The capability of accident and emergency departments to safely decontaminate victims of chemical incidents

Horby, Peter; Murray, Virginia; Cummins, Amelia; Mackway‐Jones, Kevin; Euripidou, Rico

doi:10.1136/emj.17.5.344

Cited by 21 publications

(22 citation statements)

References 12 publications

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“…4 Some of the similarities between the results of this audit and our own are worth noting and justify Horby's suggestion that the situation in these six health regions might be representative of that in the UK generally. In our study 66% departments had a written plan compared with 71% departments in Horby's study.…”

Section: Discussionsupporting

confidence: 65%

“…4 Goggles are particularly relevant for cyanide as the eyes are a route for absorbtion and exposure can cause loss of vision. We consider that full protection is always required because prolonged exposure, even to less toxic substances, may be hazardous.…”

Section: Protection For Staffmentioning

confidence: 99%

“…4 We are therefore able to compare these results with those from our own survey that covered all major accident and emergency departments in England, Scotland, Wales, and Northern Ireland.…”

mentioning

confidence: 99%

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Facilities for chemical decontamination in accident and emergency departments in the United Kingdom

George

Ramsay²,

Rochester³

et al. 2002

Emergency Medicine Journal

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Objective: To audit the facilities for chemical decontamination, with special reference to cyanide poisoning, in all major accident and emergency departments in the UK. Method: A simple postal questionnaire was used to audit planning, premises, equipment, protection for staff, and stocks of specific antidotes to cyanide poisoning. Results: 227 questionnaires from 261 departments (87%) were returned and used in the survey. Of the 227 departments who responded, 151 (66%) had a written plan; 168 (74%) departments had premises for decontamination; 55 (24%) were judged to have satisfactory premises; 146 (64%) departments had a shower or hose for decontamination; 60 (26%) departments had a decontamination trolley suitable for "stretcher" patients; 203 (89%) had some protective equipment for staff but only 77 (34%) had complete protection-that is, goggles, chemical resistant clothing, and breathing apparatus. In the authors' opinion only seven (3%) departments had satisfactory premises and equipment to treat "stretcher" patients and full protection for staff. A further 11 (5%) departments were equipped to manage ambulant patients at a similar level. Some 205 (90%) departments stocked one or more antidotes to cyanide and 77 (34%) stocked all four antidotes. Thirty four (15%) departments held all four antidotes to cyanide and had full protection for staff. Only five (2%) departments had satisfactory premises and equipment to treat "stretcher" patients, full protection for staff, and at least three of four antidotes. Conclusions: Most departments had some equipment for chemical decontamination. However, there were major inconsistencies in the range of equipment held and these limited its usefulness. Only a small minority of departments was satisfactorily equipped to deal with a serious chemical incident.

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Section: Discussionsupporting

confidence: 65%

Section: Protection For Staffmentioning

confidence: 99%

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Facilities for chemical decontamination in accident and emergency departments in the United Kingdom

George

Ramsay²,

Rochester³

et al. 2002

Emergency Medicine Journal

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“…Similar deficiencies have been identified in both the USA and UK. 10,11 Chemical An ED usually receives chemically contaminated patients as the result of overdose or industrial accident. The risk to ED staff in chemical incidents is primarily from either inhalation, or direct contact with the chemical.…”

Section: Discussionmentioning

confidence: 99%

Emergency department personal protective equipment requirements following out‐of‐hospital chemical biological or radiological events in Australasia

Sansom

2007

Emerg Medicine Australasia

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Recent events have led to a revision in ED equipment, preparedness and training for disasters. However, clinicians must still decide when, and what level of personal protection is required when a toxic threat exists. If possible, clear, simple and achievable protocols are required in such situations. Following an off-site Australasian chemical biological or radiological incident, current evidence indicates that the initial receiving ED staff will be adequately protected from all known chemical biological and radiological inhalational threats by wearing a properly fitted P2 (N95) mask, or its equivalent. Protection from serious contact injury is offered by wearing double gloves, disposable fluid-repellent coveralls or gown, eye protection, surgical mask, and ideally, a cap and shoe covers; in conjunction with universal precautions and procedures.

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“…6 It would be wise for those involved in major incident planning to re examine suggested guidance on such issues. [7][8][9][10] The hospital plan should be a brief summary, outlining key actions and crucial aspects of the plan such as the communications cascade, the areas designated as the acute receiving ward, the minor injury areas, relatives base.…”

Section: Plan Production and Maintenancementioning

confidence: 99%

Article 12. Major incidents, leadership, and series summary and review

McCormick

Wardrope²

2003

Emergency Medicine Journal

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The capability of accident and emergency departments to safely decontaminate victims of chemical incidents

Abstract: Objectives-To evaluate the capability of accident and emergency (A&E) departments in six health regions of England to safely decontaminate casualties exposed to hazardous chemicals. (J Accid Emerg Med 2000;17:344-347) Methods-In

Cited by 21 publications

References 12 publications

Facilities for chemical decontamination in accident and emergency departments in the United Kingdom

Facilities for chemical decontamination in accident and emergency departments in the United Kingdom

Emergency department personal protective equipment requirements following out‐of‐hospital chemical biological or radiological events in Australasia

Article 12. Major incidents, leadership, and series summary and review

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