In the rescue that follows a major natural disaster, blood donation is a unique, necessary method to assist the injured. To achieve effective assurance of the blood supply for medical rescue in an orderly fashion, the current procedure must be adjusted by using scientific prediction, analysis, and adaptation. After the process of ensuring the blood supply for medical rescue during the Wenchuan Earthquake, the Ministry of Health of China, with great efforts, continues to investigate and reflect upon the application of the above principals during actual practice. Objectively, these efforts will lead to better results and establish a standard supplying blood during a disaster rescue.
After Wenchuan earthquake on May 12, West China Medical School/ West China Hospital of Sichuan University organized a youth volunteer team for earthquake rescue and relief. A volunteer network was formed and relevant service regulations were formulated immediately. Volunteers have played an important role in post-earthquake evacuation of patients, emergency reception, ward care, on-call service, a service to help people find family members, telecommunications and some other major tasks.
Objective To summarize the experience of epidemic prevention in order to offer the first-hand data for reconstruction after the earthquake and epidemic control and prevention in the active seismic zone. Method We collected and analyzed the data of epidemic control and prevention and summarized their strengths and weaknesses. Results Of the 13 counties in Aba Prefecture, 12 were affl icted with 2 worst-hit counties and 5 worse-hit disaster areas. A total of 20 233 people were dead and 7 873 people were missing. Health system was severely damaged. Aba Center of Disease Control and Prevention started the contingency plan and sent 4 epidemic prevention teams to the disaster areas. With the combination of local materials and external aids, the epidemic prevention network of county, township and village was established. (1) Environment cleaning and el imination: up to August 27, 2008, 2 591 group times of teams involving 88 298 person times and 5 294 set times of vehicles were allocated. Disinfection area covered 18 181.3 m2 including 14 132 dumps, 33 271 cesspits and 154 391 breeding grounds of mosquitoes, fl ies and mice. (2) Critical supervision for the safety of drinking water and food: up to June 20, 21 central ized and 1 032 dispersed water supply sources were restored. We monitored 829 drinking water samples, among which 594 were qual ified with the qual ified rate of 66.59%. (3) A total of 86 396 people were resettled in 17 temporary sites. (4) Wild dogs were killed in Kala-azar epidemic areas. Mosquitoes, flies and mice were supervised once a week. (5) Disease supervision: A total of 762 cases in 15 legal infectious diseases were found within 90 days after the earthquake, and no death was found. No outbreak of infectious epidemic situations and burst publ ic health events was reported. A total of 57 157 Hepatitis A vaccinations were inoculated in the children aged from 18 months to 12 years old and 16 268 in children aged from 13 to 16 years old, medical staff, mil itary personnel and first-l ine workers. A total of 4 435 Japanese encephal itis vaccinations were inoculated in people in Xiaojin county. On June 15, routine inoculation cl inic recovered and on July 1, expansive inoculation was started on schedule. Conclusion Phased victory is gained in epidemic control and prevention in Aba Prefecture, although it is only a latter-wit. It is suggested that a long-term system of the earthquake disaster as well as human and environmental protection should be reconsidered through the first-hand data of anti-epidemic measures of the Wenchuan earthquake.
This article introduces the measures that the scientific research base of West China Hospital has taken in its emergent response to the unexpected huge Wenchuan earthquake disaster, including safe evacuation, safety examination and removal of hidden dangers, damage reporting and a series of subsequent measures.
Objective To analyze the outcome of patients with Blunt Abdominal Injury (BAI) in the Deyang People’s Hospital after the Wenchuan Earthquake, in order to provide evidence for future improvement in emergency response after earthquakes and in the treatment of BAI patients. Methods Data on the BAI patients within 1 week after the earthquake were collected from the Information Department of the Hospital. Microsoft EXCEL was used for data input. Results A total of 23 BAI inpatients were treated, of whom 15 were from Mianzhu City and sent to hospital within 12 hours of the earthquake. This was 1.9% of the total inpatients. The BAI inpatients suffered severe and complex injuries, and 5 of them died (mortality rate: 22%). Linenectomy was conducted for patients with spleen injuries and two inpatients developed incision infection due to lack of antibiotics during the perioperative period. Conclusions It is important to establish an emergency response mechanism for medical rescue for patients with the viscera injury, including BAI, after an earthquake. This would help to guarantee rational allocation of the rescue workers, triage of the wounded, optimization of operation, as well as a reduction in mortality from BAI.
