Shortly after Wenchuan earthquake, the administrative leaders of West China Hospital accurately defined the role of the hospital during the medical rescue work as the treatment center for the seriously wounded, the supporting center for the local hospitals/clinics of the disaster areas, and the logistic supporting center for medical teams from other provinces. Integrated leadership of management and with efficient multi-department coordination and cooperation were emphasized. The mode of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of resources were ensured to meet the ever-changing demand from all levels of rescue work. Three stages were defined based on the conditions of the wounded delivered to the hospital, with different main focuses for each stage. Owing to the multi-disciplinary cooperation and concerted efforts of a large number of experts from other provinces or even other countries, effective and efficient medical rescue service has been offered to all the wounded. Up to June 2nd, 2?618 cases from the disaster area have been treated, of whom 1 751 admitted into the inpatient department, 1 135 seriously wounded, 127 admitted into the Intensive Care Unit, 1 239 underwent operations and 77 treated with hemodialysis, with an inpatient mortality lower than 0.7%. Moreover, even during such a period of time, the routine medical service has been offered as regular to patients other than the wounded in the disaster.
The injuries caused by earthquake were characterized as complicated injuries, multiple injuries, crush injury, commonly accompanied by the impairment of the organs, open wound with susceptibility to contamination, difficulties in the implementation of in-time treatment, and resource-limited settings. Considering the specialty of early treatment of earthquake victims and existing misconduct, we propose recommendations according to general principles of early rationale use of antibiotics, in order to treat the earthquake victims safely, effectively and feasibly, and to decrease wound infection rates after surgery.
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.
Objective To analyze the rationality of emergency medication in the West China Hospital after Lushan earthquake based on the actual drug use of earthquake victims. Methods We applied DDDs and DUI as evaluation index, input data using Excel software, and analyzed if the emergency medication was required for the injury/illness and the rationality of emergency medication. Results Earthquake victims mainly had trauma and wound infection and they were given antibiotics as main treatment one week after the earthquake. Drugs for the respiratory system and digestive system were mainly used in patients who mainly manifested as non-traumatic diseases and internal diseases four weeks after the earthquake. Among 49 kinds of drugs which could be calculated for the value of DUI, injection accounted for a larger proportion than non-injection (59.18% vs. 40.82%). The results showed that, the medication (DUI=1) only accounted for 12.24%; the medication (DUIlt;1, Mean=0.65) accounted for 38.78%, which implied insufficient drug use; the medication (DUIgt;1, Mean=1.77) accounted for 46.94%, which implied drug overuse. Conclusion Medication for every system is basically timely and rational when treating symptoms and causes in the West China Hospital within one month after Lushan earthquake. However, the rationality of emergency medications using DUI=1 under normal conditions still needs to be further verified.
Objective To compare the medical emergency rescue systems used during earthquakes in America, Japan, Russia and China; so as to provide reference material for the establishment and improvement of such a system in China. Methods We searched the official websites of China, America, Japan and Russia, WHO.int, CNKI, OVID, The Cochrane Library and other authoritative sources to collect information involving the medical emergency rescue systems used during earthquakes. The mechanism, legal management, preventive measures and performance of each country’s medical emergency rescue system were summarized and compared. Results Crisis management, integrated action and legal support were highly emphasized in America, Japan and Russia. America and Japan have performed well in implementing routine preventive measures. The organizational structure of the medical emergency rescue system in China was similar to that of the other countries, but its performance was not satisfactory due to insufficient financial support, poor management, inefficient operational mechanism and poor preventive measures. Conclusion There is an urgent need for China to reinforce its medical emergency rescue system. Different models should be taken into account because of the different regional situations in China.
During the medical rescue of Wenchuan earthquake, on the condition of ensuring the security of producing environment and food, following the four concepts including standard production, instant cooling technology, networking management and nutrition guidance, the CPU of West China Hospital stopped the production of possibly uncontrolled food, developed a reasonable plan for materials in stock, reinforced the inspection of sources of raw materials and quality of food, adjusted styles of dishes, proviced made special food for the wounded and their relatives from different districts and nationalities, new dishes for the wounded and the medical staff, so as not only to assure the nutrition for the slightly wounded, but also to provide the individualized nutrition treatment for the severely wounded. A total of 70 077 person-times for the wounded from the disaster area (36 330 person-times for the wounded and 33 747 person-times for their family members), and 36 273 person-times for doctors and nurses have been served. Meanwhile, the food service has also been offered as regular to other patients and hospital staff, with a maximum of 18 372 person-times per day.
Shortly after Wenchuan earthquake, the leader group of the West China Second Hospital accurately defined the role of the hospital during the medical rescue work and ensured the safety of the inpatients. It cooperated with West China Hospital, going to the main battlefield to rescue the injured people, congregating the main medical resources to the disaster areas for medical rescue. The model of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of the resources were ensured to meet the ever-changing demands from all levels of rescue work. Assembling the elite, 12 medical teams and 148 medical staff in all were dispatched to Beichuan, Mianyang, Shifang and Dujiangyan as well as other severe disaster areas. Up to June 2nd, 329 patients from the disaster area had been treated, of whom 132 were admitted into the inpatient department, no one died. Moreover, even during such a period of time, the routine medical service had been offered as regular to patients other than the wounded in the disaster.
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.
During the medical rescue after Wenchuan earthquake, the Department of Appliances and Materials of West China Hospital took prompt action to ensure the regular operation of hospital devices and facilities. Meanwhile, owing to its specialized superiority of material and appliance purchase as well as the optimized processes for material and appliance supply, the hospital ensured the effective supply of disaster relief materials and efficiently managed the consumption of donated materials. From May 12 to 30, a total of 2 200 000 pieces of medical materials (total value RMB 3 770 000 Yuan) and 220 sets of medical appliance (total value RMB 9 000 000 Yuan) were purchased as part of the immediate medical rescue response to the earthquake.
Shortly after the disastrous Wenchuan earthquake, a harmonious working environment for healthcare professionals both at home and abroad has been formed in West China Hospital, under an integrated managerial framework and working model. Four foreign medical teams consisting of over 70 professionals and foreign medical materials weighing about 8 tons have been accepted. This model may provide references for the reception of foreign medical teams during the emergent medical rescue for any unexpected event in the future.