Hospital Preparedness Plans for Chemical Incidents and Threats: A Systematic Review

Abstract

In a wide range of events, people may be acutely exposured to chemical substances. Particular hospital preparedness plans and vital resources are essential for appropriate health-care measures. The present study aimed to conduct a systematic review to summarize and evaluate the existing evidence on hospital preparedness plans or protocols against chemical incidents and threats. In this aim, through May 15, 2018, 5 electronic databases were searched in MEDLINE (PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar) for the following key words: hospital preparedness, plan, protocol, chemical incident, and chemical threat. The final review included 11 peer-reviewed papers that met inclusion criteria. The systematic review was performed using the Preferred Reporting Items for the Systematic reviews and Meta-Analysis protocol (PRISMA) (www.prisma-statement.org). Finally, of 16,540 selected papers, 11 papers were included in the final analysis. The thematic analyses revealed 11 major categories of chemical incidents and threats planning, such as planning requirements, planning prerequisites, preparation team member (multidisciplinary team), decontamination, personal protective equipment, education and training, job descriptions and roles, communication, database, staff /volunteer organization, as well as planning barriers and challenges for chemical incidents. Most countries have launched hospital preparedness planning against chemical incidents and threat activities, but the preparedness of hospitals is often less than desirable. Many items, such as databases, hospital preparation team members, communications, etc., are still challenging.

Évaluation du risque par les professionnels de la santé et les équipes de secours lors d’incidents chimiques

“…L'évaluation du risque pour la santé humaine est un processus qui comprend trois composantes successives, à savoir : l'évaluation, la gestion et la communication. Par ailleurs, la gestion d'un incident chimique majeur peut être interprétée à plusieurs niveaux : institutionnel, scientifique, opérationnel et formatif (1). L'information doit être disponible et accessible (2).…”

“…Le présent article est axé sur l'évaluation du risque définie comme un ensemble d'analyses scientifiques dont les résultats sont des expressions quantitatives ou qualitatives de la vraisemblance de dommages causés par l'exposition à un produit chimique (11). Sur le plan opérationnel, une équipe spécialisée réunissant les départements médical, infirmier et paramédical, responsable en cas de situations d'incidents chimiques majeurs, devrait être formée à l'évaluation de l'exposition et aux risques associés (1,12). Cette équipe doit maîtriser les étapes d'évaluation du risque afin de se prémunir contre tout risque de contamination.…”

The Environmental Sustainability Assessment of an Orthopedics Emergency Hospital Supported by a New Innovative Framework

“…Most countries have equipped hospitals against chemical incidents, but some aspects remain challenging, such as databases, response team members, communication, etc. [27]. Rebmann et al [28] suggested that hospitals should use appropriate planning tools to support the development of intervention plans.…”

Overlapping Science in Radiation and Sulfur Mustard Exposures of Skin and Lung: Consideration of Models, Mechanisms, Organ Systems, and Medical Countermeasures: Overlapping science in radiation and sulfur mustard injuries to lung and skin

“…[23][24][25][26][27] Similarly, the journal has reported on findings and discussions surrounding hazardous chemical materials, including but not limited to reports on preparedness, 28,29 training exercises, 30 case studies, 31,32 and review articles. 33,34 For these reasons, the meeting organizers began working with the journal at the very beginning of the process, leading to the publication of this meeting report and the special issue in which it resides.…”

“…A clinical trial of high-dose vitamin D3 against Valchlor ™ , an FDA-approved topical NM, in healthy volunteers 34 involved multiple observations, and biopsies, as well as blood draws. These results showed that most of the pathways involved in the injury and treatment mitigation were related to inflammation, including leukocyte, lymphocyte, and chemokine activation; patients also experience a decrease in erythema, swelling, and pain.…”