After the May 12th Wenchuan earthquake, the Department of Architecture and Operation of West China Hospital took prompt action to examine the damage of the hospital buildings. And then experts were invited to perform a safety evaluation of all the hospital buildings. Meanwhile, a real-time monitoring system was initiated to identify any subsequent damage caused by after-shocks. In timely response to the clinical demand, potential dangers were removed so as to ensure the medical rescue work for the wounded.
Objective To discuss the mode of triage patient in Emergency Department of West China Hospital of Sichuan University after the Wenchuan earthquake and the major experience during the process. Method The patients’ severity level of injury and waiting time for medical care in Emergency Department were analyzed after earthquake in 2 weeks. Result 375 patients were triaged into the severity level and get the treatment followed the triage systems gave the highest rate of survival and lowest rate of over triage and under triage. Conclusion In the calamity of Wenchuan earthquake with large number of casualties, Emergency Department automatically shifted into disaster mode and triage victims by the irregular triage systems. In this situation, medical staff do not just triage the patients to the Emergency Department or to see a doctor, but triage the victims to the medical care immediately and efficiently. By the new triage system, the West China Hospital saves more lives in less time.
Objective To assess the acute high altitude sickness (AHAS) and its risk factors among public health emergency responders, so as to provide scientific proof for guaranteeing the safety and health of emergency rescue workers. Methods?The self-administered questionnaire aim at learning AHAS occurrence and its risk factors were distributed to 67 members from 4 teams at different altitudes selected among 35 rescue teams. The AHAS could be diagnosed by a total score of more than or equal to 5 within 3 days since arrival, as in the following detail: 1-3 score could be assigned in accordance with the following symptoms in degrees of the mild, moderate or severe, respectively: headache, nausea or vomiting, lassitude, dizziness and blurred vision, and sleep disorder; and 1 score could be assigned for each of the following symptoms: palpitation, shortness of breath, nosebleed, chest distress, diarrhea, constipation, cyanochroia of the lips, numbness in hands and feet, and dry cough. Results?A total of 54 among 67 (81%) responders completed the questionnaire, among whom 93% were males and the median age was 36 with the scope from 24 to 55, and 63% (34 respondents) developed AHAS. The univariate analysis showed that the altitude of the responders’ original residence (10 score for “lt;100 m” vs. 5.2 score for “gt;1 000 m”, P=0.005), experiences in high altitude areas (10 score for “having not” vs. 6.4 score for “having”, P=0.039), length of stay in an area over 2 000 m altitude before arrival (9.4 score for “≥3 days” vs. 5.7 score for “≤1 day”, P=0.011), luggage weight (9.8 score for “≥25 kg” vs. 5.5 score for “lt;25 kg”, P=0.002) were correlated with AHAS severity. The multivariate linear regression indicated that the lower altitude of the responders’ original residence and the short stay in an area over 2000m altitude before arrival were the factors influencing the severity of AHAS. The linear regression formulation was Y= 2.89 - 0.187 × the altitude of the responders’ original residence (pre 100m) + 2.43 × the length of stay in an area over 2000m altitude before arriving at Yushu (day). Conclusions?The past experiences and the pre-arrival preparation are critical factors of AHAS. Measures should be taken to protect the safety and health of responders dispatched to high altitude areas.
