Validating Signs and Symptoms From An Actual Mass Casualty Incident to Characterize An Irritant Gas Syndrome Agent (IGSA) Exposure: A First Step in The Development of a Novel IGSA Triage Algorithm.
Validating Signs and Symptoms From An Actual Mass Casualty Incident to Characterize An Irritant Gas Syndrome Agent (IGSA) Exposure: A First Step in The Development of a Novel IGSA Triage Algorithm.
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DOI：
10.1016/j.jen.2016.11.001
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发表时间：
2017-07
影响因子：
1.7
通讯作者：
DiNardi S
中科院分区：
文献类型：
--
作者：
Culley JM;Richter J;Donevant S;Tavakoli A;Craig J;DiNardi S
每天接触化学物质对生命构成重大威胁。需要由急救人员/急救护士进行快速评估，以减少死亡和残疾。目前，还没有用于刺激性气体综合征制剂(IGSA)暴露的信息学工具来有效地处理受害者、持续监测潜在体征/症状或提出分类建议。这项研究描述了为化学事故开发急诊科信息学工具的第一步：确认具有IGSA综合症特征的体征/症状。从2005年火车脱轨期间因氯气暴露而在一个急诊科接受治疗的146名患者和152名未暴露的患者(对照组)的数据被映射到两个工具(即WISER和CHEMM-IST)中的93个可能的体征/症状，该工具旨在帮助急救人员/急救护士管理危险物质暴露。使用推断统计(卡方/费雪精确检验)和诊断学测试来检查接触/未接触氯的人的体征/症状。有三组体征/症状在统计学上与IGSA综合征相关(p<；0.01)：呼吸：呼吸短促、喘息、咳嗽、窒息胸部不适：气促、疼痛、眼睛、鼻子和/或喉咙灼热：疼痛、刺激、灼热。对于暴露/可能暴露的个人，也必须考虑潜伏期。这项研究使用化学事件中的实际患者数据来表征和验证IGSA综合征的体征/症状。验证体征/症状是开发新的急诊科信息学工具的第一步，该工具有可能彻底改变急诊护士管理化学事件分流受害者的过程。
Chemical exposures daily pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for Irritant Gas Syndrome Agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. This study describes the first step to developing emergency department informatics tools for chemical incidents: validation of signs/symptoms that characterize an IGSA syndrome. Data abstracted from 146 patients treated for chlorine exposure in one emergency department during a 2005 train derailment and 152 patients not exposed (comparison group) were mapped to 93 possible signs/symptoms within two tools (i.e., WISER and CHEMM-IST) designed to assist emergency responders/emergency nurses with managing hazardous material exposures. Inferential statistics (Chi Square/Fisher’s exact test) and diagnostics tests were used to examine mapped signs/symptoms of those exposed/not exposed to chlorine. Three clusters of signs/symptoms are statistically associated with an IGSA syndrome (p<0.01): Respiratory: shortness of breath, wheezing, coughing, choking Chest discomfort: tightness, pain, burning Eye, nose and/or throat: pain, irritation, burning The syndrome requires the presence of signs/symptoms from at least two of these clusters. The latency period must also be considered for exposed/potentially exposed individuals. This study uses actual patient data from a chemical incident to characterize and validate signs/symptoms of an IGSA Syndrome. Validating signs/symptoms is the first step in developing new emergency department informatics tools with the potential to revolutionize the process by which emergency nurses manage triage victims of chemical incidents.
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影响因子：
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作者：
Culley, Joan M;Svendsen, Erik
通讯作者：
Svendsen, Erik
DOI：
10.1001/virtualmentor.2010.12.6.cprl1-1006
发表时间：
2010-06-01
期刊：
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发表时间：
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期刊：
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影响因子：
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影响因子：
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