The West China hospital of Sichuan university has underwent four times emergency medical rescue (EMR) of earthquakes, measuring 5.7 Ms to 8.0 Ms on the Richter scale, happened at Wenchuan, Yushu, Yiliang and Lushan in recent 5 years, which gradually improved and supplemented Wenchuan experience. After Lushan earthquake, a total of 392 patients were received during 2 weeks. Among 321 hospitalized patients, there were 39 (12.15%) patients with critical injury and 14 (4.36%) patients who needed intensive care. 184 operations were performed. Based on the experiences of resource centralization, multidisciplinary cooperation, and hierarchical management, zero death, a new medical record, has been achieved among 43 patients with critical injury after centralized admission and treatment. A total of 12 medical rescue teams involving 88 healthcare workers were sent to the epicenter to join and guide EMR. Besides, rehabilitation and psychological experts came to Lushan on the first day of earthquake, and started clinical intervention of mental and physical health for people needed on the second day.
Objective To evaluate the performance of emergency medical rescue (EMR) within 1 month after Lushan earthquake, and to prove and enrich the experience from Wenchuan earthquake, so as to provide useful references for global earthquake EMR with regard to decreasing death and disability rates. Methods All the following date published within 1 month after 4.20 Lushan earthquake were collected and analyzed, including official information, public documents, news release, relevant information from websites and victims’ medical records in the West China Hospital, then the relevant domestic and foreign literature about EMR (including EMR of Wenchuan earthquake). And then comparative analysis was conducted to evaluate the performance of EMR in Lushan earthquake. Results a) Being 87 km apart from each other, the main seismic zones of Lushan and Wenchuan located in the south west and middle north of Longmenshan fault zone, respectively. Although only 1 earthquake magnitude differed between them, the disaster area, and the number of affected population, deaths, disappearances, injured, severe injured and migration population in Wenchuan earthquake were 40, 23, 353, 853, 27, 14 and 51 times higher than those in Lushan earthquake, respectively. b) Learned from Wenchuan experience, the manpower scheduling in Lushan earthquake was quicker: the assembled medical personnel peak of Lushan vs. Wenchuan was 87.62% vs. 56.06 % in golden 72 hours post-quake. c) Supplies scheduling was more rational: the utilization rate was higher under the guidance of accurate information of demand. d) Medical treatment was more rational and efficient: the critical injured were treated following “Four concentration treatment principles”; saving life and restoring function at the same time; treatment and physical-mental rehabilitation at the same time; treatment and evidence production and implementation at the same time. e) Medical institutions and service returned to normal in time: 96.7% (440/455) of government owned township medical institutions in 21 affected towns returned to normal and provided medical services at their original sites. Conclusion By learning form Wenchuan experience, the following performance is implemented in Lushan earthquake: medical rescue guided by the accurate information; supplies scheduling guided by the accurate demand; both critical injured treatment,and physical-mental rehabilitation guided by the accurate assessment of injuries. So the medical rescue within 1 month after Lushan earthquake is quicker, more rational and efficient. After 20 days post quake zero death of critical injured was achieved. The early physical-mental rehabilitation fastens the functional reconstruction of the injured and helps them return to the society. So it suggests that the Lushan EMR enriches and develops the reference value of EMR experience of Wenchuan earthquake.
