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急性化学物中毒事故与应急救援牛风云课件

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急性化学物中毒与应急救援课件 急性化学物中毒与应急救援 急性化学物中毒 急性化学物中毒事故 急 性化学物中毒事故 化学物品急性中毒PPT课件 急性化学物品中毒事故 急性化学物中毒应急救援
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Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 急性化学物中毒 事故与应急救援 山西省职业病医院 牛凤云 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 概 述 急性化学性中毒突发事件的应急处理是指 发生急性中毒突发事件时,为及时控制危害源 ,抢救受毒害人员,指导群众防护,组织人员 撤离,消除危害后果而采取的卫生处理和医疗 救援行动。这是一项社会性减灾救灾工作,受 到政府和有关部门的高度重视。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. (一)急性化学物中毒事故 指各种原因,不同有毒有害物质突然大量排 放或泄漏引起众多人员急性中毒或死亡及造成其 他较大社会危害的事件。如1984年印度博帕尔镇 联合碳化厂生产农药 西维因发生甲基异氰酸酯泄 漏事故,使20余万人受害,其中约2500余人丧生 ,成为震惊世界的事件。 基本概念 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. (二)应急救援 指在发生急性中毒事故后,为及时控制危害源, 抢救受毒害人员,指导群众防护和组织撤离,消除危 害后果而组织的救援活动。就医疗卫生方面而言,“救 援”系现场急救,使患者迅速而安全脱离事故发生地, 并及时送往就近医院救治,同时对污染的空气等快速 检测,迅速查明中毒原因,处理被污染的水源、空气 、食品等,尽可能控制危害的范围,减轻危害程度。 基本概念 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 基本概念 以医疗卫生部门为主的、综合性的社会各部门协作的救援 体系,如急救中心、卫生防疫、公安、消防、环保、运输煤气 、自来水、通讯、政府等部门的合作。 (三)急救医疗体系 (四)自救 指发生化学事故时,事故单位实施的救援行动,以及在事 故现场受到事故危害的人员自身采取的保护防御行为,是化 学事故现场急救工作最基本、最广泛的救援形式。其主体是 企业及职工本身。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 基本概念 (五)互救(他救) 指事故现场的受害人员相互之间的救护,以及他 人或企业救援队伍或社会救援力量组织实施的一切救 援措施与行动。是人道主义的体现。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 急救医疗体系 急性中毒突发事件的应急处理是一项复杂的系统工程, 涉及多部门、多学科,同此,建立健全急性中毒救援网络和 应急指挥系统十分必要。其意义在于当发生急性中毒突发事 件时,可以借助网络迅速作出应急反应,并在指挥部的统一 领导下,救灾、公安、消防、化工、环保、卫生、安全等部 门密切配合,协同作战,迅速、有效地组织和实施应急行动 ,从而避免和减少不必要的伤害和损失。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 急救医疗体系 在急性中毒突发事件中,主要部门的职责和功能如下: (一)公安部门:公安消防部门应负责迅速控制毒源,营救 受害人员,扑灭火灾;公安交通部门负责保障救援交通畅通 无阻,必要时实行交通管制,以便于污染区群众的疏散和中 毒病人的护送;公安治安部门负责安全警戒,维护现场及周 围地区的社会治安和保证事件的调查、刑侦、处理厂作顺利 进行。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 急救医疗体系 (二)卫生部门: Ø 卫生行政部门 应负责组织卫生监督队伍对突发事件进行调查、取 证、处理;并负责组织快速侦查监测人员,测定事故现场及周围空气中 的毒物浓度,报告毒物性质,确定毒物污染范围,提出危害作用带,估 算受害人群的数量和受害程度;同时负责组织医疗救护队伍立即赶赴现 场对受害人员进行救护,对危重病人进行现场急救,如进行人工复苏, 并在现场诊断分级,根据病情轻重分送不同的抢救地点。 Ø 医药部门 要储备一定数量的抢救药品、器材,在紧急救援工作中保 证药品、器材的供应。 Ø 医院 要立即准备抢救病房和病床,以接受中毒病人的到来,并组织 医务人员进行抢救。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 急救医疗体系 (三)交通运输部门 负责组织紧急援救中的运输,如运输中毒受害的病人及撤离人员,以 及运送救援物资和外地组织的抢救医务人员到事故地区进行抢救。 (四)邮电部门 确保救援工作中的通信联络畅通无阻,负责向外发出救援求助信号及 向上级政府作出请示汇报。 (五)气象部门 负责快速、准确地提供与急性中毒突发事件应急处理工作有关的气象 参数,如风向、风速、气温、气压、降雨等,并作好预报服务。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 化学物中毒事故 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 一.急性突发化学物中毒事件的分类 急性突发中毒事件是指有毒有害的化学物质出人意料地突然发生 大量泄漏或引起燃烧、爆炸,造成众多人员急性中毒,甚至周围居民 中毒和较大社会危害的事件,并根据中毒人数和危害程度将其分为四 类: (一)急性中毒:毒物在短时间内或一次大量进入机体所引起的中 毒称为急性中毒。急性中毒多见于生产设备事故、检修时防护不周、 防护器具失效或误服等意外情况。 (二)多人中毒:在一次中毒事故中发生三人或三人以上中毒, 称为多人中毒。所渭“中毒”是指根据我国的职业性急性中毒诊断标准确 定为轻度或轻度以上的中毒病人,而“刺激反应’’或 “接触反应”不属中 毒。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 一.急性突发化学物中毒事件的分类 (三)重大灾害事故:在一次事故中死亡1—2人或急性中毒10人以上 的事故,称为重大伤亡事故。灾害事故是指有毒有害化学品在生产、使 用、贮存、运输等过程中突然发生泄漏、爆炸、燃烧,危及周围居民区 ,造成众多人员急性中毒的事件。 (四)特大灾害事故:在一次事故中死亡3人以上(含3人)或急性中毒 100人以上,称为特大灾害事故。这类事故往往有大量毒性气体泄漏,并 迅速扩散,短时间内造成众多人员中毒,伤亡,危害范围大,常使城镇 的综合功能受到破坏,社会秩序发生紊乱,必须动员广大社会力量进行 救援。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 二.急性突发化学物中毒事件的特点 (一)突发性 急性化学物中毒,尤其是急性职业中毒常发生在事故时,多因生产故障,违 反操作规程,忽视防护等原因所致,多发生在化学物的意外爆炸、燃烧或毒性气体 大量排放和泄漏的情况下。这种事故的发生不受地形、气候、企业大小等因素的影 响,随时随地可发生。(最常见的10种毒物是:一氧化碳、硫化氢、氮氧化物、 氮气、氨、氯、光气、苯、二氧化碳、二氧化硫,主要由刺激性气体和窒息性气体 组成。)因此,积极预防化学事故的发生,作好应急救援预案和准备是减少伤亡、 降低损失的关键。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 二.急性突发化学物中毒事件的特点 (二)群发性 急性职业中毒往往由于事故的突发性而造成现场 作业人员的群体发病,少则数人,多则数百人,甚至 上千人。这样就常常给出事单位和地区造成极大的困 难,使技术、物质、药品、人员等方面的投入得不到 及时解决,因此,及时报告申请救援是至关重要的。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 二.急性突发化学物中毒事件的特点 (三)复杂性 由于化学物质种类繁多,因而确定是哪种物质引起,十分困难复杂,许多毒 物对人体的健康不仅有近期影响,而且有远期影响,且损害具有多样性,可引起 人体各器官系统暂时性或永久性的功能性损害或器质性损害,也可致残或死亡, 可以影响本人,也可影响后代。中毒的临床表现与接触毒物的种类、浓度及接触 时间有关,因此常呈现出错综复杂的临床症状,如刺激性气体中毒,轻者有粘膜 的刺激症状和呼吸道损伤,重者可导致肺水肿,出现低氧血症,甚至心、脑、肝 、肾等多脏器损伤。刺激性气体还可导致化学性眼炎和皮肤灼伤,若突然晕倒头 部着地形成复合伤时可使伤势更加复杂。因此,在抢救时,首先要了解清楚引起 中毒的物质及其理化特性,并仔细检查中毒的程度及同时发生的复合伤,这对中 毒病人的诊断,防止漏诊、误治,给予及时的对症处理和抢救非常重要。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 二.急性突发化学物中毒事件的特点 (四)特异性 各种不同毒物可选择作用于某系统、某器官,即有不同的靶器官,而出现典 型的系统症状。如:高浓度硫化氢中毒可发生“闪电式”死亡;刺激性气体主要损害 呼吸系统,出现咳嗽、呼吸困难等症状;窒息性气体主要抑制呼吸酶,产生呼吸抑 制、惊厥、昏迷、脑水肿等症状;苯的氨基硝基化合物损害血液系统,出现高铁血 红蛋白血症;砷化氢损害红细胞,出现溶血、黄疸,重症出现急性肾功能衰竭;四 氯化碳等亲肝毒物可致肝细胞坏死,出现肝功能异常或衰竭;钡、锑等金属无机化 合物可因电解质紊乱而导致心肌损害;汞引起口腔炎、肾功能损害等。某些毒物中 毒有一定的潜伏期,如氮氧化物、光气、有机氟、裂解气中毒的早期中毒症状不显 著,经0.5~72小时后可出现肺水肿和低氧血症。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 二.急性突发化学物中毒事件的特点 (五)灾害性 如煤矿瓦斯爆炸后,不仅可造成急性一氧化碳中毒,同时可引发火灾、 塌方等。 (六)紧迫性 如高浓度的硫化氢气体中毒时,可致“闪电式”死亡,必须在短时间内及时抢救 。 (七)共同性 一次事故造成的损害有相似之处。