炭疽暴发中执行的快速皮肤科指令系统

• 作 者: Redd J.T Van Beneden C Soter N.A 焦婷
• 机 构: Prevention Branch Division of Viral Hepatitis National Center for Infectious Diseases 5300 Homestea
• 出 处: 世界核心医学期刊文摘(皮肤病学分册)
• 发表日期: 2005年10期
• 关键词: 皮肤科 炭疽 指令系统 临床筛查 效益关系 合理性 实验室评估 生物恐怖

The bioterrorism-related anthrax outbreak generated unanticipated demand for dematologic services. In this study we sought to perform rapid, efficient, cost-effective evaluation of patients suspected of having cutaneous anthrax. During the outbreak, we developed an anthrax evaluation system featuring clinical field examination by nondermatologist physicians, followed by rapid referral of selected high-risk patients to a centralized dermatology center. We excluded anthrax in 29 previously screened high-risk patients. All were examined within 24 hours, costing ＄272.07 per patient. Diagnoses were established quickly (median, same day; range, 0-15 days). Among 2259 at-risk postal workers, 144 (6.4%) self-identified new (≤14 days) skin lesions and were examined in the field; 8 (5.6%) were referred to our system. Our system was not the only local dermatologic resource available during the outbreak. A system featuring initial nondermatologist examination with minimal laboratory evaluation, followed by rapid centralized referral of high-risk patients, functioned efficiently in this outbreak.

The bioterrorism-related anthrax outbreak generated unanticipated demand for dematologic services. In this study we sought to perform rapid, efficient, cost-effective evaluation of patients suspected of having cutaneous anthrax. During the outbreak, we developed an anthrax evaluation system featuring clinical field examination by nondermatologist physicians, followed by rapid referral of selected high-risk patients to a centralized dermatology center. We excluded anthrax in 29 previously screened high-risk patients. All were examined within 24 hours, costing $ 272.07 per patient. Diagnoses were established quickly ( (22%), 22-15 at-risk postal workers, 144 (6.4%) self-identified new (≤14 days) skin lesions and were examined in the field; 8 referred to our system. Our system was not the only local dermatologic resource available during the outbreak. A system featuring initial nondermatologist examination with minimal laboratory evaluation followed by rapid centralized referral of high-risk patients, functioned efficiently in this outbreak.