- 學位論文
呼吸照護病房火災緊急應變之探討
A Study of Fire Emergency Response Plan on Respiratory Care Ward
摘要
近年來台灣醫院內設立之呼吸照護病房數量大增，其絕大部份屬於行動受限制之重症患者，故不易於火災初期時採取相關滅火措施，因此由醫護人員協助患者，進行火災緊急避難逃生之過程，即成為重要之評估議題。有鑒於此，某醫院進行年度火災緊急應變演練時，直接移動演習用病床，配備氧氣桶、甦醒球，由三名護理人員直接實施水平疏散，測得器材前置準備時間26秒，移動速度為0.841m/sec，垂直緊急疏散及搶救之演練器材則藉助緊急救護搬運椅及自走式避難梯實施垂直疏散，測得緊急救護搬運椅速度為0.007m/sec，自走式避難梯0.39m/sec。本研究依據此演練時間，植入NIST所研發之FDS + EVAC程式模擬，在模擬情境中設定所有患者在充分的醫療資源與醫護人力戒護下實施病床水平移動28.6公尺及緊急救護搬運椅做為垂直疏散距離22.8公尺之疏散工具，在二座樓梯均順暢下，患者78名於起火後於168秒脫離起火層，1216秒(含前置準備時間)完成整棟疏散避難。為能迅速完成疏散避難，本研究模擬建置自走式避難梯手1具，在二座樓梯順暢下，患者78名於起火後542秒脫離起火層，915秒(含前置準備時間)完成整棟疏散避難。就整體疏散避難，加裝自走式避難梯能有效將疏散時間減少301秒，故建議加裝自走式避難梯，以有效增進醫護人員及患者之生命安全，且模擬結果發現FDS可有效地模擬水平及垂直之避難疏散。
並列摘要
In recent years, the number of respiratory care wards in Taiwan hospitals has increased significantly, with the majority of the patients being physically challenged, making it difficult to take fire extinguishing procedures during the early stages of fires. Because of this, the process of having medical personnel assist the patients with emergency fire escape has become an important evaluation issue. Based on these conditions, when a certain hospital was practicing their annual fire escape drills, three people from the nursing staff directly moved the hospital beds which were equipped with oxygen cylinders and bag-valve-masks, and then proceeded with horizontal evacuation; with the time needed for the equipment to be set up being 26 seconds, and the movement speed of the equipment being 0.841 m/sec. The execution of vertical evacuation must be cooperated with the drill equipment of emergency rescue chairs and movable escape ladders, with the movement speed of the chairs being 0.007 m/sec and the speed of the ladders being 0.39 m/sec. This research inserted the drill times into the simulation programs created by NIST of both FDS and EVAC to simulate the entire evacuation of hospital personnel and patients under adequate manpower and resources. With a horizontal evacuation distance of 28.6m for hospital beds and a vertical evacuation distance of 22.8m for emergency rescue chairs, while under the circumstance of having two unobstructed stairways, the 78 patients were evacuated from the floor with the fire after 168 seconds and the entire building was evacuated after 1216 seconds, also including the time needed for preparations. In order to lessen the time needed for evacuation, this research added self-movable escape ladders; also under the circumstance of having two unobstructed stairways, it took 542 seconds for the 78 patients to evacuate the floor with the fire and 915 seconds for the entire building to be evacuated, also including the time needed for preparations. When only looking at the evacuation time of the entire building, the addition of self-movable escape ladders cut the time needed for escape by 301 seconds, therefore it is recommended that these ladders be installed to ensure the lives of the hospital personnel and the patients.