突发事件中超高层建筑人员紧急疏散策略研究

现代社会生产经营活动活跃,人员高度密集,各类突发事件频繁发生,一旦发生台风、火灾、踩踏、暴恐等突发事件,将造成难以估量的灾难性后果和舆论影响,人员紧急疏散是将受灾人员撤离到安全区域最科学、高效的方式。通过对超高层建筑人员紧急疏散策略研究,开展相应的测试演练工作,优化人员紧急疏散流程,提升应对突发事件的人员紧急疏散能力以及有关队伍的协同应急能力,为人员紧急疏散、演练、应急救援等提供理论参考依据。     

生物恐怖袭击现场处置与医疗救援应急演练

2008年7月15日，北京举行生物恐怖袭击现场处置与医疗救援应急演练，参加演练人员对疏散出的人进行消毒。此次演练模拟恐怖分子在某电影院里使用不明物质实施生物恐怖袭击，市卫生局接警后立即启动处置生物恐怖袭击事件应急预案，参加演练人员完成了事发现场划定和封控、暴露人员疏散、流行病学调查等课目的演练。     

护理部对护理实习生火灾应急预案实景演练的培训及效果观察

目的通过对护理实习生进行火灾应急预案实景演练培训,提高护生应急处理突发事件和防灾救灾能力。方法细化护理实习带教培训计划,规范带教老师教学水平,对护理实习生进行发生火灾应急预案的理论学习,安排科室见习,以及护理示教室角色分配,明确人员职责,实景模拟演练。结果护理实习生认为火灾应急预案实景演练培训对激发其学习热情和理解护理工作岗位有益,比理论授课和视频学习更为直观,更有助于其理解掌握,认为通过演练降低了对火灾的恐惧,增加了对自然灾害的认识。结论对护生实景演练应急预案能够有效提高护生应急反应,调动实习生的参与性和主动性,提高护生应急处理突发事件和防灾救灾能力。     

PDCA循环在医院火灾应急演练中的应用

目的 研究PDCA循环方法在医院火灾应急演练中的实践应用。 方法 将PDCA循环与中日友好医院火灾应急演练相结合,检查演练效果。 结果 每年的应急演练按照计划(P)、执行(D)、检查(C)、处理(A)四个步骤进行。在三年的PDCA循环过程中,医院对每一年存在的问题进行了有针对性的改进,完善了演练的内容与目的,医院消防应急工作取得了较大进步。 结论 PDCA循环在医院火灾应急演练中的应用,能够提高应急队伍的火灾应急处置能力,拓宽应急演练的作用。对消防应急管理工作具有一定的借鉴意义。     

火灾疏散逃生要点

1熟悉环境在平常,临危时刻不惊慌市民平时要了解居住建筑物安全出口和楼梯间的位置,设计好最佳的疏散逃生路径,定期参加应急逃生演练,掌握火灾逃生的基本方法。     

医院举办反恐疏散演练的体会

为了提高人们对医院反恐工作紧迫性和重点、难点的认识,加强医院应急疏散预案的贯彻落实,2009年9月17日,受北京市卫生局委托,我院举办了一次以"反恐排爆应急疏散"为主题的演练活动,现将我们参与策划、组织、演练的实践体会作以下介绍以期为国内医院开展反恐应急疏散工作提供借鉴.     

昆山市化工企业突发化学中毒事故应急能力调查

为掌握昆山市化工企业对突发化学中毒事故的应急能力,抽样选取107家化工企业开展调查。结果显示我市化工企业在应急组织和队伍建设、应急预案编制和演练、应急救援物资维护更新、安全管理制度和操作流程、人员疏散撤离、应急培训、个人防护用品配备、专项经费等诸多方面还须进一步改进和完善,突发化学中毒事故应急能力整体上亟待提高。 更多还原     

四川省市联动核事故卫生应急救援演练实践与探讨

目的积累开展核事故卫生应急救援演练经验,提高其处置能力。方法从应急演练的培训、场景设计、演练科目、流程和评估等方面的论述,展示省市联动核事故卫生应急救援演练。结果培训73名人员,检验了预案的可行性,锻炼了队伍,掌握了核应急处理程序,提高了应急意识,达到了展示性演练目的,但在培训、演练衔接和人员防护措施尚有不足。结论四川省核事故卫生应急救援能力还有待进一步提高。     

疾控机构应急人员应急演练能力影响因素分析

目的 了解黑龙江省疾病预防控制机构(简称疾控机构)应急人员演练能力及影响因素,为提高应急人员演练能力提供参考.方法 采用分层整群抽样方法,抽取黑龙江省(地市、区县)不同级别疾控机构1 033名应急人员开展问卷调查,运用logistic回归分析方法对资料数据进行分析.结果 疾控应急人员应急演练自评总体能力偏低,仅有22.6％的调查对象认为自身能力较强;多因素logistic回归分析结果显示,职称(OR=1.314)、工龄(OR=1.299)、现场处置经验(OR=1.792)、培训效果(OR=1.539)及预案编制能力(OR=1.601)是应急人员演练能力的影响因素.结论 疾控机构应急人员自评应急演练能力较低,通过增加现场处置经验、开展预案编制以及相关培训工作等措施有助于提高应急人员演练能力.     

