Trusts perform better on chemical incidents but protective suits and tents still imperfect

04/19/05

[Impact of the Department of Health initiative to equip and train acute trusts to manage chemically contaminated casualties 2005;22;347-350]

Trusts are far better prepared to deal with patients injured in chemical incidents following national training but the design and distribution of chemical protective suits and shelters are still a problem, says research published this week in Emergency Medicine Journal.

Birmingham researchers sent a questionnaire to all UK acute hospital and ambulance trusts and organised simulated incidents at two acute trusts in the West Midlands, England.

Research in 1999 showed that most trusts were woefully unprepared to deal with chemical incident patients. Since 2001, The Department of Health has provided them with chemical personal protection equipment (CPPE) made up of a protective suit and an inflatable decontamination shelter and an accompanying training package.

Of the 55 trusts which responded to the new research, all the ambulance trusts had chemical personal protection equipment (CPPE) and 83% had trained staff in its use. Of the responding hospital trusts, 98% had CPPE and 82% had trained staff to use them.

Following the simulated incidents, staff interviewed were critical of the CPPE suits, saying

  • they were 'very fiddly and cumbersome to assemble'
  • it took trained staff at least 15 minutes to prepare, test and put them on
  • when wearing the suits, staff struggled to hear each other even when shouting
  • there were frequent battery failures
  • the suits had inadequate flexibility at the knees, shoulders and elbows when lifting
  • some suits leaked in the foot area

At both hospitals, the process of assembling the shelter took approximately four minutes but at one trust, estates personnel erected the shelter for clinical staff to then prepare it, while at the other trust, clinical staff had to perform both roles and felt overstretched.

Tests showed that staff failed to decontaminate patients adequately and staff decontamination was poor due to leaks in the boot area of the protective suits. At both hospitals, no one was certain of correct procedures to dispose of the contaminated suits and they were left uncovered in the open.

The report concludes: 'Although the training package and dogma seem to have been delivered effectively to hospitals, the current suit and inflatable shelter pose a number of considerable ergonomic and functional difficulties.'

Source: Eurekalert & others

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