汶川地震伤员转送方式及其物资准备分析
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摘要
目的调查分析急诊收治512汶川地震伤员来院前的各种转送方式,探讨地震医疗救援中院前转送时所需要的物资准备,为今后重大灾害性事件发生后伤员的现场转送提供借鉴。方法收集震后3周内四川大学华西医院急诊科所接收地震伤员的受伤类型和伤情等基础资料,对救护车和直升飞机转送伤员的特点进行统计分析。结果在2338名被统计的伤员中,经救护车转送来的伤员比例最大,达60.56%,其它方式(包括汽车、船、警车、消防车、步行、抬送等)次之,占25.96%,飞机占13.47%。经由救护车转送伤员中重伤以上患者的比例明显大于飞机及其它方式,而后两者差异无统计学意义(P>0.05)。结论重大灾难性事件发生后应尽快建立现场急救指挥体系,简洁快速分检伤员,根据病情轻重合理选择转送方式,并根据不同转送方式的特点配备相应足够的急救物资。
Objective To investigate the transferring methods of earthquake casualties accepted by the Department of Emergency, discuss the requirement for rescue materials in pre-hospital transference and provide information for transferring casualties after disasters in future. Methods Traumatic types and conditions of the wounded admitted by the Department of Emergency of West China Hospital within 3 weeks after Wenchuan earthquake, were collected. The characteristics of the wounded transferred by ambulances and helicopters were analyzed. Results Of the 2 338 wounded, ambulances transferred the most accounting for 60.56%, helicopter transferred 13.47%, and the other transport modes took up 25.96%. As for the macrotraumas, ambulances transferred more than helicopter and other transport mode did (P<0.05), while there was no statistical significance between helicopters and other transport modes (P>0.05). Conclusion After the disaster, a field first-aid command system should be immediately established, casualties should be triaged concisely, an appropriate transference mode should be decided according to the degree of injuries and sufficient rescue materials should be provided based on different transference modes.
Objective To investigate the transferring methods of earthquake casualties accepted by the Department of Emergency, discuss the requirement for rescue materials in pre-hospital transference and provide information for transferring casualties after disasters in future. Methods Traumatic types and conditions of the wounded admitted by the Department of Emergency of West China Hospital within 3 weeks after Wenchuan earthquake, were collected. The characteristics of the wounded transferred by ambulances and helicopters were analyzed. Results Of the 2 338 wounded, ambulances transferred the most accounting for 60.56%, helicopter transferred 13.47%, and the other transport modes took up 25.96%. As for the macrotraumas, ambulances transferred more than helicopter and other transport mode did (P<0.05), while there was no statistical significance between helicopters and other transport modes (P>0.05). Conclusion After the disaster, a field first-aid command system should be immediately established, casualties should be triaged concisely, an appropriate transference mode should be decided according to the degree of injuries and sufficient rescue materials should be provided based on different transference modes.
引文
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6Schultz CH,DiLorenzo RA,Koenig KL,et al.Disaster medical direction:a medical earthquake response curriculum.Ann Emerg Med,1991,20:470-471.abstract.
7Black JJM,Ward ME,Lockey DJ.Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom:an algorithm.Emerg Med J,2004,21:355-361.
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9Schultz CH.Conscious sedation in the emergency department.West J Med,1993,159:600-601.
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11黄丽婷,阎成美,宋斌.战伤空运后送救护特点.解放军护理杂志,2008,25:72-73.
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13徐相瑞,马晓鸥,徐功志,等.直升机飞行中舱内医疗急救的实施.中华急诊医学杂志,2002,11:208.
2Auf der Heide E,ed.Disaster response:principles of preparation and coordination.St.Louis:C.V.Mosby,1989.
3Schultz CH,Koenig KL,Noji EK.A medical disaster response to reduce immediate mortality after an earthquake.N Engl J Med,1996,334:438-444.
4Benson M,Koenig KL,Schultz CH.Disaster triage:START,then SAVE:a new method of dynamic triage for victims of a catastrophic earthquake.Prehosp Disaster Med(in press).
5Chan YF,Alagappan K,Gandhi A,et al.Disaster management following the Chi-Chi Earthquake in Taiwan.Prehosp Disast Med,2006,21(3):196–202.
6Schultz CH,DiLorenzo RA,Koenig KL,et al.Disaster medical direction:a medical earthquake response curriculum.Ann Emerg Med,1991,20:470-471.abstract.
7Black JJM,Ward ME,Lockey DJ.Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom:an algorithm.Emerg Med J,2004,21:355-361.
8Warren J,Fromm RE Jr,Orr RA,et al.Guidelines for the inter-and intrahospital transport of critically ill patients.Crit Care Med,2004Jan,32(1):256-262.
9Schultz CH.Conscious sedation in the emergency department.West J Med,1993,159:600-601.
10Chen KT,Chen WJ,Malilay J,et al.The Public Health Response to the Chi-Chi Earthquake in Taiwan,1999.Public Health Rep,2003,118(6):493-499
11黄丽婷,阎成美,宋斌.战伤空运后送救护特点.解放军护理杂志,2008,25:72-73.
12Kianoush BK,Christopher JF.The support of severe respiratory failure beyond the hospital and during transportation.Current Opinion in Critical Care,2006,12:43-49.
13徐相瑞,马晓鸥,徐功志,等.直升机飞行中舱内医疗急救的实施.中华急诊医学杂志,2002,11:208.
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