车辆伤害应急处置方案
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1 北京市兴南园林绿化有限公司 车辆伤害应急处置方案
编 写 张艳红 审 核 周立娜 批 准 王华
颁发日期:2015-08-20 2
1. 事故特征 1.1. 风险分析 停车厂经常有车辆进出容易出现车辆伤害事故。 1.2. 事故发生区域:绿化作业、院内停车场。 1.3. 事故的危害程度 1) 导致员工受伤,严重导致死亡。 2) 导致车辆损坏。
2. 应急组织与职责 2.1. 应急组织体系 应急指挥部人员组成 总指挥: 总经理 副总指挥: 主管安全副总经理 指挥部成员:各部(室)负责人 2.2. 指挥机构及职责 根据事故类型,应急救援指挥机构构成单位和人员的具体职责分别为: (1) 总指挥 组织指挥本单位的应急救援工作;负责向公司领导报告。 (2) 副总指挥 协助总指挥负责应急救援的具体指挥工作,各司其职。 3
(3) 指挥部成员 1) 负责应急预案的启动工作; 2) 负责应急救援组织成员及公司相关救援部门的信息联络工作; 3) 负责医院及所需车辆救援的信息联络工作; 4) 协助总指挥做好事故报警、情况通报及事故处置工作; 5) 负责事故后恢复正常生产的组织协调工作。
3. 应急处置 3.1. 应急报告程序 发生车辆事件时,员工应直接向应急指挥部报告。 3.2. 报告内容 (1) 发生时间、地点和部位 (2) 事故的简要经过; (3) 事故已经造成或者可能造成的伤亡人数(包括下落不明的人数)和初步估计的直接经济损失; (4) 已经采取的措施; 3.3. 救援方法 3.3.1. 如果有车辆压住伤者,应立即小心移开车辆,或用千斤顶顶起车辆,将伤者小心移出。再根据伤 4
者的具体情况进行医疗救治。 3.3.2. 如果发现车辆有漏油,疏散无关人员,禁止点火源出现,并根据下列情况,立即采取堵漏措施: (1) 油管折断时,可找一根与油管直径适应的胶皮或塑料管套接。如套接不够紧密,两端再用铁丝捆紧,防止漏油; (2) 油管破裂时,可将破裂处擦干净,涂上肥皂,用布条或胶布缠绕在油管破裂处,并用铁丝捆紧,然后再涂上一层肥皂; (3) 油管接头漏油时,可用棉纱缠绕于油管接头,再将油管螺母与油管接头拧紧;还可将泡泡糖或麦芽糖嚼成糊状,涂在油管螺母座口,待其干凝后起密封作用; (4) 漏油漏水时,可根据砂眼大小,选用相应规格的保险丝,用手锤轻轻将其砸入砂眼内,便可消除漏油、漏水现象。 3.4. 对人员的抢救方法 3.4.1. 不要轻易移动受伤者,保持其呼吸道通畅。 3.4.2. 有出血时,应有效止血,包扎伤口。 3.4.3. 如果发生骨折,用双手稳定及承托受伤部位,限制骨折处活动并设置软垫,用绷带、夹板或替代品妥善固定伤肢。 5
3.4.4. 发生断指(肢)应立即止血,应马上用止血带扎紧受伤的手或脚,或用手指压迫受伤的部位止血。伤口用无菌纱布或清洁棉布包扎,将断指(肢)也要用无菌纱布包扎,有条件的与冰块一起放入干净胶袋,并立即送医院进行手术。 3.4.5. 伤者出现呼吸或心跳停止,应进行心肺复苏急救。
4. 注意事项 4.1. 受伤者伤势严重,不要轻易移动伤者。 4.2. 去除伤员身上的用具和口袋中的硬物,注意不要让伤者再受到挤压。 4.3. 如上肢受伤将其固定于躯干,如下肢受伤将其固定于另一健肢。应垫高伤肢,消除肿胀。如上肢已扭曲,可用牵引法将上肢沿骨骼轴心拉直,但若拉伸时引起伤者剧痛或皮肤变白,应立即停止。 4.4. 如果伤口中已有脏物,不要用水冲洗,不要使用药物,也不要试图将裸露在伤口外的断骨复位,应在伤口上覆盖灭菌纱布,然后进行适度的包扎、固定。 4.5. 若发现窒息者,应及时解除其呼吸道梗塞和呼吸机能障碍,应立即解开伤员衣领,消除伤员口鼻、咽喉部的异物、血块、分泌物、呕吐物等。 6
4.6. 5. Topical agents, alternative medicine, and disease severity assessment are the subjects of the latest updated set of guidelines for the management and treatment of psoriasis issued jointly by the American Academy of Dermatology and the National Psoriasis Foundation. 6. 7. The guidelines, published in the Journal of the American Academy of Dermatology, focus on treatment for adults, and follow the release of other AAD-NPF guidelines on biologics for psoriasis, psoriasis-related comorbidities, pediatric psoriasis, and phototherapy in 2019, and earlier this year, guidelines for systemic nonbiologic treatments. The latest guidelines' section on topical treatment outlines evidence for the efficacy, effectiveness, and adverse events related to topical steroids, topical tacrolimus and pimecrolimus, vitamin D analogues, tazarotene, moisturizers, salicylic acid, anthralin, coal tar, combinations with biologic agents, and combinations with nonbiologic treatments (methotrexate, cyclosporine, acitretin, and apremilast). 8. 9. The guidelines noted the "key role" of topical corticosteroids in treating psoriasis "especially for localized disease," and include a review of the data on low-, moderate-, high-, and ultrahigh-potency topical steroids for psoriasis. 10. 11. In general, all topical steroids can be used in combination with biologics, according to the guidelines, but the strongest recommendations based on the latest evidence include the addition of an ultra-high potency topical corticosteroid to standard dose etanercept for 12 weeks. Currently, 11 biologics are approved by the Food and Drug Administration for the treatment of psoriasis. 12. 13. In addition, "while not FDA approved for psoriasis, the topical calcineurin inhibitors tacrolimus and pimecrolimus are often employed in the treatment of psoriasis," can be helpful for "thinner skin such as facial and intertriginous areas," and can be steroid sparing when used for more than 4 weeks, according to the guidelines. 14. 15. Don't discount the role of patient preferences when choosing topical treatments, the authors noted. "The optimal vehicle choice is the one the patient is mostly likely to use." 16. 17. The guidelines also address the evidence for effectiveness, and adverse events in the use of several alternative medicines for psoriasis including traditional Chinese medicine, and the herbal therapies aloe vera and St. John's wort, as well as the potential role of dietary supplements including fish oil, vitamin D, turmeric, and zinc in managing psoriasis, and the potential role of a gluten-free diet. 18. 19. In general, research on the efficacy, effectiveness, and potential adverse effects of these strategies are limited, according to the guidelines, although many patients express interest in supplements and herbal products. For example, "Many patients ask about the overall role of vitamin D in skin health. Rather than adding oral vitamin D supplementation, topical therapy with