背景:急诊室(ED)对外部灾难做好了充分的准备,比如自然灾害,大规模伤亡事件,和恐怖袭击。然而,在医院内出现和展开的危机和灾难似乎比外部事件更常见。ED经常受到影响。内部医院危机和灾难(IHCD)有可能危及患者,工作人员,游客,并破坏设施作为公共卫生和安全管家的完整性。此外,ED患者安全和后勤可能受到严重阻碍。
方法:案例系列ED中的3次灾难。从PubMed数据库的搜索中检索到的当前IHCD相关文献的叙事概述,手搜索,和权威文本。
结论:IHCD的原因是多方面的,内部灾难通常是一连串事件的结果。它们可能与社区范围的事件相关联,也可能不相关联。例子包括火灾,洪水,停电,结构损伤,信息和通信技术(ICT)故障,和网络攻击。ED尤其处于危险之中。虽然急性发作的灾害对急性护理服务有直接影响,流行病和大流行是可能造成长期后遗症的威胁。
结论:医院及其ED面临危机的风险,并可能升级为医院灾难。由于与气候相关的紧急情况而出现的风险,传染病爆发,恐怖主义,网络攻击构成了特别的威胁。如果医院没有为IHCD做好准备,它削弱了行政部门和工作人员保障病人安全的能力。因此,医院及其ED必须检查,并在必要时加强对这些突发事件的准备。
BACKGROUND: Emergency departments (EDs) are reasonably well prepared for external disasters, such as natural disasters, mass casualty incidents, and terrorist attacks. However, crises and disasters that emerge and unfold within hospitals appear to be more common than external events. EDs are often affected. Internal hospital crises and disasters (IHCDs) have the potential to endanger patients, staff, and visitors, and to undermine the integrity of the facility as a steward of public health and safety. Furthermore, ED patient safety and logistics may be seriously hampered.
METHODS: Case series of 3 disasters within EDs. Narrative overview of the current IHCD-related literature retrieved from searches of PubMed databases, hand searches, and authoritative texts.
CONCLUSIONS: The causes of IHCDs are multifaceted and an internal disaster is often the result of a cascade of events. They may or may not be associated with a community-wide event. Examples include fires, floods, power outages, structural damage, information and communication technology (ICT) failures, and cyberattacks. EDs are particularly at-risk. While acute-onset disasters have immediate consequences for acute care services, epidemics and pandemics are threats that can have long-term sequelae.
CONCLUSIONS: Hospitals and their EDs are at-risk for crises and their potential escalation to hospital disasters. Emerging risks due to climate-related emergencies, infectious disease outbreaks, terrorism, and cyberattacks pose particular threats. If a hospital is not prepared for IHCDs, it undermines the capacity of administration and staff to safeguard the safety of patients. Therefore, hospitals and their EDs must check and where necessary enhance their preparedness for these contingencies.