The Survey Study Of Scene Disposition Of Acute Poisoning

Background:With the rapid development of world economy and wide application of chemical and pharmaceuticals, the number of patients with acute poisoning and acute poisoning incidents has sharp raised, so that acute poisoning has become one of the major diseases in the emergency. Acute poisoning incidents which have so many types and high fatality rates often occur suddenly and the outcome always change quickly. Patients'lives and prognosis always depend on effective disposal on-site as well as on time, and can also provide a good basis for further treatment and reduce the difficulty of hospital treatment.Objective:To analyze the epidemiological features of acute poisoning, review the status of pre-hospital acute poisoning treatment, and the progress of first-aid by oneself and/or others in workplaces with toxic substances, in order to find out the situation of grasping the first-aid knowledge of acute poisoning among first-aiders, dispatchers, toxic operators and the public, explore the problem of scene disposition of acute poisoning, and provide reference materials and basis for standardization of pre-hospital treatment and public education of acute poisoning in the future.Methods:Review the status of pre-hospital treatment of acute poisoning in the Emergency Centers of Shijiazhuang city and Cangzhou city. Data obtained from individual depth interviews, questionnaires and on-site observations. The descriptive epidemiological analysis is performed based on the pre-hospital medical record information in two Emergency Centers within 2007 to 2008. Analyze the situation of first-aid by oneself and/or others among toxic operators involving exposure to toxic substances in 5 factories of Chaoyang District of Beijing by interviews and questionnaires, and learn the status of awareness and acquiring the first-aid knowledge about acute poisoning in one community of Chaoyang distract of Beijing by questionnaires.Results:1. Acute poisoning was a common emergency category, cases of acute poisoning were 6.61% and 8.42% respectively in investigated Emergency Centers. There were many different types of poisons, acute alcoholism (63.32%) and carbon monoxide poisoning (15.19%) endangered prominently. There were gender difference (P<0.05) and seasonal variation in toxicity categories. In short, poisoning was observed with more cases in winter, and age ranged from 20 to 49 years old had high risk of acute poisoning.2. The investigated Emergency Centers had established systems of personnel, materials, management to carry out pre-hospital treatment of acute poisoning basically. At the same time, they had set up different modes of dispatch and pre-hospital emergency procedures. The rates that ambulance was dispatched within 1 minute were 75.02%,97.92% respectively, and the response time less than 10 minutes were 84.12% and 53.59% respectively.3. Low level staff while dominate team formed by junior doctors and nurses was a chief problem., and junior doctors and nurses accounted for 71.43% and 78.10% in investigated Emergency Centers respectively. There were limited therapeutic measures and less instant toxicological testing measures could be taken in pre-hospital treatment of acute poisoning, and only 25.82% out of all had better grasped the knowledge of pre-hospital emergency treatment of acute poisoning.4. Workers of toxic substances exposed in different factories had various awareness rates between 13.30%-66.70%.68.78% of exposed workers could use personal protective supplies according to requirements. There were 66.92% and 68.82% respectively of exposed workers received emergency rescue training for acute poisoning during the pre-service and on post. Only 39.54% exposed workers had certain knowledge of first-aid by oneself and/or others of acute poisoning.5. There were only 23.48% of the public who often accessed knowledge of acute poisoning. Average score of the knowledge about acute poisoning was 6.27±1.33 points (out of 10 points), in short, relatively low in the elder, workers, farmers, and teenagers. The top three means which people tend to access to relevant knowledge are television (83.52%), newspapers (61.17%) and broadcast (60.61%).Conclusion:1. Acute poisoning was a common category and complex disease in emergency treatment.2. The investigated Emergency Centers had already set up pre-hospital treatment system basically. However, the pre-hospital emergency treatment of acute poisoning need be standardized and strengthened.3. The knowledge of first-aid by oneself and/or others of acute poisoning in toxic operators and the public need be improved.4. It was suggested that more attention had to be paid on education of acute poisoning and propaganda about preventive measures of acute poisoning had to be strengthened to make efficient poisoning control. It was to say that funds needed to be increase, a rational management mechanism had to be set up, guidelines of pre-hospital emergency treatment of acute poisoning had to be established as soon as possible, extensive on-site disposal training of acute poisoning had to be carried out according to the personnel characteristics. It was also need to develop technology research and cooperation.