张盖 金晓胜 袁轶俊 张豪 叶侃 王振渊

[摘要] 讨论甲类呼吸道传染病感染疫情中院前医疗机构的感染控制管理原则和策略。分析院前急救机构应对甲类呼吸道传染病时高风险因素和环节，根据实际情况设计、制定感染控制措施和流程。针对不同的急救工种人员开展相应的培训和教育，遵循感染控制标准实行防护措施，启用感染控制管理监测及反馈，能有效地防止感染的发生与扩散，确保急救转运的安全快捷，避免了员工职业暴露及交叉感染的发生。同时为建立科学的院前急救感染防控体系，提升卫生系统的综合感染控制管理能力，完善卫生应急体系提供借鉴和参考。

[關键词] 院前医疗机构;感染控制;标准防护;培训教育

[中图分类号] R181          [文献标识码] C          [文章编号] 1673-9701（2021）06-0155-04

Pre-hospital medical institutions′ infection prevention and control strategies for class A respiratory infectious diseases

ZHANG Gai1   JIN Xiaosheng1   YUAN Yijun2    ZHANG Hao1   YE Kan1   WANG Zhenyuan1

1.Department of Medical Administration， Wenzhou Emergency Medical Services in Zhejiang Province， Wenzhou   325000， China; 2.Department of Medical Administration， Hangzhou Emergency Medical Center in Zhejiang Province， Hangzhou   310012， China

[Abstract] This paper discussed pre-hospital medical institutions′ principles and strategies in the management of infection control during the epidemic of class A respiratory infectious diseases.It analyzed that in reaction to the high-risk factors and links during class A respiratory infectious diseases，pre-hospital emergency institutions should design and formulate infection control measures and procedures according to the actual situation. The measures such as carrying out corresponding training and education for the personnel of different emergency work， implementing protective measures according to infection control standards and starting to monitor and feedback the management of infection control can effectively prevent the occurrence and spread of infection， ensure the safety and rapidity of emergency transportation， and avoid the occurrence of occupational exposure of the employees and cross infection among them. Meanwhile， it provided experience and reference for establishing a scientific pre-hospital emergency infection prevention and control system， improving the health system′s comprehensive ability in the management of infection control， and perfecting the health emergency system.

[Key words] Pre-hospital medical institutions; Infection control; Standard protection; Training and education

目前全球传染病流行都出现了“新的传染病出现，旧的传染病死灰复燃的新特征”，故传染病仍是一个十分严重的公共健康卫生问题。特别是甲类呼吸道传染病，发展速度快、传播性强、涉及范围广、严重危害患者生活质量，给公众身心健康带来严重威胁[1]。院前医疗急救机构在突发公共卫生事件中扮演着重要的角色，各地急救中心作为院前急救机构需承担传染病患者的转运任务，然而，院前急救不同于一般的医疗机构能在可控的环境下提供医疗服务，风险远大于普通的医疗机构。因此，院前医疗机构应根据中国卫生健康委员会和世界卫生组织（World health organization，WHO）推荐的甲类呼吸道染病防控标准[2-3]，制定详细、符合实际的感染控制措施和流程，并确保执行实施到位，防范感染的发生与扩散，以保障患者安全与工作人员的健康。……