2026 Volume 59 Issue 4 Pages 283-291
Background： Although chlorine gas incidents caused by accidental mixing of sodium hypochlorite and acetic acid have been reported in dialysis facilities, most publications have focused on prevention, with limited reports on post‒incident response protocols. Objective： To develop a practical response manual for chlorine gas incidents in dialysis facilities through joint training with the fire department. Methods： We initially developed a response manual at our facility (mechanical room on the first floor； inpatient ward on the second floor). Subsequently, we conducted joint training with the local fire department. Fire department personnel inspected our facility structure and ventilation systems, and provided expert guidance on evacuation routes, zoning procedures, and information required for emergency calls. Results： The training clarified specific response procedures, including： immediate closure of the machine room and dialysis unit, complete evacuation of the first floor, opening windows on the second floor (except for the room directly above the dialysis unit), elevator‒use permission, and additional evacuation following fire department zoning assessment. We developed a 10‒item checklist for emergency calls and established a system for preparing facility diagrams and documentation for fire department use. The manual was markedly revised based on training outcomes. Key outcomes are summarized in Table 2. Conclusion： Joint training with the fire department is valuable for developing practical post‒incident response manuals tailored to facility‒specific characteristics. This approach is expected to be applicable to other dialysis facilities.
