汶川地震3周2621例急诊伤员分检流程分析
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摘要
目的探讨汶川地震发生后,根据接诊地震伤员的特点动态调整分检流程的意义与要点,为建立在大型灾害事件中的分检处理流程,及时合理配置医疗资源,启动应急预案,提高医疗救援水平提供思路。方法以华西医院在震后不同时段接收地震伤员的诊治信息数据为基本资料,分析不同时段伤员特点,对流程变化进行归纳分析。结果震后3周,华西医院共收治地震伤员2621例,伤员的伤情特点在不同时段有所改变,皮肤软组织伤和肢体骨折占总就诊量的45%,挤压伤占4.3%,气性坏疽5例,无一例院内交叉感染。结论根据急诊人数及病情的变化,急诊流程动态改变和调整有助于伤员早检早治,提高生存率和治愈率,从而提高医疗救援水平及效果。
Objective According to characteristics of the wounded, we discussed the key points of Triage Algorithm during the large scale disasters occurring. It will provide some suggestion for establishment the triage process, matching with reasonable medical resources on time and making medical care promotion. Method Analysis the data of patients sent to emergency department of West China Hospital in different periods after temblor, and make conclusion on alternation of the triage process. Result A total of 2621 wounded people have been treated in West China Hospital three weeks after earthquake. The severity of patients in a seimic disaster sent to hospital changed as time went on. The percentage of skin and soft tissue injuries and limbs fractures is 45%. The percentage of crush injury is 4.3%. There are five cases of gas gangrene and none of hospital cross-infection. Conclusion Triage the victims after earthquake dynamically increases the survival rate and decreases the mortality and overtriage rate, the key process of triage systems should be modified dynamically with characters alternation of the victims after China Wenchuan earthquake, the rescue level and effect can be made progress.
Objective According to characteristics of the wounded, we discussed the key points of Triage Algorithm during the large scale disasters occurring. It will provide some suggestion for establishment the triage process, matching with reasonable medical resources on time and making medical care promotion. Method Analysis the data of patients sent to emergency department of West China Hospital in different periods after temblor, and make conclusion on alternation of the triage process. Result A total of 2621 wounded people have been treated in West China Hospital three weeks after earthquake. The severity of patients in a seimic disaster sent to hospital changed as time went on. The percentage of skin and soft tissue injuries and limbs fractures is 45%. The percentage of crush injury is 4.3%. There are five cases of gas gangrene and none of hospital cross-infection. Conclusion Triage the victims after earthquake dynamically increases the survival rate and decreases the mortality and overtriage rate, the key process of triage systems should be modified dynamically with characters alternation of the victims after China Wenchuan earthquake, the rescue level and effect can be made progress.
引文
1李向晖.赴国外紧急医疗救援工作流程的初步探讨.中国急救医学,2007,7(27):7.
2刘少忠,王守安,张北和.尚义地区抗震救灾卫勤保障工作的难点与对策.国防卫生论坛,1998,7(22):8.
3Chan YF,Alagappan K.Disaster management following the Chi-Chi earthquake in Taiwan.Prehosp Disaster Med,2006,21(3):196-202.
4Schultz CH,Koenig KL,Noji EK.A medical disaster response to reduce immediate mortality after an earthquake.N Engl J Med,1996,334(7):438-444.
5Sever MS,Vanholder R,Lameire N.Management of crush-related injuries after disasters.N Engl J Med,2006,354(10):1052-1063.
6Vanholder R,Sever MS,Erek E,et al.Acute renal failure related to crush syndrome:towards an era of seismo-nephrology.Nephrol Dial Transplant,2000,15(10):1517-1521.
2刘少忠,王守安,张北和.尚义地区抗震救灾卫勤保障工作的难点与对策.国防卫生论坛,1998,7(22):8.
3Chan YF,Alagappan K.Disaster management following the Chi-Chi earthquake in Taiwan.Prehosp Disaster Med,2006,21(3):196-202.
4Schultz CH,Koenig KL,Noji EK.A medical disaster response to reduce immediate mortality after an earthquake.N Engl J Med,1996,334(7):438-444.
5Sever MS,Vanholder R,Lameire N.Management of crush-related injuries after disasters.N Engl J Med,2006,354(10):1052-1063.
6Vanholder R,Sever MS,Erek E,et al.Acute renal failure related to crush syndrome:towards an era of seismo-nephrology.Nephrol Dial Transplant,2000,15(10):1517-1521.
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