汶川、玉树地震伤病员医疗后送特征比较分析
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摘要
目的系统分析并比较汶川地震与玉树地震伤病员的医疗后送特征,以期为将来应对特大地震伤病员医疗后送的组织实施提供借鉴。方法全面收集源于汶川、玉树地震伤病员医疗后送的现场调研、卫生部工作报告、国内外官方网站,以及数据库文献资料,并采用描述性方法进行分析。结果从汶川到玉树,伤病员后送原则趋于早期后送、全部后送;后送层级逐渐简化,由灾区一线经公路、铁路直接后送至后方医院,或以空运作为主要后送方式;分级救治概念弱化,力求早期进行专科治疗。结论早期确立适宜的后送原则、建立简化的后送体系、保证充足的卫生运力、科学评估各级救治能力是保证特大地震安全迅速有效的伤病员后送亟需解决的问题。
Objective To systematically analyze and compare the casualties' medical evacuation(ME) in Wenchuan and Yushu earthquakes,so as to provide useful references for earthquake casualties' ME in the future.Methods The data about casualties' ME in Wenchuan and Yushu earthquakes were collected from the field research,work statement of the Ministry of Health,official websites,and literatures.And the descriptive analysis was then performed.Results From Wenchuan to Yushu,the principle of ME tended to be "early evacuation,all evacuation";the evacuation level was gradually simplified,the casualties were evacuated directly from the disaster area to the rear hospital through highway and railway,or air evacuation became the major method of ME;triage became less prominent,while specialist treatment was strived as early as possible.Conclusion The early establishment of appropriate evacuation principles,building of a simplified evacuation system,ensuring adequate medical transport capacity,and scientific assessment of treatment capacity at all levels are the main issues of effective and safe ME after earthquakes that require to be solved urgently.
Objective To systematically analyze and compare the casualties' medical evacuation(ME) in Wenchuan and Yushu earthquakes,so as to provide useful references for earthquake casualties' ME in the future.Methods The data about casualties' ME in Wenchuan and Yushu earthquakes were collected from the field research,work statement of the Ministry of Health,official websites,and literatures.And the descriptive analysis was then performed.Results From Wenchuan to Yushu,the principle of ME tended to be "early evacuation,all evacuation";the evacuation level was gradually simplified,the casualties were evacuated directly from the disaster area to the rear hospital through highway and railway,or air evacuation became the major method of ME;triage became less prominent,while specialist treatment was strived as early as possible.Conclusion The early establishment of appropriate evacuation principles,building of a simplified evacuation system,ensuring adequate medical transport capacity,and scientific assessment of treatment capacity at all levels are the main issues of effective and safe ME after earthquakes that require to be solved urgently.
引文
1刘旭,张鹭鹭,刘源,等.汶川抗震救灾医疗后送调查分析及思考解放军医院管理杂志,2009,16(3):249-251.
2 Naja I,van Biesen W,Shari A,et al.Early detection of patients at high risk for acute injury during disasters:developing of a scoring system based on the Bam earthquake experience.J Nephrol,2008,21:776-782.
3 Kopp JB,Ball LK,Cohen A,et al.Kidney patient care in disasters:Lessons from thehurricanes and earthquake of 2005.Clin J Am Soc Nephrol,2007,2:814-824.
4 Sternberg E,Lee GC,Huard D.Counting crises:US hospital evacua-tions,1971-1999.Prehosp Disast Med,2004,19:150-157.
5 Paul SA.Civil–Military Collaboration in the Initial Medical Re-sponse to the Earthquake in Haiti.New Engl J Med,2010,362:e32
6 Tanaka H,Iwai A,Oda J,et al.Overview of evacuation and transport of patients following the 1995 Hanshin-Awaji earthquake.J Emerg Med,1998,16:439-444.
7 Mallick M,Aurakzai JK,Bile KM,et al.Large-scale physical disabili-ties and their management in the a ermath of the 2005 earthquake in Pakistan.Eastern Mediterranean Health Journal,2010,16:S98.
8 Joseph LN,Virginia AM.Lessons from Hurricane Katrina,tsuna-mis,and other disasters.e Lancet,2005,366:1144-1146.
9卢世壁.汶川地震伤员救治分级处理的重要性.解放军医学杂志,2008,33(8):919-920.
