Objective To provide references for production and dissemination of evidence in the fields of medical emergency management, treatment, and prevention of epidemics after May 2008 Wenchuan earthquake by systematically reviewing, analyzing, and comparing quake related papers in medical journals. Methods We systematically searched MEDLINE and CBM (Chinese Biomedical Literature) databases (range: from inception to Sept. 2009). Quake related papers were imported into EndNote software, checked for duplication, and categorized by predefined standards. Descriptive statistical analysis was performed by SPSS 13.0. Results There were relatively fewer quake related articles globally before the occurrence of the Wenchuan earthquake, and the quantity of papers in MEDLINE was four times than that in CBM. In contrast, the quantity of Chinese quake articles increased rapidly after Wenchuan earthquake, peaking in Aug. 2008 at 6.9 times the average during the 50 years before the quake. The quake related papers in CBM appeared in 378 journals covering a diverse range of subject matter. Meanwhile, there was little change in the quantity of quake related articles in MEDLINE database. Conclusions The effort of producing and disseminating Wenchuan earthquake related medical research has been effectively organized and conducted in a scientific and timely manner, producing the largest in number of quake related medical papers in human history. It has provided first-hand guidance for disaster medical relief around the globe. We should strengthen the systematic construction of disaster medicine, and make an effort to summarize and disseminate evidence in the fields of rehabilitation, system reestablishment, and prevention of epidemics.
Objective To analyze clinical characteristics and treatment experience of 143 tibetan victims of China Yushu earthquake, so as to provide reference for emergency preparation for earthquake disasters. Methods A retrospective study from April 16th to April 22th, 2010 was designed. A total of 143 injured Tibetans (74 men, 69 women) of the magnitude 7.1 Yushu earthquake were included in this study. Data from victims was collected retrospectively as follows: age, gender, cause of injury, place and time of rescue, chief complaint, primary diagnosis, onsite treatment, transfer, psychological crisis intervention and so on. Results The 143 tibetan victims contained 67 fracture cases (4 open fracture, 63 closed fracture), 5 joint dislocation cases and 3 neural injury cases. 62 victims with fracture were treated by Tibetan-Chinese therapy combined with external fixation, 5 victims were operated with emergency surgery, 6 victims refused to the surgical debridement and suture, and no dead case reported. All patients were given 3 to 11 psychological intervention treatments. As to the aspect of the wounded transferring, 48 cases among 54 supposed evacuating victims were transferred to Xinin hospitals, and the other six refused to be transferred and kept staying in the original place for treatment. Conclusion The clinical characteristics of the tibetan victims are outstanding. The medical rescue for disaster in ethnic region should be appropriate for features of disaster areas.Both the individualized remedy and early psychological intervention are regarded as the important measures for improving the general level of earthquake medical rescue in ethnic regions.
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 structure and influencing factors of overall medical treatment expenses of 1 635 inpatients of Wenchuan earthquake in West China Hospital and to provide references for setting up the criteria of medical expenses and for assess the cost-effect of medical rescue and treatment. Methods The data of earthquake casualties were collected to analyze the constitution and influencing factors of the overall medical expense by SPSS 13.0 software. The data were described by X±SD. Comparison of data categories was tested by rank sum and influencing factors were analyzed by multi ple l inear regression analysis. Results A total of 1 635 casualties including 1 413 (86.04%) earthquake wounded and 222 (13.96%) patients from the disaster area were identified. The average expense per capita was 9 165.05±12 426.11 yuan. The overall cost was made up of operation expenses (71.75%) including material cost, examination fee and treatment fee, drug cost (18.41%) as well as bed fee and others (less than 10%). The cost of patients from the disaster area was higher than that of the earthquake wounded (Z= –4.109, P=0.000). The operation, compl ications, multiple-site damages, injures induced by the secondary disaster of the earthquake such as burn and corrosion were the direct reason leading to the high overall expense. The influencing factors included operation (r=0.386), ICU (r=0.336) and the day of hospital ization (r=0.246). Conclusion The earthquake wounded occupy the predominant percentage of the earthquake inpatients in West China Hospital. The operation, compl ications, multiple-site damages and injures induced by the secondary disaster of the earthquake lead to a high overall expense. The influencing factors include operation, ICU and the day of hospital ization. The relationship between the expense and the disease category largely depends on the classification criteria. The relationship between the expense and the age as well as the prognosis needs further study. But no correlation between the expense and the gender is found.
