Objective To provide reference for hospital emergency preparedness for disasters in China by summarizing the main results from articles involving hospital emergency readiness. Method We systematically searched MEDLINE (1950 to June 2008), CNKI (1980 to June 2008) and some websites. The main results of the eligible articles are described. Results A total of 85 articles were included, of which expert articles and surveys accounted for 44% and 29%, respectively. An emergency hospital plan should address the following 4 phases of disaster management: mitigation, preparation, response, and recovery. The following factors should be considered when developing hospital emergency plans: surge capacity, disaster planning, collaboration, training, drill, personnel, equipment, triage, diagnosis, treatment, decontamination, funding, individual security, logistic, psychological support, etc. Questionnaires, checklists or specific tools could be applied to evaluate such emergency plans. Conclusion Hospital emergency preparedness is essential for effective disaster relief. Hospitals should develop emergency plans for a variety of disasters, based on their local situations.
Objective To investigate the mass casualty triage system and its application, to provide evidence and advice for its future standardized use. Method Based on the principles and methods of systematic reviews, we searched MEDLINE (1950 to 2008), The Cochrane library (Issue 2, 2008) and CBM (from establishment to May 2008) to identify papers written in English of Chinese which described mass casualty triage systems or triage systems specific to the aftermath of earthquakes. We extracted information on name, grades, criteria, main characteristics and application of each triage system from the papers involving mass casualty triage systems. We also extracted information on setting, personnel performing the triage, grades, and characteristics from those papers describing any specific triage system for earthquake. We compared the colour of tags, codes and other materials used in different triage systems. Result We included 38 English and 6 Chinese papers. For mass casualty triage systems, we identified 7 primary triage methods with 4 grades.Three of these had relevant application reports. There were 6 secondary triage methods with 3-5 grades, and none had relevant application reports. Four tag methods were identified. Seven papers, 2 of which were published in China, reported specific secondary triage methods for earthquakes. Conclusion Based on the current evidence, there is no universally accepted mass casualty triage system with documented reliability and validity. No triage system has been developed specifically for the wounded in earthquakes. There are large differences between the triage methods for earthquake and other mass casualty incidents. Future research should focus on the development of a reliable and valid mass casualty triage system, aimed at maximizing the capacity for medical rescue.