Objective To analyze the equipment and the working model of Pakistan international medical rescue team in Wenchuan earthquake in order to provide the first hand references for our medical rescue. Methods We analyzed the aim, the staff composition, the medical equipment, the logistic material and the working model of the Pakistan international medical rescue team by working with the Pakistan team, and summarized its strengths and weaknesses. Result The main aim of the Pakistan international medical rescue team is to search, rescue and treat the wounded and sick in mass casualty incident. The team consisted of 28 staffs, including 2 leaders (the executive leader was an epidemic expert, and the vise leader was an administrative officer), 6 clinical doctors, 2 nurses, 3 medical technicians, 10 field search and rescue staffs and 5 logistics staffs. The medical equipment included a field ambulance, 7 field tents and 2 marine satellite phones. The medical equipment and instruments include an X-ray table, a B-ultrasound scanner, an ECG tester, a set of surgery operation equipment and 2 sets of ICU instruments. The main medicines included antibiotics, analgesics and for trauma treatment. Narcotic drugs and surgical supplies supported 200 patients; fluid infusion and drugs were enough for 500 patients; other laboratory reagents were enough for 500 patients; oral drugs, disinfection cotton and bandages were for 3 000 patients. Logistics materials contained a set of cooking appliances, 2 sets of toilet facilities and enough rice, flour and water for the whole team for two weeks. The field tent hospital was built in one day. In the field tent hospital, 1 256 patients were treated, 14 surgeries were performed, 236 X-ray and B-ultrasound examinations as well as 314 biochemical examinations were conducted within 10 days. Conclusion With complete disciplines and rational structure, the configuration of the Pakistan team is fitful for its aim, and it balances the function of search, rescue and public health. Apart from equipment and instruments enough for 300-500 patients rescue, the team also considers both its own survival and environmental protection. The outcome would be better if they could arrive at the spot in the first week after the earthquake happened.
This paper compares emergency medical rescue experience of West China Hospital of Sichuan University in the latest three earthquakes occurred in western Sichuan, and mainly introduces the experience in organization and coordination, rescue speed, treatment of the injured, and rescue characteristics in Jiuzhaigou earthquake, which can provide reference for future earthquake emergency medical rescue.
Objective To provide reference for hospital emergency preparedness for disasters in China by summarizing the main results from articles involving hospital emergency readiness. Method We systematically searched MEDLINE (1950 to June 2008), CNKI (1980 to June 2008) and some websites. The main results of the eligible articles are described. Results A total of 85 articles were included, of which expert articles and surveys accounted for 44% and 29%, respectively. An emergency hospital plan should address the following 4 phases of disaster management: mitigation, preparation, response, and recovery. The following factors should be considered when developing hospital emergency plans: surge capacity, disaster planning, collaboration, training, drill, personnel, equipment, triage, diagnosis, treatment, decontamination, funding, individual security, logistic, psychological support, etc. Questionnaires, checklists or specific tools could be applied to evaluate such emergency plans. Conclusion Hospital emergency preparedness is essential for effective disaster relief. Hospitals should develop emergency plans for a variety of disasters, based on their local situations.
Earthquakes happened frequently and caused a lot of injuries and serious economic loss, which destroyed the ecological environment and challenged the ability and speed in human rescue, treatment, epidemic, and post-disaster reconstruction. This paper compared the medical rescue between Yushu earthquake and Wenchuan earthquake in order to summarize the experience, form the standard, and provide references for decision-making.
We systematically and retrospectively analyzed the experience and lessons from the command system, medical rescue force deployment, medical treatment, public health response for infectious disease control, and health counterpart assistance for emergency medical rescue after the 2008 earthquake in Wenchuan, Sichuan Province, China. We propose that emergency medical rescue after tremendous catastrophes in China link responses at the national, provincial, city, and county levels, to set up an effective and cooperative medical relief forces coordination system and an effective triage system and rehabilitation plan. In addition, infectious disease control should be planned and assessed more quickly, and developing vital functions of pairing-assistance as a means with Chinese characteristic. Our aim is to provide a useful reference for medical rescue after natural catastrophes worldwide, especially after earthquakes.
Objective To retrospectively analyze the rescue activities of 11 foreign medical teams during the Wenchuan earthquake in Sichuan, China, and summarize their rescue patterns and procedures to provide a reference for disaster medical treatment. Methods Statistics in the study are based on information from the Sichuan Provincial Earthquake Relief Headquarters. The authors also directly involved foreign medical teams in the data collection and statistical analysis. Results The different rescue patterns and procedures of foreign medical teams were based on specific conditions and were in strict accordance with scientific and prudent work processes. This resulted in high efficiency and effectiveness in the rescue. Conclusion Chinese medical staff could learn from foreign medical teams’ serious work attitude, patient service, and scientific working patterns.