To retrospectively summarize the medical rescue organization and strategy of West China Hospital medical team during the Wenchuan earthquake so as to provide reference for rescue practice in the future. We emphasize that the key point to improve the efficiency of rescue is scientifically assigning and util izing medical resource according to the demand at the actual locale of the earthquake and the characters of various stages of the earthquake .
ObjectiveTo investigate the correlation between rapid emergency medicine score (REMS) and therapeutic intervention scoring system (TISS-28) score and analyze the feasibility of assessing the nursing workload by REMS score for critically wounded earthquake victims, in order to provide reference for rapid and effective resource allocation for earthquake victims.
MethodsA retrospective analysis was carried out on 39 Lushan earthquake victims with their acute plysiology and chronic health evaluationⅡ scores higher than 25, who were directly transferred from the earthquake site to the Emergency Department of West China Hospital between April 20 and 27, 2013. Among them, there were 24 males and 15 females aged between 5 and 90 years old averaging (57.1±19.8) years. REMS score and TISS-28 score were calculated for each victim. The relationship between REMS score and TISS-28 score was analyzed by correlation analysis and curve estimation including linear model, quadratic model, composite model, growth model, logarithm model, cubic model and exponential model. Then, we tried to find out the most suitable description for the relationship between REMS score and TISS-28 score.
ResultsThe Spearman correlation coefficient between the two score systems was 0.710 and the most suitable description for the relationship between REMS score and TISS-28 score was logarithmic curve model. The formula was TISS=-5.946+4.467lnREMS.
ConclusionREMS score can be applied as a nursing workload predicting tool for critically wounded victims in Lushan earthquake and it provides a guidance for rational allocation of health resources.
Objective To analyze retrospectively the 875 procedures of earthquake related patient in West China Hospital of Sichuan University after the Wenchuan earthquake, so as to provide reference for the improvement of medical rescue for the disaster of earthquake and the establishment of state-level regional medical centers. Methods The analysis was based on the data provided by the Department of Information of the Hospital up until July 11. The software of Microsoft EXCEL was used for data input and statistical analysis. Results Up to July 11, 1 265 operations in earthquake injuries have been performed in the hospital, of which 875 were done in operating rooms. Initial peak of admission to hospital was positively correlated to peak of surgery performed, which the type of the operation was all emergency operation and most of which were amputation (43%). Second peak of surgery was 2 days delayed following admission to hospital. The type of operation mainly was elective surgeries. Most patients received second stage procedure-open reduction and internal fixation (61%). Conclusion Our hospital played a key part in rescue effort following such huge natural disaster. Our prompt response and effective leadership demonstrated our hospital’s flexibility and capability in the state-level hospital near the epicenter.
After Wenchuan earthquake, the West China Second University Hospital immediately started the preparation of emergency pharmaceutical administration. The pharmaceutical department effectively controlled the provision, purchasing, utilization and donation of medications through a double-track operation system. In this way, the medication supply was ensured for both the patients suffering from the disaster and routine patients, which guaranteed the rationality in medication and promoted the utilization of the donated drugs so that more than 80 000 drug cost was saved for the hospital.
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.
Energy interruption and infrastructure damage are the common characteristic between the snow disaster occurred in some southern provinces of China and the 5?12 Wenchuan earthquake in China in 2008. This paper summaries the effects on medical and health institutions caused by interruption of energy flow and damaged infrastructure, shares the preparation and response practices, experience, and lessons of medical disasters, and gives suggestions about how to prepare and response for medical and health institutions when energy flow is interrupted and infrastructure is damaged.
