摘要:目的: 了解綿竹市社區衛生服務系統震后現狀,同時分析社區醫療震后居民滿意度和社區衛生服務機構震后災害干預能力,以期為社區衛生服務體系地震應急恢復和重建提供參考意見。 方法 :采用隨機抽樣的方法,抽取綿竹市劍南社區衛生服務中心和天河社區衛生服務中心進行訪談,采取方便抽樣的方法,抽取24‰的綿竹城區居民采用面對面訪談的方式用自制問卷進行調查,并用Epidata30 進行數據錄入、SPSS130進行統計分析。 結果 :共發放問卷240份,收回有效問卷229份(有效回收率954%)。當地社區衛生服務系統在地震中受損嚴重。社區衛生服務系統災后工作居民滿意度為454%,社區衛生服務機構對居民進行抗災/防災知識教育的比例為336%,災后是否有持續而足夠的常見病藥品供應及是否有持續而足夠的慢性病藥品供應是影響當地居民對當地社區衛生服務體系災害應急工作的滿意度的影響因素(P 值分別是0033,0001)。 結論 :震后社區衛生服務居民滿意度較低,服務體系地震災害干預能力不足。居民在在災前接受抗災教育的比例較低,加強藥品儲備能提高社區衛生機構災害應急工作的效果。在社區衛生服務體系重建的過程中,應注重社區醫療基礎工作的恢復,基礎設施的重建和健全社區急救體系。Abstract: Objective: To investigate the reality of community health service system after earthquake in Mianzhu, the satisfaction of community residents to the community health service as well as the postdisaster emergency response capability of community hospital in order to provide decisionmaking suggestions on better reconstruction of community health service system. Methods : Jiannan and Tianhe community hospital were randomly selected for visiting and 24‰ of community residents in the city zone of Mianzhu were selected by convenience sampling for a facetoface interview using a questionnaire. Data entry and statistically analysis were completed by Epidata30 and SPSS130 respectively. Results :A total of 240 questionnaires were conducted to facetoface interviews, and 229 questionnaires were returned (response rate 954%).The community health service system was badly injured. Residents’ satisfactory degree of the community health service after earthquake was 454%. The proportions of disaster / disaster prevention education was 336%,medicine supply for familiar diseases and the chronic were the main factors which influenced judgements of residents to the emergency response capabilities of community hospitals(〖WTBX〗P =0033,P=0001,respectively). Conclusion :The community health services after earthquake had not been widely satisfied and the emergency response capability of community hospital was far from enough. The proportions of disaster / disaster prevention education were far from enough. The effectiveness of emergency response work of community hospitals can be enhanced by reinforcing medicine preparation.In the course of the reconstruction, community health service system should pay attention to the resumance of basic community health service,reconstruction of basic establishment and construction of firstaid system.
The Wenchuan Earthquake caused severe injuries and deaths as well as subsequent serious potential risks to public health and hygiene in the worst-hit areas. There were 16 casualties in the Mianyang CDC system and the township amp; county CDC networks were destroyed in the worst-hit counties after the earthquake. The Mianyang CDC quickly launched its emergency response plan for major natural disasters within two hours after the earthquake, prepared and improved the technical guide for disease prevention after the earthquake and rapidly sent out quick response team. With the help of CDC aid teams across the country, Mianyang CDC successfully disinfected and buried 6,767,568 corpses, and disposed of millions of animal carcasses.They also disinfected and sterilised an area of 932.595 million square metres, eradicating 3,514,166 fly and mosquito breeding places and treating 5,254,228 cesspit times. By June 30, they had examined 11,092 water supply units and carried out disinfection of 319.7997 million cubic metres of drinking water. Besides, dynamic monitoring for water quality in the four worst-hit areas in Mianyang urban areas. They organised hygienic enforcement supervisors to develop food safety inspection, regulated catering services of the centralised settlements, destroyed spoiled and expired food and vegetables. The authorities prevented the masses from eating dead poultry or meat from carcasses to ensure no occurrence of food poisoning after the earthquake. Standard administration of the 170 settlements of the earthquake-afflicted people and 132 settlements of evacuated people was carried out in accordance with the rules of "Six Provisions and Four Reinforcements" and this would ensure no recurrence of public health events in the settlements. On Day 3 (May 15) after the earthquake, they established a real-time monitoring and report network of the epidemic situation after the earthquake and monitored diseases and symptoms of the people in the resettled region to ensure no occurrence of major epidemic cases. The monitoring results showed that the number of infectious disease cases was comparable to that in the previous years. Moreover, they carried out intensive vaccination with hepatitis A vaccine in children 41196 person times, stored 100,000 person oral cholera vaccine and monitoring for new sexually transmitted diseases. A total of 10.1265 million copies of publicity materials were organised printed and distributed. They developed large-scale health education and a massive patriotic health campaign by means of the media and organised the masses to engage in sanitation and hygiene as well as controlling flies, mosquitoes and rats in the temporary earthquake-proof places. Under the unified command of the Mianyang emergency response headquarters, the centers for health and epidemic control and prevention at various levels of disaster relief continued to dispose of carcasses and disinfect and bury corpses as well as monitor water quality, so as to ensure the secondary disasters could be prevented in advance.
After the Wenchuan Earthquake on May 12th, 2008, under the b leadership of the SichuanProvincial Party Committee, the People’s Government of Sichuan Province, and the Ministry of Health of the People’sRepublic of China, the Medical Security Team working at the Sichuan Provincial Headquarters for Wenchuan Earthquakeand Disaster Relief Work constructed a secure medical material distribution system through coordination and interactionamong and between regions, systems, and departments.
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.
During the medical rescue after the Wenchuan earthquake, in order to prevent hospital environmental pollution and cross infection, the nosocomial infection control committee of West China Hospital of Sichuan University immediately initiated the emergency response plan, improved the triage system, and organized multi-disciplinary infection control groups to improve the triage of the wounded and the infection control of the emergency department. At the same time, we regulated the individual behavior of healthcare professionals and took appropriate measures for personnel protection so as to ensure the safety of both the wounded and healthcare professionals.