Objective To collect and analyze the data of emergency medicine supply for both Wenchuan and Lushan earthquakes victims in the West China Hospital, so as to provide evidence for scientifically and efficiently carrying out the logistical support for emergency rescue medicines supply, and improving the coping capacity for those similar public health emergencies. Methods Both medicine constituent ratios and DDDs were taken as evaluation indexes, and the data were input by Excel software. Then the following items were analyzed: the use and cost of emergency medicine for victims admitted in the hospital from one day to one month after earthquake, as well as, the acceptance, allocation and use of the donation medicines for both Wenchuan and Lusan earthquakes. Results During the first month after Lushan earthquake, the victims used 26 categories of medicines involving 455 drug specifications in the West China Hospital. The dosage and DDDs of therapeutic medicines were higher than those of ancillary medicines. The donation medicines for Lushan earthquake accepted by the hospital were in 8 categories involving 16 drug specifications, and they were all used to rescue the victims in the hospital. Based on the hospital emergency medicine supply system oriented by the information of victim’s medicine use, the drug specification and total drug cost of the donation medicines for Lushan earthquake decreased by 90.91% and 89.73%, respectively, indicating a more accurate and efficient system compared with those for Wenchuan earthquake. Conclusion The implementation of the hospital emergency medicine supply system oriented by the information of victim’s medicine use is helpful to improve the time efficiency and pertinence of earthquake medical rescue.
Objective To analyze the injury characteristics and the rescue process and effects for the victims admitted in the People’s Hospital of Deyang City within 72 hours after 4.20 Lushan earthquake, so as to discuss how to adopt the emergency program to implement medical rescue in disaster relief. Methods The data of 25 earthquake victims admitted in the hospital from April 20th, 2013 to April 23rd, 2013 were collected to analyze age, gender, the location of injury, the injury state of different age groups, and the prognosis of victims. Results Of the 25 victims with injuries on 32 locations of the body, there were 20 cases with single injury (80.00%) and 5 cases with multiple injuries (20.00%). Most injuries were seen in four limbs, body surface, and soft tissues; and the incidence of single injury was higher than that of multiple injuries. The number of admitted victims was largest on the first day after earthquake, accounted for 92.00%, which was obviously higher than that on the second and the third day. Victims aged from 19 to 45 years old was more than those of other ages. Conclusion Scientific emergency command system and disaster emergency program play an high-efficient command role in disaster rescue, shorten the time of emergency response, and improve the ability of disaster rescue. The comprehensive capacity of self-rescue and well-organized rescue for disaster area can be improved as long as the general public is educated about the disaster emergency program and cooperative emergency drill. Meanwhile, smooth traffic and unobstructed communication are guaranteed in the disaster area, and the cooperative efforts are made by all walks of society.
Objective To analyze the injury and dysfunction as well as the rehabilitation status and demand of the 188 Lushan earthquake victims admitted in the hospitals in and around Ya’an city and the West China Hospital of Sichuan University, so as to provide guidance for the rehabilitation work in the following step. Methods By means of the onsite investigation, 122 victims admitted in 7 hospitals and 2 health centers in and around Ya’an city within 1-9 days after Lushan earthquake, and the other 66 victims treated in the West China Hospital of Sichuan University were analyzed. Results The injury categorization of 122 victims in and around Ya’an city was as follows: upper limb fracture (12.30%), lower limb fracture (42.62%), spine fracture (16.39%) (25.00% treated by surgery and 75.00% treated by non-surgery treatment), pelvis fracture (1.64%), rib fracture (4.10%), traumatic brain injury (10.66%), soft tissue contusion (8.20%), and others (4.09%). At the corresponding period, the injury categorization of 66 victims treated in the department of rehabilitation medicine of the West China Hospital of Sichuan University was as follows: fracture (77.27%), traumatic brain injury (3.03%), spinal cord injury (4.55%), and others, including soft tissue injury (15.15%). At the ninth day after earthquake, among the 122 victims in and around Ya’an city, 8 victims (6.56%) were recovered with self-care ability of daily living, and the other 144 (93.44%) still needed the strengthened rehabilitation treatment. At the corresponding period, among the 66 victims in the West China Hospital, one victim (1.52%) was recovered with self-care ability of daily living, and the other 65 (98.48%) still needed the strengthened rehabilitation treatment. Conclusion Early rehabilitation treatment such as active exercise, elevating injured limbs, physical therapy, turning over at regular time, and psychological intervention can help the earthquake victims to return to home and society early.
