Within 4 weeks after Lushan earthquake, 400 person-times were rescued in the West China Hospital of Sichuan University. There were 325 hospitalized victims, 238 surgeries including 202 orthopedic surgeries, 28 critical victims, and 1 severe victim. In order to avoid and reduce the complications, minimize disability, and recover in the early stage, a set of early rehabilitation nursing process was established by the department of rehabilitation of the West China Hospital since the 28th hour after the earthquake: set up the emergency teams for early rehabilitation nursing, and clarify the responsibilities of each team; select the technicians of early rehabilitation nursing, and perform scientific management; build the information platform for early rehabilitation nursing, and make information unobstructed; strengthen the cooperation with professional and social organizations. This nursing mode helps the victims get rehabilitation care and treatment timely and efficiently. Up to the 4 weeks after earthquake, 178 person-times recover, accounted for 44.5%; and the records of 69 victims in Wenjiang branch of the hospital show zero death after orthopedic surgery.
In recent years，West China Hospital of Sichuan University actively participated in medical assistance and rescue in Wenchuan，Yushu and Lushan earthquakes. However，professional roles of cardiovascular surgeons in medical assistance and rescue in earthquakes remain unclear because of the particularity of cardiovascular surgery, which often affects the assembly of medical assistance and rescue teams. Thus，we need to explore the necessity for cardiovascular surgeons to join medical rescue teams within 72 hours after earthquake. In this article，medical rescue work of cardiovascular surgeons within 72 hours after 2008 “5?12” Wenchuan earthquake and 2013 “4?20” Lushan earthquake is analyzed and compared to identify professional roles of cardiovascular surgeons in medical rescue within 72 hours after earthquake. It is necessary for cardiovascular surgeons to join medical rescue teams within 72 hours after earthquake.
Objective To analyze the costs of emergency medication in the West China Hospital within one month after Lushan earthquake based on actual medication of the victims’ disease spectrum. Methods We collected emergency medication data as evaluation index in the West China Hospital within one month after Lushan earthquake, including daily cost, cumulative percentage of pharmacology category, average cost per day/person, average cost per day/person when DUI=1, difference between average cost per day /person, and average cost per day/person when DUI=1, etc. Then, we input data using Excel software for statistically analyzing the costs of emergency medication within one month after the earthquake. Results During one month after the earthquake, the costs changed consistently with the number of victims, which implied the change of costs was rational. Injuries were classified into 6 categories and 12 kinds according to ICD-10. The costs of medication accounted for 71% of the total costs. Six kinds of illness accounted for 21%. Medication for injuries was classified into 3 categories and 18 kinds; average cost per day was 186.87 yuan and average cost per person was 1 702.70 yuan. Medication for illness was classified into 5 categories and 28 kinds; average cost per day was 38.96 yuan and average cost per person was 185.13 yuan. The mean value of average cost per day/person of injection was 14.52/5.08 times more than that of non-injection. Meanwhile, the mean value of average cost per day/person of imported medication was 7.10/5.28 times more than that of domestic medication. Conclusion The factors that impact the medication costs include: a) disease burden and traumatic conditions of the sick and wound; b) administration pathway (injection vs. non-injection); c) imported or domestic medication; and d) the rationality of taking DUI as evaluation index. When DUIgt;1, injection through the vein and imported medication take a larger share which increase the costs of medication. Emergency rescue package should mainly prepare for the injury. In order to ensure the timely, safe and effective medication, injection should be given priority to. We also should take into consideration crash-resistance/anti-quake package, reasonable dosage, convenience-to-use of drugs as well as the needs of the illness.
Objective To report the screening, prevention and treatment of venous thrombosis for Lushan earthquake victims in the West China Hospital of Sichuan University. Methods Among the Lushan earthquake victims screened by vascular color Doppler, those with detected venous thrombosis were treated reasonably, and those without detected venous thrombosis were prevented early. Results There were total 235 Lushan earthquake victims in the hospital as of the 11th day after earthquake, and they were screened by vascular color Doppler. Among 26 cases with detected venous thrombosis, 25 were lower limb venous thrombosis, and the other one was upper limb venous thrombosis. Three cases were treated by rehabilitation intervention alone, three cases were treated by drug intervention alone, and the other 20 cases were treated by both rehabilitation and drug intervention. As of 30 days after the earthquake, the reexamination results of 26 victims with venous thrombosis showed that: 11 cases improved, including 5 completely recanalization and 6 incompletely recanalization. Among the three cases with drug intervention alone, one got completely recanalization, accounted for 33.33%. Among the three cases with rehabilitation intervention alone, one got incompletely recanalization, accounted for 33.33%. Among the 20 cases with both rehabilitation and drug intervention, four got completely recanalization, accounted for 20.0%, and five got incompletely recanalization, accounted for 25.0%. Conclusion Most Lushan earthquake victims with venous thrombosis are the elderly and women, stay in the ICU, and suffer from fractures in different degrees. The timely prevention and treatment can relieve local pain, promote early entry in the rehabilitation treatment, and prevent pulmonary embolism and other risks. The rehabilitation intervention and/or drug intervention should be adopted to the victims with detected venous thrombosis as well as the victims without detected venous thrombosis but have high risk factors, for it can effectively prevent and treat the further thrombosis and other bad consequences of the detachment of thrombus.
