汶川地震2周2283例急診傷員分檢方案的總結與探討_《中國循證醫學雜志》

作者：

蔣耀文 ¹ , 張建成 ¹ , 鐘彥 ² , 李大江 ² , 張衛東 ² , 曾智 ³ , 王一平 ¹ ,  曹鈺 ¹

1. 四川大學華西醫院急診科（成都 610041）；2. 四川大學華西醫院醫務部；3. 四川大學華西醫院內科;

關鍵詞：

汶川地震醫療救援傷員分檢

DOI：

10.7507/1672-2531.20080163

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目的　回顧性分析四川大學華西醫院在汶川地震后采取非常規方法（傳統分檢方法結合災害救援的特點）分檢傷員的效果，為建立大型災害事件傷員分檢處理流程，及時合理配置醫療資源，提高醫療救援水平提供參考。
方法　以華西醫院在震后兩周內接診的所有地震傷員的診療信息數據為基礎，對傷員傷情嚴重程度和所需醫療干預的迫切程度進行分檢。
結果　按傷情嚴重程度和所需醫療干預的迫切程度對傷員進行分檢，使危重傷員得到了及時處理，一般傷員得到了足夠重視，輕傷員被及時分流，從而充分合理地利用了醫療資源，使各類傷員都得到了最恰當的處理。
結論　重大災害事件發生后，傷員分檢方法的選擇要因地制宜，不應局限于傳統的分檢方法。采用災害救援傷員分檢方式分檢地震后大批傷員，可使重傷員不延誤病情，輕傷員不浪費醫療資源，使有限的醫療資源得到充分合理地利用。

引用本文： 蔣耀文,張建成,鐘彥,李大江,張衛東,曾智,王一平,曹鈺. 汶川地震2周2283例急診傷員分檢方案的總結與探討. 中國循證醫學雜志, 2008, 08(9): 722-725. doi: 10.7507/1672-2531.20080163 復制

1.	Milzman DP, Boulanger BR, Rodriguez A, et al. Pre-existing disease in trauma patients: A predictor of fate independent of age and ISS. J Trauma, 1992, 32(2): 236-243.
2.	Champion HR, Sacco WJ, Hannan DS, et al. Assessment of injury severity: The triage index. Crit Care Med, 1980, 8(4): 201-208.
3.	Winkler JV, Rosen P, Alfry EJ. Prehospital use of the Glasgow Coma Scale in severe head injury. J Emerg Med, 1984, 2(1): 1-6.
4.	Meredith W, Rutledge R, Hansen AR, et al. Field triage of patients based upon the availability to follow commands: A study in 29,573 patients. J Trauma, 1995, 38(1):　129-135.
5.	Kirkpatrick JR, Youmans RL. Trauma index: An aide in evaluation of injury victims. J Trauma, 1971, 11(8): 711-714.
6.	Yoshimura N, Nakayama S, Nakagiri K, et al. Profile of chest injuries arising from the 1995 Southern Hyogo Prefecture earthquake. Chest, 1996, 110(3): 759-761.
7.	Bywaters EGL, Beal D. Crush injuries and renal function. Br Med J, 1941, 1: 427-434.
8.	Coll ins AJ, Burzstein S. Renal failure in disasters. Crit Care Clin, 1991, 7(2): 421-435.
9.	Osler T, Hales K, Baack B, et al. Trauma in the elderly. Am J Surg, 1988, 156(6): 537-543.
10.	Morris JA, MacKenzie EJ, Edelstein S. The effect of pre-existing conditions on mortality in trauma patients. JAMA, 1990, 263(14): 1942-1945.
11.	Sacco WJ, Copes WS, Bain Jr LW, et al. Effect of preinjury illness on trauma patient survival outcome. J Trauma, 1993, 35(4): 538-542.
12.	Emerman CL, Shade B, Kubincanek J. A comparison of EMT judgment and prehospital trauma triage instruments. J Trauma, 1991, 31(10): 1369-1375.
13.	Ornato J, Milnek EJ, Craren EF, et al. Ineffectiveness of the Trauma Score and the CRAMS Scale for accurately triaging patients to trauma centers. Ann Emerg Med, 1985, 14(11): 1061-1064.
14.	Benson 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).

1. Milzman DP, Boulanger BR, Rodriguez A, et al. Pre-existing disease in trauma patients: A predictor of fate independent of age and ISS. J Trauma, 1992, 32(2): 236-243.
2. Champion HR, Sacco WJ, Hannan DS, et al. Assessment of injury severity: The triage index. Crit Care Med, 1980, 8(4): 201-208.
3. Winkler JV, Rosen P, Alfry EJ. Prehospital use of the Glasgow Coma Scale in severe head injury. J Emerg Med, 1984, 2(1): 1-6.
4. Meredith W, Rutledge R, Hansen AR, et al. Field triage of patients based upon the availability to follow commands: A study in 29,573 patients. J Trauma, 1995, 38(1):　129-135.
5. Kirkpatrick JR, Youmans RL. Trauma index: An aide in evaluation of injury victims. J Trauma, 1971, 11(8): 711-714.
6. Yoshimura N, Nakayama S, Nakagiri K, et al. Profile of chest injuries arising from the 1995 Southern Hyogo Prefecture earthquake. Chest, 1996, 110(3): 759-761.
7. Bywaters EGL, Beal D. Crush injuries and renal function. Br Med J, 1941, 1: 427-434.
8. Coll ins AJ, Burzstein S. Renal failure in disasters. Crit Care Clin, 1991, 7(2): 421-435.
9. Osler T, Hales K, Baack B, et al. Trauma in the elderly. Am J Surg, 1988, 156(6): 537-543.
10. Morris JA, MacKenzie EJ, Edelstein S. The effect of pre-existing conditions on mortality in trauma patients. JAMA, 1990, 263(14): 1942-1945.
11. Sacco WJ, Copes WS, Bain Jr LW, et al. Effect of preinjury illness on trauma patient survival outcome. J Trauma, 1993, 35(4): 538-542.
12. Emerman CL, Shade B, Kubincanek J. A comparison of EMT judgment and prehospital trauma triage instruments. J Trauma, 1991, 31(10): 1369-1375.
13. Ornato J, Milnek EJ, Craren EF, et al. Ineffectiveness of the Trauma Score and the CRAMS Scale for accurately triaging patients to trauma centers. Ann Emerg Med, 1985, 14(11): 1061-1064.
14. Benson 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).

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