Objective To find effective ways for controlling the hospital infection to the skeptical gas gangrene patients. Method From May 14th to June 24th, the hospital set up triage spots originally and dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded. Owing to correctly treating the wound and screening the skeptical gas gangrene patients, preventing nosocomial infections was shifted forward. Sprending the gas gangrene wound after having flushed it with 3% H2O2. If the wound have been stitched, the stitches should bee taken out, and open the wound and take the debridement for it completely, then treat it with b antibacterial after debridement by sterilization and isolation about operation of gas gangrene. Result Up to June 24th, none of 67 cases of doubtful gas gangrene from the disaster area died and no hospital cross infections happened in courtyard. At present, amomg the 67 cases, 32 were highly suspected of gas gangrene infection, 26 cases were discharged, while 6 cases were undergoing treatment in the hospital. Conclusion Correct management and appropriate treatment are effective ways for controlling hospital cross infection to the skeptical gas gangrene patients.
Objective To explore the structure and influencing factors of overall medical treatment expenses of 1 635 inpatients of Wenchuan earthquake in West China Hospital and to provide references for setting up the criteria of medical expenses and for assess the cost-effect of medical rescue and treatment. Methods The data of earthquake casualties were collected to analyze the constitution and influencing factors of the overall medical expense by SPSS 13.0 software. The data were described by X±SD. Comparison of data categories was tested by rank sum and influencing factors were analyzed by multi ple l inear regression analysis. Results A total of 1 635 casualties including 1 413 (86.04%) earthquake wounded and 222 (13.96%) patients from the disaster area were identified. The average expense per capita was 9 165.05±12 426.11 yuan. The overall cost was made up of operation expenses (71.75%) including material cost, examination fee and treatment fee, drug cost (18.41%) as well as bed fee and others (less than 10%). The cost of patients from the disaster area was higher than that of the earthquake wounded (Z= –4.109, P=0.000). The operation, compl ications, multiple-site damages, injures induced by the secondary disaster of the earthquake such as burn and corrosion were the direct reason leading to the high overall expense. The influencing factors included operation (r=0.386), ICU (r=0.336) and the day of hospital ization (r=0.246). Conclusion The earthquake wounded occupy the predominant percentage of the earthquake inpatients in West China Hospital. The operation, compl ications, multiple-site damages and injures induced by the secondary disaster of the earthquake lead to a high overall expense. The influencing factors include operation, ICU and the day of hospital ization. The relationship between the expense and the disease category largely depends on the classification criteria. The relationship between the expense and the age as well as the prognosis needs further study. But no correlation between the expense and the gender is found.
Objective To investigate the curative effect of facility negative pressure closed drainage on wounds in earthquake. Methods We retrospectively analyzed the data of 35 patients treated by facility negative pressure closed drainage after debridement in earthquake. The same category patients treated by conventional therapy as the control group. Results Time of facility negative pressure closed drainage was 6-12 days, average 7.5±1.8 days. The woundswere all cured. The wounds closure were performed with skin grafting in 24, with secondary suturing in 4, with regionalflap transposition in 5, and with cross leg flap in 2. There were significant differences in time of secondary closure, timesof dressing and the total time of hospitalization between two groups (Plt;0.01). And there was a significant difference incurative effect of skin grafting between two groups (Plt;0.05). Conclusion Facility negative pressure closed drainage on treating wounds in earthquake is a simple, safe method, and has significant curative effect.
ObjectiveTo carry out an investigation on the life quality of amputees in the “5·12” Wenchuan earthquake before and after rehabilitation of one year (short term), three year (intermediate term) and five year (long term) and find out the best program of recovery. MethodsIn September 2008, 52 patients who were treated in the higher-level hospital and came back to the Second People’s Hospital of Mianzhu City for rehabilitation were divided into two groups: group A and B with 26 patients in each. Phased rehabilitation program was adopted for group A while traditional program was chosen for patients in group B. “The Personal Information Table of Amputees of Deyang City” and The Life Quality Measurement Table of World Health Organization were chosen as the research tools before the program and one year, three years and five years after the program. ResultScores of the life quality of both groups showed a general rising tendency, while group A was higher than group B in each single phase, especially in the longterm one. For positive feeling, group A got a score of 193.0±12.3 and group B got 126.0±11.2; for ability to work, group A had a score of 62.0±5.2 and group B had 41.0±2.3; for life satisfaction, group A achieved 150.0±2.1 and group B achieved 101.0±6.2; for ability of action, the score of group A was 17.0±2.6 and group B was 11.0±5.2. The differences were statistically significant (P ＜ 0.05) . ConclusionCompared with conventional rehabilitation program, phased rehabilitation program can better enhance and consolidate the amputees’ quality of life and promote their returning to family and society, which can make up for the deficiency of the existing rehabilitation programs and is worth popularization and application.
This article introduces the information release and news reports related to the medical rescue in West China Hospital after Wenchuan earthquake, in terms of organization and management of internal and external propaganda, as well as how to organize and optimize volunteers’ involvement in news report. A total of more than 500 medias and over 2000 journalists have been received, 439 items of information have been released, 6675 photos covering 159 topics and 30-hour video records covering 100 topics have been collected. In addition, 5-hour video records and over 1000 photos have been provided to more than 20 medical teams or individual from other provinces.