安全疏散设施设计备忘录

医院建筑一旦发生火灾,怎样确保建筑内的人员在最快的时间内逃生呢?从消防专业的角度看,安全疏散设施的设计举足轻重. 这是因为,医院建筑功能复杂,人员多元且集中,大多数患者自主疏散能力弱或者完全缺乏,个别患者遇到火灾威胁,只能靠他人担抬、背身进行疏散,这些都无疑增加了医院在遭遇火灾时疏散人员的难度.     

地铁车站火灾时人员安全疏散仿真分析

目的通过对火灾场景下地铁车站内人员疏散情况的仿真分析,可为国家城市轨道交通疏散设计与预案制定提供指导。方法结合上海市某地铁车站远期(2037年)预测客流量,利用Smartfire和BuildingExodus软件对火灾场景下地铁车站内人员疏散情况进行了仿真模拟。结果当一部自动扶梯关闭,同时采用工作人员合理引导等手段对人群的疏散路线进行人工干预时,疏散时间可满足规范规定的6 min要求。结论工作人员的合理疏导可使各个出入口的利用率较均匀,从而节约人群宝贵的逃生时间,有效防止发生重大人员伤亡事故。     

Individual protection aids for saving people during a fire]

All existing individual protective means can not be applied to the life saving and the mall evacuation of people from fire due to their technical complexity and inadequate protective efficiency. The research work carried out by the authors served to produce a crucially new type of physiologically acceptable individual protective means against burning products and high environmental temperature.     

空运后送机上护理组工作流程模式

总结参加野战救护、演习及培训的经验,提出统筹护理力量,优化处置流程,体现空运后送护理的独特性,提高转运安全性及护理组织绩效,为实战条件下组织伤员空运后送提供有益的经验和参考.     

Heart rates in fire fighters using light and heavy breathing equipment: similar near-maximal exertion in response to multiple work load conditions

Intense exertion is an occupational hazard inherent to fire fighting. This study was designed to look at the exertion levels that fire fighters attain during a fire fighting exercise when using (1) no self-contained breathing apparatus (SCBA), (2) light SCBA, and (3) heavy SCBA. Exertion levels were measured as a function of the heart rate increase relative to the maximum predicted heart rate determined by a standard treadmill exercise test. Five fire fighters wore electrocardiographic monitors during a routine fire fighting exercise. Heart rates increased rapidly to 70% to 80% of maximum within the first minute and then plateaued at 90% to 100% until the attack on the fire was completed. There was no significant difference between exertion levels when using no SCBA, light SCBA, and heavy SCBA (split-plot analysis of variance, p greater than .25). These results suggest that fire fighters attain an intense level of physical activity quickly and maintain that level as long as they are actively engaged in fighting fire. These results also suggest that regardless of the weight of the SCBA, if employed, fire fighters exert themselves from 85% to 100% of their maximum and adjust their work output to maintain that near-maximal level.     

制定医院火灾应急预案 确保患者灾时撤离安全

医院不同于其他场所,发生火灾时患者的撤离十分困难,有时撤离本身就可能给患者带来伤害。因此,医院必须制定切实可行的应急预案,将火灾时患者安全保障措施都预先制定出来,并通过反复培训演练,使每一位工作人员都熟练掌握。只有这样,火灾发生时才能最大程度地保障患者的生命安全。     

An analysis of hospital fire reports

All fires notified from one English Regional Health Authority for a six-year period were analyzed using a method developed by the Department of Fire Safety Engineering at Edinburgh University. Three of the important factors in fire safety--control of the fire, evacuation from threatened areas and the prevention of ignition--are evaluated and recommendations are made with regard to them.     