Objective To evaluate the performance of emergency medical rescue (EMR) within 1 month after Lushan earthquake, and to prove and enrich the experience from Wenchuan earthquake, so as to provide useful references for global earthquake EMR with regard to decreasing death and disability rates. Methods All the following date published within 1 month after 4.20 Lushan earthquake were collected and analyzed, including official information, public documents, news release, relevant information from websites and victims’ medical records in the West China Hospital, then the relevant domestic and foreign literature about EMR (including EMR of Wenchuan earthquake). And then comparative analysis was conducted to evaluate the performance of EMR in Lushan earthquake. Results a) Being 87 km apart from each other, the main seismic zones of Lushan and Wenchuan located in the south west and middle north of Longmenshan fault zone, respectively. Although only 1 earthquake magnitude differed between them, the disaster area, and the number of affected population, deaths, disappearances, injured, severe injured and migration population in Wenchuan earthquake were 40, 23, 353, 853, 27, 14 and 51 times higher than those in Lushan earthquake, respectively. b) Learned from Wenchuan experience, the manpower scheduling in Lushan earthquake was quicker: the assembled medical personnel peak of Lushan vs. Wenchuan was 87.62% vs. 56.06 % in golden 72 hours post-quake. c) Supplies scheduling was more rational: the utilization rate was higher under the guidance of accurate information of demand. d) Medical treatment was more rational and efficient: the critical injured were treated following “Four concentration treatment principles”; saving life and restoring function at the same time; treatment and physical-mental rehabilitation at the same time; treatment and evidence production and implementation at the same time. e) Medical institutions and service returned to normal in time: 96.7% (440/455) of government owned township medical institutions in 21 affected towns returned to normal and provided medical services at their original sites. Conclusion By learning form Wenchuan experience, the following performance is implemented in Lushan earthquake: medical rescue guided by the accurate information; supplies scheduling guided by the accurate demand; both critical injured treatment,and physical-mental rehabilitation guided by the accurate assessment of injuries. So the medical rescue within 1 month after Lushan earthquake is quicker, more rational and efficient. After 20 days post quake zero death of critical injured was achieved. The early physical-mental rehabilitation fastens the functional reconstruction of the injured and helps them return to the society. So it suggests that the Lushan EMR enriches and develops the reference value of EMR experience of Wenchuan earthquake.
Objective To comparatively analyze the rationality of emergency medication after Wenchuan earthquake with that after Lushan earthquake in West China Hospital of Sichuan University, based on the use of medicine of the victim’s disease spectrum. Method By using Excel, defined daily dose system (DDDs) and drug utilization index (DUI) were used as the evaluation indexes to analyze the rationality of emergency medication in West China Hospital of Sichuan University within one month after Wenchuan earthquake and Lushan earthquake. Results Within one month after Wenchuan and Lushan earthquake, there were 1 839 and 488 victims treated in the hospital, respectively. Within one month after the two earthquakes, the variation tendency of DDDs of drugs and number of victims was consistent, and the consistency was better in Lushan earthquake than that in Wenchuan earthquake. Among the 60 drugs which DDDs were ranked top five in their pharmacological class (top ten for antimicrobials) in Wenchuan earthquake, the majority of them were injections (injections vs. non-injections: 70.0% vs. 30.0%); the results showed that the medication (DUI=1) only accounted for 10.0%, the medication (DUI<1) accounted for 28.3%, which implied that the use of drugs was insufficient, the medication (DUI>1) accounted for 61.7%, which implied that drugs were overused; the average of DUI was 1.61. And in Lushan earthquake, injections also accounted for a larger proportion than non-injections (63.3%vs. 36.7%); the results showed that the medication (DUI=1) accounted for 15.0%, the medication (DUI<1) accounted for 38.3%, the medication (DUI>1) accounted for 46.7%; the average of DUI was 1.30. Conclusions Base on the DUI, we draw the conclusion that the rationality of emergency drug use and the timeliness of emergency drug supply were better in Lushan earthquake than those in Wenchuan earthquake. But the rationality of using the DUI, which is an evaluation index for normal conditions, to evaluate the emergency conditions still needs to be further verified.
