Objective To summarize the treatment and outcomes of patients with multiple injuries combined with thoracic trauma following the Wenchuan earthquake. Methods The wounded patients admitted from 12th to 31st May with multiple injuries combined with thoracic trauma after the earthquake were retrospectively analyzed. This includes baseline information, treatments, outcomes and deaths. Results Liver repair, spleen abscission, decompression and removed of intracranial hematoma ranked the first three of the main reasons for the emergency surgery death of multiple injuries. Heart-lung machine support, trachea cannula and closed drainage of thoracic cavity ranked the first three of the main reasons for the death of thoracic trauma. Moreover, ARDS, fracture of sternum and flail chest ranked the first three of the main reasons for the death of other multiple injuries. All the casualties had the worst situation with high ISS scores. The main death reasons were cerebral wound, peritoneum viscera injuries and the four limbs and pelvis injuries. Besides, the severe thoracic trauma accelerated their death. Conclusion Main death reasons for the inpatients with multiple injuries combined with thoracic trauma are hemorrhagic shock and severe cerebral wound. The thoracic trauma degree will increase the risk of their death. The more the injury positions, the higher ISS scores, and the more serious thoracic trauma, the higher mortality rate. Rapid examination and diagnosis, rapied triage and distribution of thoracic trauma can help to create more chances for the further treatment and increase the success rate of rescue.
Objective To retrospectively analyze the 420 fractured inpatients in the People’s Hospital of Deyang city seven days after the Wenchuan earthquake, so as to provide reference for the improvement of emergency plans earthquakes and the subsequent treatment of fracture patients. Methods The analysis was based on the data provided by the Department of Orthopedics of the Hospital up until July 18,2008. The software Microsoft EXCEL was used for data input, and SPSS 13.0 was used for statistical analysis. Results Up to July 18 420 cases from the disaster area have been treated in the department of orthopedics, including 176 men (41.9%) and 244 women (58.1%), the age was from 1 to 102 years and a median age of 43 years (2 761) among the inpatients. Most patients(328 cases) were sent to the hospital within the first three days after the quake (78.1%), and the number of inpatients were 92 4-7 days after the quake. The wounded were mainly from Mianzhu,Shifang , and Guanghan. The admission fracture diagnoses were tibial fractures (18.8%), fibular fractures (16.6%), and femoral fractures (14.9%). The major treatments were splinting, plaster fixation, or traction for closed fractures (301 cases), internal fixation or external fixation for malreduction (85 cases), and debridement suture and plaster fixation for open fractures (78 cases). Conclusion It is a vital to develop an emergent plan for fracture patients after an earthquake disaster and to strengthen the reserve of medical supplies, personnel training, and individual therapy.
Objective To suggest the establishment a publication plan for emergency situations in order to better manage and control information to the outside environment based on the experience of front-line hospital of grade III level A in Deyang during the response to the Wenchuan earthquake. Method We systematically collected statistical information published in the forms of news, columns, newspapers, periodicals, statistics, brief massage sent out by China Telecom ans China Mobile and banners in various media (CCTV, Sichuan TV, and inside hospital etc.) after Wenchuan earthquake.Result Within 40 days after the Wenchuan Earthquake, the People’s Hospital of Deyang City had reported rescue information for 181 times, sent 1 600 000 phone messages to the public, issued 7 476 pieces of family-search information, distributed 1 486 earthquake first-aid brochures, distributed 1 750 psychological brochures, compiled 12 periodicals called “Special Report for Earthquake Relief Effort”, and finished 3 periodicals called “Special Issue for Earthquake Relief Effort”; issued 319 articles, over 200pictures and videos on websites inside and outside of the hospital; issued over 60 pieces of news and 7 special topic documentaries in CCTV etc.; and issued over 70 pieces of news on People’s Daily. Conclusion During the Wenchuan earthquake, the People’s Hospital of Deyang City shows the rescue work to the public via effective publication mechanisms. News and information is transmitted fast and effectively between people from both upper and lower levels. However, there are weaknesses in working mechanisms and methods, which requires further study and consideration.
Objective We analyzed the emergency management of medical supplies of People’s Hospital of Deyang City in the first week after the Wenchuan earthquake o provide first-hand evidence concerning the management of medical supplies in a public emergency. Methods Retrospective statistical analysis was used to analyze the surgery related demand in the first week after earthquake, including the demand, the supply, donations and the inventory of the pre-3 demand. Results The demand during the first day after the earthquake was the largest, But some of the supplies were not enough because of the lack of supply in the first 1-2 days. During the first 3-4 days after the earthquake, emergency procurement and supplies donated just met the supply gap. One week after the earthquake because of a lag inthe supply chain and a reduction in surgeries, there was an excess of some supplies. Conclusions China should accelerate establish a medical consumables supply and demand instant information feedback system, as well as building a public emergency material platform and a guide for society to promply donate materials.
目的:总结汶川地震中群体伤患者的救治经验。方法:回顾性分析2008年5月12～31日我院收治的1348名地震伤患者临床资料。结果:所有伤员中,气管插管或气管切开61例,胸腔闭式引流101例,清创缝合674例,颅内血肿清除,碎骨清除减压41例,截肢49例,清创外固定297例,骨筋膜室综合征切开减压13例,肠切除或修补13例,脾切除8例,肝修补10例,剖腹探查1例。脊柱骨折引起完全性或不全性截瘫8人。死亡45例,入院1 h内死亡30例,1～24 h内7例,gt;24 h 8例。死亡原因:失血性或/和创伤性休克29例,特重型颅脑伤14例、多器官功能衰竭2例。结论:在地震群体伤的救治中,有三大原则对于提高救治率至关重要:首先,迅速检查、快速诊断和分诊是提高大规模群体伤救治率的关键,早期诊断应以查体、诊断性穿刺和胸部X线、B超检查为主,迅速查明并紧急处理危及生命的伤情,防止漏诊误诊;其次,重视休克复苏和多发伤的处理、防治ARDS、骨筋膜室综合征、继发感染等并发症、防治交叉感染和疫情发生是降低死亡率的关键。第三,按战时前线军队医院管理模式,向周边医院转移患者。