Objective To explore the allocation of necessary living goods for the emergency medical rescue teams at Lushan earthquake sites. Methods The living goods requirements of 59 emergency medical rescue members at Lushan earthquake sites were investigated using a questionnaire and then analyzed, in order to provide references for the allocation of necessary living goods for emergency medical rescue teams in future. Results The top five necessary living goods for emergency medical rescue members at earthquake sites were food, drinking water, toilet, communication product, and bedclothe. The needs of bath of the members who stayed longer than 3 days were more than the members who stayed shorter than 3 days, with a significant difference (Plt;0.05). The number of living goods that female members need were more than that male members need (Plt;0.05). Conclusion For improving the work efficiency and quality of life, emergency medical rescue teams need to be equipped with not only the medical supplies, but also necessary living goods based on the length of stay and the ratio between male and female.
The injuries caused by earthquake were characterized as complicated injuries, multiple injuries, crush injury, commonly accompanied by the impairment of the organs, open wound with susceptibility to contamination, difficulties in the implementation of in-time treatment, and resource-limited settings. Considering the specialty of early treatment of earthquake victims and existing misconduct, we propose recommendations according to general principles of early rationale use of antibiotics, in order to treat the earthquake victims safely, effectively and feasibly, and to decrease wound infection rates after surgery.
目的:了解参与“5?12”四川大地震救援医护人员的应急减灾与备灾现状,为促进备灾教育和备灾行为提供参考依据。方法: 用自行设计的调查表,对参加四川大地震医疗救援的223名医护人员及其所在医疗机构的应急减灾与备灾情况等进行调查。结果: 本调查中的全体医护人员所在医疗机构地震发生时均采取了积极的应急减灾处理,成功地履行了医护人员救死扶伤的神圣使命。经历大地震后,95.1%~83.9%医护人员所在医疗机构对急救减灾对策、物资应急供应装备与后勤保障方面的备灾措施进行了加强与完善,但信息畅通的保障与备灾行动的落实方面尚存在不足;85.7%~64.6%医护人员所在医疗机构建立或完善了相关备灾规章制度与指南。结论: 经历“5?12”大地震后,医疗机构在应急救治能力的储备、救援人员的反应力与意识、信息畅通、物资供应保障等方面具有了一定的备灾基础,同时也提示了对于促进备灾教育和备灾行动的落实以及进一步完善相关制度/手册的必要性和迫切性。
目的:通过分析2007年自贡市急救中心院前急救反应能力,探讨其影响制约因素及解决方法。方法:回顾性分析2007年1~12月份自贡市急救中心院前出诊的全部有效病例呼救时间、出车时间、到达现场时间及出诊距离,计算出车准备时间、车辆行驶速度、应急反应时间、急救半径。结果:全年院前出诊共3336例,出车准备时间(2.06±0.93) min,车辆平均行驶速度32.17 km/h,应急反应时间(12.51±10.87) min,急救半径(5.60±5.35) km。结论:我市急救中心目前取得一定成绩,需采取多种措施进一步提高急救反应能力。
Objective To strengthen and improve the decision of emergency medical rescue and provide the experience for the world, the article evaluates the performance of emergency command in Yushu Earthquake.Methods All the materials seen during the first year after Yushu earthquake were collected, such as all documents, information notifications and work reports issued by the Central Government and the Ministry of Health, and all the information from the website of News Office of the State Council, Ministry of Health, State Seismology Bureau, Qinghai Provincial People’s Government, and Department of Health of Qinghai Province. The data were also searched from CNKI and descriptively analyzed after the retrospective study. Results Based on the experience from Wenchuan Earthquake, the emergency command in Yushu Earthquake was characterized by: a) Promptly starting a Level-1 response; b) Setting up and completing an integrated work mechanism of military, police and the local government; and c) Achieving an accurate command under the guidance of precise information. Conclusion As the successful precedent of large-scale medical and health rescue at the high-altitude area in the world, the experience of Yushu Earthquake supplements and enriches the Wenchuan’s, and provides references for both domestic and overseas disaster medical emergency response.