本研究目的探討嚴重急性呼吸道症候群(Severe Acute Respiratory Syndrome - SARS) 首次發生流行期間，有鑑於此嶄新疾病之高度傳染性及快速散佈，本院急診部於鄰近之醫學中心爆發疑似院內感染之時，首次於急診室外成立緊急應變的發燒篩檢站，透過醫護人員人力配置，作業動線流程及可能應變防護措施，瞭解SARS流行期間急診疾病症狀及分佈。研究期間2003/5/15-7/15，研究對象為急診室外發燒篩檢站內科病患3730位，採病歷回溯性以隨機取樣300位個案。
本研究以結構式問卷發燒篩檢記錄量表，進行資料收集，採用EPI-INFO 10.0版本統計分析。研究結果為：(1) 個案主訴項目喉嚨痛(38.3%)及發燒(17%)為主，符合SARS臨床症狀，SARS發病流行前後疾病分佈比較，仍是以腸胃道系統(18.7%)及心臟血管系統疾病(16.7%)為主，前後並無顯著明顯差異 (2) 成立急診室外發燒篩檢站後，護理人力安排比平常日多50%，期間篩檢一例疑似/可能個案 (以300筆樣本統計)。（3）研究期間共計護理人員參與篩檢流程 2160人次，無醫護人員發生類似SARS感染現象，本研究證實成立急診室外發燒篩檢站，能有效控制首次突發傳染疾病(SARS)擴散，並可避免院

The objectives of this research study are:
1. To probe into the widespread period of severe acute respiratory syndrome.
2. To study on this highly contagious and rapid spread of this new kind of disease
At the time when nearby emergency department of medical center breaks out a suspicion of nasocomial infection. First, our emergency department immediately formed a strict fever screening station. After comparing the outcome of the prevention and spreading of this disease by the set-up of the emergency fever station between the central and southern medical institution. The research period was from May 15, 2003to July 15, 2003. Our research targets made by the emergency fever station were around 3730 patients with a random selection of 300 cases.
This research uses the structure of fever screening measurement questionnaires to gather information and then adapted the EP1-INFO 10.0 version of statistical analysis. The results of the research are as follows:
1. Chief complaint of sore throat (38.3%) and fever (17%) fitted to the clinical symptoms of SARS. In relation to SARS before and after the spread of the disease, there are still other complaints such as the gastrointestinal system (18.7%) and cardiovascular disease (16.7%) that showed no obvious difference.
2. During the period of emergency fever screening station, an additional 50% of manpower are being arranged to screen probable or non-probable affected cases. (from the 300 randomly selected cases)
3. There are no obvious difference showed after comparing the outcome of the prevention and spreading of this disease by the set-up of the emergency fever center between the central and southern medical institution.
4. After tallying the number of doctors and nurses participated in screening procedure and number of non-medical staff developed similar symptoms to SARS, we can see the result of total number of medical staff from the emergency fever screening station that can successfully control the spread and prevention of the disease, making it the standard and model in the prevention and control of other communicable disease in the future.
Key words: Severe acute respiratory syndrome, fever screening station, emergency room, emergency task force

中文摘要 ----------------------------------------------------- Ⅱ
Abstract ----------------------------------------------------- Ⅳ
致謝 --------------------------------------------------------- Ⅶ
目錄 --------------------------------------------------------- Ⅸ
表目錄 ------------------------------------------------------- Ⅹ
圖目錄 ------------------------------------------------------- Ⅹ
第一章 緒論 ------------------------------------------------- 1
第一節 研究背景與動機 ---------------------------------- 2
第二節 研究重要性 -------------------------------------- 4
第三節 研究目的 ---------------------------------------- 5
第四節 研究流程 ---------------------------------------- 6
第五節 名詞界定 ---------------------------------------- 6
第二章 文獻探討 --------------------------------------------- 9
第一節 嚴重急性呼吸道症侯群 ---------------------------- 9
第二節 台灣嚴重急性呼吸道症候群SARS流行情況------------ 27
第三節 SARS感染控制（Infection Control）----------------- 30
第三章 研究方法 --------------------------------------------- 35
第一節 研究設計與架構 --------------------------------- 35
第二節 研究對象與地點 --------------------------------- 36
第三節 研究工具 --------------------------------------- 37
第四節 研究過程 --------------------------------------- 38
第五節 資料分析 ---------------------------------------- 39
第四章 研究分析與結果 -------------------------------------- 40
第一節 疾病症狀與疾病分布 ----------------------------- 39
第二節 發燒篩檢站護理人員人力配置、作業動線流程及應變防措施分析與結果 ----------------------------------- 44
第三節 討論 -------------------------------------------- 51
第五章 結論與建議 ------------------------------------------- 53
第一節 研究與建議 -------------------------------------- 53
第二節 未來研究方向 ------------------------------------ 58
第三節 研究限制----------------------------------------- 58
參考文獻 ----------------------------------------------------- 62
表目錄
表一 SARS與一般感冒徵兆、症狀比較表 ------------------------ 19
表二 發燒篩檢記錄表------------------------------------------ 36
表三 患者人數、旅遊、接觸史統計表 ----------------------------- 41
表四 發燒篩檢站患者就診症狀統計表 --------------------------- 43
表五 發燒篩檢站患者就診疾病分怖------------------------------ 44
表六 樣本醫院人力配置表 ------------------------------------- 45
表七 篩檢站防護措施表 --------------------------------------- 51
表八 醫院2002、2003/5-7月內科病患人數對照表----------------- 52
圖目錄
圖2.1.1 冠狀病毒屬分類圖 ----------------------------------- 15
圖2.2.1 SARS可能病例流行曲線-------------------------------- 28
圖2.2.2 ARS PCR或抗體陽性病例流行曲線圖---------------------- 29
圖2.2.3 SARS PCR或抗體陽性病例之年齡及性別分佈圖------------- 29
圖4.2.1病患就診及處置動線圖--------------------------------- 48
圖4.2.1 工作及會診動線圖 ----------------------------------- 50
附錄一 SARS期間檢傷工作內容--------------------------------- 68
附錄二 疑似SARS病患處置流程--------------------------------- 69
附錄三 疑似SARS轉入本院處理流程----------------------------- 70
附錄四 SARS病患住院流程------------------------------------- 71
附錄五 SARS病患住院流程查核表------------------------------- 72
附錄六 篩檢站檢體收集---------------------------------------- 73
附錄七清潔班長收垃圾、清潔病床及洗衣工廠收被服動線 ----------- 74
附錄八急診發燒病患處置流程----------------------------------- 75

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