗CBRN事件受害者的特定解毒剂，如羟基钴胺素、硫代硫酸盐、普鲁士蓝、二乙烯三胺五乙酸（DTPA）或解磷定，则不太常见（分别为74%、65%、18%、14%和42%）。6%的医院配备了具有报警功能的放射性检测设备，22.5%的医院配备了核专家，以应对灾难。在60%的医院中，免疫科医生一直都在。集体隔离设施，目前在15%的hospital.Conclusion：有一个严重缺乏医院的CBRN事件在荷兰的准备。
Introduction: Being one of Europe's most densely populated countries, and having multiple nuclear installations, a heavy petrochemical industry, and terrorist targets, the Netherlands is at-risk for chemical, biological, or radionuclear (CBRN) incidents. Recent world and continental events show that this threat is real and that authorities may be underprepared.Hypothesis: The hypothesis of this study is that Dutch hospitals are underprepared to deal with these incidents.Methods: A descriptive, cross-sectional study was performed. All 93 Dutch hospitals with an emergency department (ED) were sent a link to an online survey on different aspects of CBRN preparedness. Besides specific hospital information, information was obtained on the hospital's disaster planning; risk perception; and availability of decontamination units, personal protective equipment (PPE), antidotes, radiation detection, infectiologists, isolation measures, and staff training.Results: Response rate was 67%. Sixty-two percent of participating hospitals were estimated to be at-risk for CBRN incidents. Only 40% had decontamination facilities and 32% had appropriate PPE available for triage and decontamination teams. Atropine was available in high doses in all hospitals, but specific antidotes that could be used for treating victims of CBRN incidents, such as hydroxycobolamine, thiosulphate, Prussian blue, Diethylenetriaminepentaacetic acid (DTPA), or pralidoxime, were less frequently available (74%, 65%, 18%, 14%, and 42%, respectively). Six percent of hospitals had radioactive detection equipment with an alarm function and 22.5% had a nuclear specialist available 24/7 in case of disasters. Infectiologists were continuously available in 60% of the hospitals. Collective isolation facilities were present in 15% of the hospitals.Conclusion: There is a serious lack of hospital preparedness for CBRN incidents in The Netherlands.