如急性氯气中毒时均有上呼吸道的刺激症状 。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 一旦发生突发中毒事件,当地人民政府应立即进行社 会动员,组织应急救援,及时控制危害源,抢救受害人员 ,指导群众防护和组织疏散撤离,还要进行检测、洗消, 并要维护治安、管制交通,使伤害和损失减少到最低程度 。这种应急救援包括事故单位自救和对事故单位以及事故 单位周围危害区域的社会救援,其中工程救援和医学救援 是最主要的两项任务。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 (一)应急救援的基本原则 应急救援工作必须实行“预防为主,防救结合”的方针 ,贯彻统一指挥、分级负责、区域为主、单位自救与社会 援救相结合的原则。由于突发中毒事件往往是事故造成的 ,具有发生的突然性、扩散的快速性及危害的广延性,因 此,预防工作是基础,充分的应急准备是关键.并且必须 在统一指挥下,多方协作、配合,才能达到救援工作的迅 速、准确和有效。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 (二)应急救援的基本任务 1. 控制危险源:这是应急救援的首要任务.只有及时控制住危险源,防止危害 的继续打大,才能及时、有效地进行救援,此时以工程救援为主。 2. 抢救受害者:这是应急救援的重要任务,此时以医疗救援为主,及时、有序 、准确、有效地实施现场急救与安全转送伤病员是降低伤亡率、减少事故损失的关键 。 3. 指导群众防护,组织群众撤离:事故发生突然,扩散迅速,涉及范围广,危 害大,应及时指导、组织群众在加强自身防护的同时,向上风向撤离出危险区,避免 伤亡的扩大。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 (二)应急救援的基本任务 4.做好现场洗消,清除危害后果:对事故外逸的有毒、 有害物质和可能对人和环境继续造成危害的物质,进行彻底 洗消,清除隐患和危害,防止污染的延伸和持续影响。 5.查清事件原因,估算危害程度:公安、卫生、安全等 有关部门应及时调查事件发生的原因和性质,估算其损失和 危害,依法行使各部门的职权,做好事故的调查和处理工作 。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. (三)应急救援的基本形式 三.突发化学物中毒事件的应急救援 两大 过程 院前急救 现场急救 运送途中急救 非专业人员 医务人员 自救 互救 院内急救 送急诊科 进ICU 转专科医院(如职业病医院、烧伤医院、骨科等) Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 (三)应急救援的基本形式 1.事故单位自救:这是最基本,也是最重要的救援形式,因为事故单 位了解毒物的情况和现场情况,有助于现场的紧急自救和互救。如发现毒物泄漏后 戴好防毒面具,切断电源,脱离现场,脱去被污染的衣服,井下通风等。 2.社会救援:对重大或灾害性中毒突发事件,危害虽然发生在局部,但 就其程度、范围、影响而言,若单纯依靠本单位以及消防部门的力量不能控制危害 的扩展,不能及时消除危害后果时,必须有社会救援。如果事故危害超出单位区域 ,甚至跨区、县时就更需社会各方面力量的协同、配合及采取统一行动的社会救援 。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 (四)应急救援的组织机构 要做好急性突发性中毒事件的应急处理,应抓好组织机 构、人员、装备三落实。目前国家有关部委已建立了化学事 故应急救援中心,卫生部门已建立了中毒控制中心,有应急 救援办公室、应急救护站、应急救护专业队和应急救援专家 组以及指挥体系和通讯网络,但正式成立相应机构的城市还 不多。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and electrical equipment and construction safety of Party B. 三.突发化学物中毒事件的应急救援 (五)应急救援的上报程序 1.报警:事故报警的及时与准确是能否及时实施应急 救援的关键。发生突发中毒事故的单位,除了积极组织自救 外,必须及时、准确地向有关部门报警。在向当地政府报告 的同时,应向企业主管部门、安全主管部门及卫生部门报告 。灾害性事故要在24小时内报至国务院有关主管部门。 Set up safety production leading group and provide Party A with copies of job certificate, operation certificate and ID card of the responsible person on site, safety responsible person and all employees. Party B shall be responsible for the personal safety, construction equipment, living facilities, mechanical and ele
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