本文選題：中毒現(xiàn)場 + 應急救援��； 參考：《中國疾病預防控制中心》2012年碩士論文

【摘要】：研究背景： 個體防護是預防危害、保護人員健康與安全的重要措施和最后防線。突發(fā)事件應急專項條例和預案中明確衛(wèi)生部門在應急救援中承擔相應的職責和任務,要求進入現(xiàn)場參與醫(yī)療衛(wèi)生救援的人員,要了解各類防護裝備的性能和局限性,根據(jù)毒物種類及危害水平選擇適宜的個體防護裝備,在沒有適當個體防護的情況下不得進入現(xiàn)場工作。近年來國內(nèi)外多次發(fā)生救援人員在化學事故實施救援過程中發(fā)生中毒的報道。個體防護關系到救援人員自身安全和執(zhí)行任務的總體效率,越來越受到重視。個體防護裝備對生理健康影響及使用安全性、可接受性以及佩戴的舒適性等是其綜合質(zhì)量特性的體現(xiàn)。 研究目的： 救援人員穿戴個體防護裝備在現(xiàn)場作業(yè)時,防護裝備的配備對人員作業(yè)能力的影響非常突出,也是國內(nèi)外評價實踐活動的關鍵點。本研究結(jié)合中毒事件疾控衛(wèi)生應急人員現(xiàn)場工作實際,通過實驗室和現(xiàn)場模擬試驗探討人體生理影響和實用性,探討典型個體防護裝備對中毒現(xiàn)場衛(wèi)生應急人員人體生理影響及對作業(yè)的限制,指導專業(yè)人員正確選擇、使用適合現(xiàn)場的個體防護裝備,為制定我國衛(wèi)生應急人員個體防護儲備、使用等技術(shù)方案提供依據(jù),提升我國衛(wèi)生應急救援水平。 研究方法： 參考GJB3664-1999個人防護器材生理評價的實驗方法及步驟,測試穿著進口和國產(chǎn)A、C級兩類個體防護裝備的受試者在設定常溫常濕及高溫高濕作業(yè)環(huán)境實驗室,呼吸、體溫、心率等相關生理指標。 參考GB/T23465-2009呼吸防護用品實用性評價的實驗方法,專家評分法對各項指標進行權(quán)重,結(jié)合受試者現(xiàn)場模擬中毒事件應急現(xiàn)場工作對個體防護裝備的實用性評分結(jié)果,采用綜合法評價進口和國產(chǎn)A、C級兩類個體防護裝備的實用性。 結(jié)果： 高溫高濕的現(xiàn)場作業(yè)時,穿戴進口A級防護裝備體熱積蓄(133.40±21.53W)低于國產(chǎn)防護裝備(137.79±25.82W),差異無顯著性(t0.05(5)=2.571)。 穿戴A級防護裝備在高溫高濕環(huán)境中的攝氧量約為17.2ml/(min-kg),穿戴C級防護裝備后高溫高濕環(huán)境下攝氧量約為13.7ml/(min-kg)。 專家評分權(quán)重反映出實際工作中更重視防護裝備安全性相關指標,A級防護裝備在安全性內(nèi)容中重要性居前三位分別是呼吸、報警裝置和視覺,C級防護裝備在安全性指標中重要性居前三位分別是面具各零部件穩(wěn)固性、呼吸和視覺,在使用方便內(nèi)容里將穿防護服便利性排在首位。 現(xiàn)場模擬試驗過程中,穿著進口A級、國產(chǎn)A級、進口C級、國產(chǎn)C級防護裝備人員的最大心率均值分別為：158次/min、157次/min、143次/min、145次/min。 國產(chǎn)A級防護裝備實用性評分74.93±10.88,進口A級防護裝備實用性評分79.78±5.81,但兩類裝備評分差別無統(tǒng)計學意義(P=0.063)。頭部活動自由度、低頭轉(zhuǎn)動的自由度和下肢活動自由度進口裝備優(yōu)于國產(chǎn)裝備,且具有統(tǒng)計學意義(P=0.034,P=0.011,P=0.030)。進口A級個體防護裝備非安全性相關內(nèi)容評分高于國產(chǎn)裝備,具有統(tǒng)計學意義(P=0.048)。 國產(chǎn)C級防護裝備評分(80.65-4-9.38)分,進口C級防護裝備評分(86.40±9.92)分,兩類裝備評分差異有統(tǒng)計學意義(P=0.00099)。安全性相關內(nèi)容評分分值最高的為穩(wěn)固性,最低的為調(diào)節(jié)裝置。進口裝備安全性評分及非安全性評分均高于國產(chǎn)裝備,有統(tǒng)計學意義(P=0.005,P=0.048)。 結(jié)論： 高溫高濕的作業(yè)環(huán)境穿著A級防護裝備,至警報器報警時受試者的熱應激已達到危險限值,應急救援人員在工作時間盡量控制到30min以內(nèi)為宜。 常溫舒適的作業(yè)環(huán)境穿著C級防護裝備,工作時間控制到60min以內(nèi)為宜,高溫高濕環(huán)境中穿著C級防護服工作時,工作時間控制到40min以內(nèi)。 降溫背心對于人體的體熱蓄積非但沒有改善,反而增加,不適用于高溫高濕穿戴A級防護裝備作業(yè)。 衛(wèi)生應急救援時更重視防護裝備的安全性,A級防護狀態(tài)下現(xiàn)場模擬執(zhí)行應急任務雖然為重度體力勞動,但受試人員能夠在規(guī)定時間內(nèi)能完成整套工作任務,A級防護裝備的實用性基本能滿足衛(wèi)生應急現(xiàn)場工作需要。 為適應現(xiàn)場工作需要,迫切需要提升應急救援人員的通訊能力和通話效果,可采用無線操作。通過改良個體防護設計、材質(zhì)等,提升防護裝備的舒適性,減少對現(xiàn)場應急工作的限制。加強應急救援人員的防護培訓,提高防護裝備的實用性。深入開展對應急救援人員健康監(jiān)護的研究。
[Abstract]:Research background:
Individual protection is an important measure to protect the health and safety of the personnel and the final defense line. In the special regulations and plans for emergency emergency, the health department assumes the corresponding duties and tasks in the emergency rescue, and requires the personnel involved in the field to participate in the medical and health rescue, to understand the performance and limitations of all kinds of protective equipment. According to the species of poison and the level of harm, the appropriate individual protective equipment should be selected, and no proper individual protection should be used. In recent years, reports of poisoning occurred in the process of rescue workers in the process of chemical accidents. Individual protection relates to the overall safety of rescue personnel and the overall implementation of the task. Efficiency is becoming more and more important. The effects of individual protective equipment on physical health, safety, acceptability, and comfort are the embodiment of its comprehensive quality.
The purpose of the study is:
When the rescue workers wear the individual protective equipment in the field operation, the effect of the equipment is very prominent, and it is also the key point to evaluate the practical activities at home and abroad. It is practical to discuss the physiological effects of the typical individual protective equipment on the body physiology of the health emergency personnel in the poisoning scene and the restrictions on the operation, to guide the professional personnel to choose correctly, to use the individual protective equipment suitable for the field, to provide the basis for the formulation of the individual protective reserve and the use of the health emergency personnel in our country, and to improve the emergency medical emergency in China. Aid level.
Research methods:
With reference to the experimental methods and steps of the GJB3664-1999 personal protective equipment physiological evaluation, the subjects of two types of individual protective equipment wearing imported and domestically made A and C class were tested for the physiological indexes such as breathing, body temperature, heart rate and so on in the Environment Laboratory of normal temperature and high temperature and high humidity and high humidity.
According to the experimental method of the practical evaluation of GB/T23465-2009 respirator, the expert scoring method is used to weigh all the indexes, and the practicability of the two types of individual protective equipment of the imported and national A and the C class is evaluated by combining the results of the field work of the subjects to simulate the practical score of the individual protective equipment.
Result錛，

本文編號：1781941