分级整合式救治:关于汶川地震批量伤员医疗救治经验的思考
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摘要
汶川大地震发生在地形复杂的山区,导致了大量的死伤。地震医疗救治的主要矛盾是救援黄金时间内大批量伤员与医疗资源供给不足之间的矛盾。我们在此次医疗救治中的经验提示,分级整合式救治将是未来灾害医疗救治的有效组织形式。由于地震灾害发生时间和地点的不可预知性,备灾时医院应按照前方与后方医院的职责建立两套预案并进行演练。
Wenchuan earthquake occurred in a geographically complicated mountain area,resulting in a massive death and casualties.The key dilemma challenging the medical rescue was the contradiction between a large number of casualties and the shortness of medical resource supply.One of the lessons we learned from medical rescue in this disaster is that the "integral graded medical rescue" would be an ideal mode for the disaster medical rescue.Considering that when and where an earthquake would happen in the future are both unpredictable,it is better for a hospital to do the dual-role preparations at the ordinary time,one is for becoming a rare hospital,the other is for becoming a frontline hospital.
Wenchuan earthquake occurred in a geographically complicated mountain area,resulting in a massive death and casualties.The key dilemma challenging the medical rescue was the contradiction between a large number of casualties and the shortness of medical resource supply.One of the lessons we learned from medical rescue in this disaster is that the "integral graded medical rescue" would be an ideal mode for the disaster medical rescue.Considering that when and where an earthquake would happen in the future are both unpredictable,it is better for a hospital to do the dual-role preparations at the ordinary time,one is for becoming a rare hospital,the other is for becoming a frontline hospital.
引文
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[2]Schwartz DGA,Ashkenasi I.Prehospital care of tsunamivictims in Thailand:description and analysis[J].PrehospDisaster Med,2006,21(3):7.
[3]Lerner EB,Schwartz RB,Coule PL,et al.Mass casualty tri-age:universal versus specific reply[J].Disaster Med PubHealth Preparedness,2009,3(2):72.
[4]Nestor P.Baron dominique jean larrey 1766-1842[J].JEPHC,2003,1(3):7.
[5]Weinerman ER,Edwards HR.'Triage'system shows promisein management of emergency department load[J].Hospi-tals,1964,38:55-62.
[6]列本蒂施,斯托尔茨,王衍发.军事医学若干问题[M].北京:解放军出版.1984:6.
[7]Baker MS.Creating order from chaos:part I:triage,initialcare,and tactical considerations in mass casualty and disas-ter response[J].Milit Med,2007,172(3):232-236.
[8]温世浩,周亚平,戴阳.灾害现场救援大批伤员分类的方法[J].灾害学,2007,22(2):2.
[9]Bmkks CH.Disaster triage:start,then save a new method ofdynamic triage for victims of a catastrophic earthquake[J].Prehosp Disaster Med,1996,11(2):117-124.
[10]Swjnmf EA.Precise formulation and evidence-based ap-plication of resource-constrained triage[J].Acad EmergMed,2005,12(8):759.
[11]Shi YK,Wang LL,Lin YD,et al.Challenges for rear hos-pital care of Wenchuan Earthquake casualties:experiencefrom West China Hospital[J].Chin J Traumatol,2010,13(3):131-136.
[12]Oster NS.Disaster medicine[J].Mount Sinai J Med,1997,64(4-5):323-328.
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