Objective To investigate the injury characteristics of 33 children of Lushan earthquake victims no more than 14 years old treated in the West China Hospital of Sichuan University, and to put forward the early rehabilitation strategy. Methods A total of 33 earthquake children victims were investigated with the modified barthel index score (MBI) and analyzed in following aspects: age, causes, and injury. Results a) The 33 children victims accounted for 10.28% of the total earthquake victims treated in the hospital, they were all no more than 14 years old, and the average age was 7.24 years old. 17 cases were fractures of trunk and limbs, six were traumatic brain injury, and four were soft tissue injury. b) The main traumatic causes were crush by falling objects and heavy stuffs; and some children rarely suffered from hurt, burn and fall injury when running. c) Most children victims were simple open injuries and fractures, especially the limbs fractures accounted for 51.51% of the total cases, and there was only one case suffered from abdominal organ injuries. d) Among 33 children victims, 30 (90.9%) were from the towns and villages. They mainly got injured by the collapse of house or courtyard walls which were not as ber as the house in the cities, so the incidence of severe injury was lower, the degree of injury was milder, and the injury of major organ was rarer. Conclusion Early rehabilitation treatment is helpful to prevent the complications and early recover the functions. It suggests the early rehabilitation treatment should be carried out for the earthquake children victims in order to promote the fracture healing and functional recovery, as well as to prevent the complications. In addition, attention should also be paid to the psychological problems while concerning rehabilitation training.
A 7.0 Ms earthquake hit Lushan country at Ya’an city of Sichuan province at 8:02 am, on April 20th, 2013. Rehabilitation medicine department of the West China Hospital, a regional state-level hospital arrived at stricken area, and super early rehabilitation rescue was organized at the second day after Lushan earthquake. On the third day after Lushan earthquake, patients receiving super early rehabilitation intervention were moved forward to orthopedics, neurosurgery, thoracic surgery, pediatric surgery and ICU for super early rehabilitation intervention. Up to 6 pm, 14 days after the earthquake, 69 wounded in total were admitted in early rehabilitation. The experiences of Wenchuan earthquake has been applied, improved and sublimated more rapidly, more appropriately, more effectively in the Lushan earthquake rehabilitation rescue.
Lu-shan earthquake occurred at 8:02 am, on April 20th, 2013. The epicenter of earthquake was located in Lu-shan county, Ya’an city, Sichuan province, about 100 km from Chengdu along the Longmenshan fault zone in the same province heavily impacted by the 2008 Wenchuan earthquake. The earthquake has resulted in 196 people dead, 24 missing, at least 11,470 injured as of 14:30, April 24th, 2013. After Lu-shan earthquake, medical rescue teams were dispatched from the West China Hospital, Sichuan University to the stricken area. This article written by a member of the rescue team reported the difficult and dangerous rescue work and the performance of rescue members in the stricken area.
Objective To assess the impact of earthquake magnitude scale on injury characteristics of patients admitted to an earthquake rescue hospital，and provide references for rescue strategy formulation and medical resourceallocation. Methods We retrospectively analyzed clinical data of patients injured in 2008 “5 ? 12” Wenchuan earthquakeand 2013 “4 ? 20” Lushan earthquake who were admitted to West China Hospital of Sichuan University. Patient gender，age，time of admission，mechanisms，types and severity of injury and their prognosis were compared between the 2 groups.Results A total of 1 856 patients who were injured in Wenchuan earthquake，including 974 male and 882 female patients with their age of 45.8±22.7 years，and 316 patients who were injured in Lushan earthquake，including 174 male and 142 female patients with their age of 43.0±23.1 years，were enrolled in our study. No significant difference was found in genderor age between these 2 groups （P＞0.05）. Peak time of admission of Wenchuan earthquake patients was significantlylater than that of Lushan earthquake patients，and transfer duration of Wenchuan earthquake patients was significantly longerthan that of Lushan earthquake patients. The percentage of patients with crash injury of heavy objects or buried trauma ofWenchuan earthquake patients was significantly higher than that of Lushan earthquake patients. Injury severity and in-hospitalmortality of Wenchuan earthquake patients were significantly higher than those of Lushan earthquake patients. The proportionof patients with chest or cerebral injury of Lushan earthquake patients was significantly higher than that of Wenchuanearthquake patients. Conclusions Earthquake magnitude scale has a significant influence on mechanisms，types andseverity of injury of patients injured in earthquakes，as well as their timely transfer，management and prognosis. In earthquakeswith a comparatively lower magnitude scale，more thoracic surgeons and neurosurgeons are needed to ensure timelymanagement for patients with chest or cerebral injury.