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 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.
ObjectiveTo analyze the cases of surgical wounded characteristics after Lushan county 7.0 earthquake for government departments to formulate relevant policies to provide references for future decision-making.
MethodsThe data of surgical wounded were collected from various hospitals in Sichuan province. Origin, operation time and the injured area were counted according to gender and operation time was counted according to origin. In the descriptive statistics the frequencies and proportions were used to describe categorical data and x±SD was used to describe quantitative data. SPSS 13.0 software was used to analyze the data.
ResultsA total of 975 cases of surgical wounded included 586 cases of male (accounting for 60.10%) and 389 cases of female (accounting for 39.90%). The average age of the surgical wounded was 40.42±20.06 years. Ya'an city had completed the largest number of surgical cases. Medical institutions completed 53.85 percent of the surgery in the first three days, 41.03 percent of the surgery from four days to seven days after the earthquake. They completed 94.88 percent of surgery in one week after the earthquake. Ya'an city was the largest city in the number of surgical cases within 3 days after the earthquake. Medical institutions directly under the province and the Ministry of Health medical institutions in Sichuan were the largest medical institutions in number of surgical cases from four days to seven days after the earthquake. The largest number of cases was wounded ankle and foot injuries, followed by the abdomen, lower back, lumbar spine and pelvis injuries, once again the knee and calf injuries, and finally the head injury.
ConclusionIn the face of natural disasters like earthquakes, the health care system should establish a reasonable and effective medical emergency response mechanisms and plans, and establish a scientific and rational triage mechanism. Multi-disciplines such as orthopedics and surgery should be ready ahead of first aid equipment and emergency medicine, so as to rationalize the allocation of medical resources, achieve maximum utilization of medical resources, reduce morbidity and mortality, and save surgical treatment time for more wounded.
Objective To explore the traumatic situation and transfer methods of the in-patients injured in Lushan Earthquake, and to provide evidence for treating injured mass in future. Methods The information of the patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital were collected by “No. 1 Military Medical Project” hospital information system and a self-edited “Questionnaire for Hospitalized Patients Injured in 4.20 Lushan Earthquake”. Results A total of 65 patients were admitted in this hospital: 63 (96.92%) patients were injured in the main shock; 28 (43.08%) patients were injured by building collapse; 23 (35.38%) patients got injured due to falls or got bruised when escaping; and 14 (21.54%) patients were accidentally injured. Rescue methods: 32 (49.23%) patients were saved by themselves; 23 (35.38%) patients were mutually helped; 10 (15.38%) patients were rescued by local non-military rescue team; 34 (52.31%) patients were rescued by military rescue teams; and 26 (44.83%) patients were transferred by air transport. Conclusion In order to cope with emergencies and major disasters (e.g. earthquake) and to treat injured mass scientifically in the future, we should set up emergency wards scientifically and reasonably, carry out education on earthquake prevention and disaster mitigation widely, reinforce self-care and mutual aid in the stricken area, quickly send rescue and medical teams, and organize training for air transportation of patients.
Baoxing airborne medical team of West China Hospital participated in the medical rescue in 2013 “4?20”Lushan earthquake. The medical team excellently fulfilled their rescue task for 1 week in the earthquake-struck areas where there was power and communication failure and lack of water and food supply. We found some experiences and problems in airbornemedical team assembly and member selection, which may provide quotable experiences for future disaster assistance and rescue teams.
Objective To analyze drug use for 23 sick and wounded hospitalized in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital, during one month after Lushan earthquake, so as to provide references for the drug use for the sick and wounded women and children. Methods Medication information was retrospectively investigated in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. We extracted data including hospitalization duration, medication prescriptions, types and costs of essential medicines, types and costs of antibiotic medicines using the HIS system. Discharge diagnosis was standardized and classified according to ICD-10. Indicators of rational drug use included defined daily dose (DDD), defined daily dose statistic (DDDs), drug utilization index (DUI), children defined daily dose (cDDD), children drug utilization index (cDUI), proportion of essential medicines, proportion of antibiotic medicines, mismatch of medicine and diagnosis, repeated drug use, improper combination of drug, incorrect usage and dosage, and frequently drug change. Medication information was evaluated and discussed by the prescription working group. Discrepency was resolved by consulting with the panel. Results A total of 23 sick and wounded women and children were assessed during one month after Lushan Earthquake. There were 13 sick and wounded children in the department of pediatrics (mainly manifested as bronchial pneumonia) and 10 sick and wounded women in the department of gynaecology and obstetrics (mainly involved in cesarean delivery). Proportions of essential medicines were 13/13 in the department of pediatrics and 9/10 in the department of gynaecology and obstetrics. Proportions of antibiotic medicines were 10/13 in the department of pediatrics and 8/10 in the department of gynaecology and obstetrics. Irrational drug use was mainly caused by improper use of antibiotics. Conclusion The drug use for 23 hospitalized sick and wounded is rational in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. Evaluation methods of rational drug use in high-risk population are urgently needed. Using cDDD and cDUI is an active exploration for the evaluation of pediatric drug use, which needs more practice to test and improve.
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 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.
Objective We evaluated effectiveness and performance of medical rescue after Lushan earthquake during 2 weeks, and enriched Wenchuan lessons to provide useful references for emergency medical rescue (EMR) after similar earthquake worldwide. Methods We collected and analyzed official information, public documents, news release, and relevant information from websites, and then we systematically reviewed and descriptively analyzed all included literature of EMR after earthquake (domestic and foreign). Results Learned from Wenchuan earthquake, EMR for Lushan earthquake were characterized as: a) Assess the situations of quake damage and injuries were scientifically assessed; human resources, funds and materials were reasonably distributed; and the EMR relied mainly on regional rescue power of Sichuan province. b) Patients’ with critical injuries were treated using “Four concentration treatment principles”, which resulted in a new medical record of zero death, 14 days after the earthquake. c) The experience of EMR after Lushan earthquake verified, enriched and improved lessons from Wenchuan, Yushu and Yiliang earthquake, which provided first-hand references of evidence-based decision making for earthquake EMR worldwide.
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.