Nursing home evacuation plans

Objectives. I examined evacuation plans from 2134 nursing homes and analyzed national data to determine the types of nursing homes cited for deficiencies in their evacuation plans.Methods. Evacuation plans were assessed according to criteria developed by an expert panel funded by the Office of the Inspector General. Deficiency citations came from the Online Survey, Certification, and Recording database, collected from 1997 to 2005. Four specific citations, for written emergency plans, staff training, written evacuation plans, and fire drills, were examined with multivariate logistic regression.Results. Most plans had water supply provisions (96%). Only 31% specified an evacuation route. The rate of citations was relatively stable throughout the study period: each year approximately 0.6% of facilities were found to be deficient in written emergency plans, 2.1% in staff training, 1.2% in written evacuation plans, and 7.9% in fire drills.Conclusions. Some nursing homes need more specific evacuation plans. Water supply was the most and evacuation routes were the least well-addressed areas.The US Department of Health and Human Services recently reported that administrators from 5 of 13 nursing homes evacuated as part of Hurricane Katrina described negative effects on residents’ health, such as dehydration, depression, and skin tears. The report further stated that “problems can be tied to a lack of effective emergency planning.”1^(pii)In nursing homes, an important tool used as part of emergency planning is the evacuation plan. Federal law requires that Medicare-and Medicaid-certified nursing homes have written plans for evacuation. Nursing homes are subject to deficiency citations (and fines) if the Medicare or Medicaid survey and certification process determines that they do not have adequate written evacuation plans.State Medicaid programs are responsible for approximately 50% of all nursing home expenditures, and Medicaid recipients consume 70% of all bed days. Because the federal government is such a dominant purchaser of nursing home care, it is also the dominant overseer of care quality. This oversight primarily occurs via the certification process. Titles XVIII and XIX of the Social Security Act require that all nursing homes accepting Medicare or Medicaid residents must be certified. Specific minimum standards were established for this certification, and surveyors inspect facilities for compliance.2 The standards require facilities to have “detailed written plans and procedures to meet all potential emergencies and disasters.”3^(p19) In addition, facilities must “train employees in emergency procedures when they begin work in the facility, periodically review procedures, and carry out unannounced staff drills.”3^(p19)The intent of the survey and certification process is to monitor and ensure quality of care. Several mechanisms are available to the government when facilities fail to meet certification minimum standards. These include varying levels of fines (≤ $10000/day) and termination from the Medicare and Medicaid programs. In all cases, however, when a facility does not meet government standards, a deficiency citation is issued. The deficiency citations (commonly called F-tags) for evacuation planning are F-517 and F-518. F-517 states, “The facility must have detailed written plans and procedures to meet all potential emergencies and disasters, such as fire, severe weather and missing residents.”4^(p32) F-518 states,

The facility must train all employees in emergency procedures when they begin to work in the facility, periodically review the procedures with existing staff, and carry out unannounced staff drills using those procedures.4^(p32)

In addition, incorporated into survey and certification regulations are Life Safety Code requirements (commonly called K-tags). These regulations focus mainly on fire safety but also include evacuation planning procedures, such as K-48 and K-50. K-48 states, “There is a written plan for the protection of all patients and for their evacuation in the event of an emergency.”5^(p42) K-50 states,

Fire drills are held at unexpected times under varying conditions, at least quarterly on each shift. Staff are familiar with procedures and aware that drills are an established routine. Responsibility for planning/conducting drills is assigned only to competent persons who are qualified to exercise leadership.5^(p42)

To my knowledge, the report from the Department of Health and Human Services is the only published document addressing evacuation plans used by nursing homes.1 The authors of the report interviewed 20 nursing home top managers involved with facility evacuation and examined deficiency citations given nationally in 2004 for having no plans or deficient plans for evacuation (codes F-517, F-518, K-48, and K-50). They found that nationwide, 94% of nursing homes met federal standards for emergency plans and 80% had sufficient emergency training. They also found substantial variation in the content of evaluation plans used by the 20 nursing homes examined.I examined evacuation plans from 2134 nursing homes and analyzed national data to determine the types of nursing homes (such as for-profit or nonprofit) that received deficiency citations for inadequate plans. My analysis extends the previous research by (1) examining evacuation plans from a large sample (n = 2134) of nursing homes and (2) analyzing longitudinal panel data (1997–2005) from nursing homes (n = 121 779) to determine the types of nursing homes that received deficiency citations for inadequate evacuation plans.     

The challenge of mandatory evacuation: providing for and deciding for

Insufficient attention has been given to the ethical and legal questions surrounding mandatory evacuation in disasters and emergencies. We argue that mandatory evacuation orders entail a governmental duty both to provide for people and to decide for people: Government must trigger the provision of critical resources as well as vigorous and persistent efforts to persuade reluctant citizens to leave. Public health professionals, with their experience in weighing costs and risks in the face of uncertainty and balancing individual liberties with the need to protect the common welfare, offer a unique perspective that should be brought to bear in emergencies and disasters.     

辅助诊断医疗装备在非洲维和行动卫勤保障中的价值

目的:探讨辅助诊断医疗装备在非洲维和行动卫勤保障中的应用价值。方法:使用90%以上国产辅助诊断医疗装备为联合国维和人员进行检验、X线拍片、B超和心电图等各项检查。结果:检验5000人,X线机拍片2100人,B超检查2686人,心电图检查988人,后送伤病员20例,紧急抢救后送2例。主要辅助诊断的疾病:疟疾、伤寒、HIV阳性、肺结核、肝脾肿大、泌尿系结石、肝癌、肾癌、女患者子宫肌瘤、盆腔积液和心肌缺血等,各诊室诊断阳性率为56%～86%,准确率均达到98%以上。结论:辅助诊断医疗装备在非洲维和行动卫勤保障中,为中国二级维和医院救治联合国维和伤病员提供了可靠的临床治疗依据,并在执行紧急后送危重患者的任务中体现出其重要价值,顺利通过联合国每半年一次的各项医疗卫生装备核查任务。     

垃圾中转站压缩车间二层防火疏散设计

以天津市潘楼垃圾中转站为例,分析了我国已建垃圾压缩车间二层防火疏散设计存在的问题,提出既可满足GB 50016-2006建筑设计防火规范的相关要求又可降低工程造价的设计方案.