10 Gautschi OP,Cadoseh D,Rajan G,et al.Earthquakes and trauma:review of triage and injury—speci c,immediate care.Prehosp Dis-aster Med,2008,23(2):195-201.
11 iel CC,Schneider JE,Hiatt D,et al.911 EMS process in the Loma Prieta earthquake.Prehosp Disaster Med,1992,7:348-358.
12李红樱,代小舟,刘蔚,陈理.5.12汶川大地震2196例住院伤员综合分析.实用医院临床杂志,2008,5(6):26-28.
13田伟,马娟.汶川地震住院伤员伤情及住院费用影响因素分析.中华医院管理杂志,2010(3):198-201.
14 Hiroshi T.Overview of evacuation and transport of patients follow-ing the 1995 Hanshin-awaji earthquake.J Emerg Med,1997,16:439-444.
15 Mohebbi HA,Mehrvarz S,Sagha nia M,et al.Earthquake related injuries:assessment of 854 victims of the 2003 Bam disaster trans-ported to tertiary referral hospitals.Prehosp Disast Med,2008,23:510-515.
16刘琼,马学华.批量空运伤员的实践和思考.解放军医院管理杂志,2007,14(1):25.
17 Teichman PG,Donchin Y,Kot RJ.International Aeromedical Evac-uation.New Engl J Med,2007,356(3):11.
2 Naja I,van Biesen W,Shari A,et al.Early detection of patients at high risk for acute injury during disasters:developing of a scoring system based on the Bam earthquake experience.J Nephrol,2008,21:776-782.
3 Kopp JB,Ball LK,Cohen A,et al.Kidney patient care in disasters:Lessons from thehurricanes and earthquake of 2005.Clin J Am Soc Nephrol,2007,2:814-824.
4 Sternberg E,Lee GC,Huard D.Counting crises:US hospital evacua-tions,1971-1999.Prehosp Disast Med,2004,19:150-157.
5 Paul SA.Civil–Military Collaboration in the Initial Medical Re-sponse to the Earthquake in Haiti.New Engl J Med,2010,362:e32
6 Tanaka H,Iwai A,Oda J,et al.Overview of evacuation and transport of patients following the 1995 Hanshin-Awaji earthquake.J Emerg Med,1998,16:439-444.
7 Mallick M,Aurakzai JK,Bile KM,et al.Large-scale physical disabili-ties and their management in the a ermath of the 2005 earthquake in Pakistan.Eastern Mediterranean Health Journal,2010,16:S98.
8 Joseph LN,Virginia AM.Lessons from Hurricane Katrina,tsuna-mis,and other disasters.e Lancet,2005,366:1144-1146.
9卢世壁.汶川地震伤员救治分级处理的重要性.解放军医学杂志,2008,33(8):919-920.
10 Gautschi OP,Cadoseh D,Rajan G,et al.Earthquakes and trauma:review of triage and injury—speci c,immediate care.Prehosp Dis-aster Med,2008,23(2):195-201.
11 iel CC,Schneider JE,Hiatt D,et al.911 EMS process in the Loma Prieta earthquake.Prehosp Disaster Med,1992,7:348-358.
12李红樱,代小舟,刘蔚,陈理.5.12汶川大地震2196例住院伤员综合分析.实用医院临床杂志,2008,5(6):26-28.
13田伟,马娟.汶川地震住院伤员伤情及住院费用影响因素分析.中华医院管理杂志,2010(3):198-201.
14 Hiroshi T.Overview of evacuation and transport of patients follow-ing the 1995 Hanshin-awaji earthquake.J Emerg Med,1997,16:439-444.
15 Mohebbi HA,Mehrvarz S,Sagha nia M,et al.Earthquake related injuries:assessment of 854 victims of the 2003 Bam disaster trans-ported to tertiary referral hospitals.Prehosp Disast Med,2008,23:510-515.
16刘琼,马学华.批量空运伤员的实践和思考.解放军医院管理杂志,2007,14(1):25.
17 Teichman PG,Donchin Y,Kot RJ.International Aeromedical Evac-uation.New Engl J Med,2007,356(3):11.
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