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.
During the medical rescue after Wenchuan earthquake, based on the design and implementation of the management process of blood purification equipment, we gave the top priority to those patients with post-disaster crush syndrome to ensure their hemodialytic treatment. Through strict management of blood purification technology, the outcomes of these patients have been fundamentally improved and the incidence of complications was substantially reduced. Safe and effective hemodialytic treatment have been administered to 77 patients with crush syndrome (813 case-times).
Objective To analyze data for 1950 injured patients in the People’s Hospital of Deyang City following the Wenchuan earthquake, to provide relavent evidence to inform future decision-making in relation to establishing and improving frontline hospitals in disaster areas. Methods The basic situation of the wounded inpatients and the total situation of medical rescue were analyzed with data provided by the Department of Information at the hospital from May 12th to July 12th 2008. Microsoft EXCEL was used for data input and SPSS 11.0 was used for statistical analysis. Results By July 12th, a total of 1950 injured patients and 1378 inpatients had been treated in the hospital. Most inpatients were treated during the first week after the earthquake (about 65.6%), with the number of the inpatients reaching a peak of 703 on the first day, May 12th. The majority of the wounded inpatients were from the Mianzhu, Shifang and Jingyang districts of Deyang city. The diagnosis on admission included fracture (45.9%), craniocerebral injury (20.9%) and thoracoabdominal injury (14.7%). There were 48 deaths including 30 pre-hospital deaths, 10 emergency deaths and 8 inpatient deaths. There were 441 patients who were transported and transferred to the 2nd and 3rd hospitals from the People’s Hospital of Deyang City, which was the first hospital to organize the large-scale transporting of patients in the whole province. There were 1378 inpatients from the disaster area and 726 healthcare workers were sent to the disaster area to provide medical rescue. Psychological treatment was provided to more than 5000 inpatients, inhabitants, healthcare workers and army members. Conclusion The People’s Hospital of Deyang City successfully has accomplished a difficult task as the hospital nearest to the disaster area and played an important role during emergency medical rescue.
Objective To analyze retrospectively the overall situation of medical rescue in the Third People’s Hospital of Chengdu after the Wenchuan earthquake, so as to provide references for the emergency preparedness for the disaster of earthquake. Methods The analysis was based on the data provided by the Department of Information, the Medical Record Library, the Department of Emergency, the Department of Orthopaedics and other related departments of the Hospital up to 8 a.m. of July 12. The software of Microsoft EXCEL was used for data input, and SPSS 11.5 was used for statistical analysis. Results Up to July 12, 563 cases from the disaster area had been treated in the hospital, of whom 249 were admitted into the outpatient department and 314 into the inpatient department, including 287 men and 276 women, with a median age of 42 years (28, 57) in the outpatient department and a median age of 46 years (33, 65) in the inpatient department. The inpatients’ age was older than the outpatients’s (P=0.003). Most outpatients were sent to the hospital within the first 3 days after the quake (73.50%), while less than half of the inpatients were sent to the hospital during this period of time. The wounded were mainly from Dujiangyan, Aba Prefecture and Pengzhou, which was correlated with the transportation distance, the casualty and the condition of the local hospitals. The wounded were mainly admitted into the Departments of Orthopaedics (69.3%), Neurosurgery (15.6%) and General Surgery (3.7%). The total cost in the Department of Orthopaedics was the highest, followed by the Intensive Care Unit (ICU) and the Department of Neurosurgery. However, the median cost in the ICU was the highest, followed by the Department of Neurosurgery and the Department of Nephrology. Only 9 out of the 563 patients died, including 5 outpatients and 4 inpatients, of whom 8 deaths were due to craniocerebral injury and 1 died of crush syndrome. Conclusion Based on the data, it is of vital importance to develop an emergent plan for the medical rescue after an earthquake disaster, and to strengthen the reserve of medical supplies, personnel training, scientific field triage as well as the construction of information platforms.
Objective To analyze retrospectively the overall situation of medical rescue in the First Affiliated Hospital of Guangxi Medical University after the Wenchuan earthquake, so as to provide references for the emergency preparation for the disaster of earthquake. Methods Analysis was based on the data provided by the Department of Information, the Medical Record Library, the Department of Emergency, the Department of Orthopaedics and other related departments of the hospital. The software Microsoft EXCEL was used for data management, and SPSS 13.0 was used for statistical analysis. Results From May 22 to May 26, 91 cases from the disaster area had been treated in the hospital, of which 90 were from Mianyang and 1 from Chengdu. These patients included 44 males with a median age of 38 (27, 53) years old and 47 females with a median age of 51 (33, 62) years old. Most patients were sent to the hospital within the first 10 or 11 days after the earthquake, with 86.8% hospitalized after 10 days and 22.0% after 11 days. The number of outpatients reached its peak of 37.1% of all the outpatients (33 cases) within 34 days after the earthquake. The wounded were mainly admitted into the Department of Orthopaedics, with 34.81% of the patients having lower limb fracture, 18.26% having spine fracture, and 12.59% suffering pelvis fracture. Only 2 out of the 89 patients died. One death was due to 60% burning injury and 1 died of multiple catastrophic injuries. Conclusion Based on the data, it is important to develop an emergent plan for medical rescues after an earthquake disaster and to strengthen the reserve of medical supplies, personnel training, scientific field triage and the construction of information platforms.
This article introduces the information release and news reports related to the medical rescue in West China Hospital after Wenchuan earthquake, in terms of organization and management of internal and external propaganda, as well as how to organize and optimize volunteers’ involvement in news report. A total of more than 500 medias and over 2000 journalists have been received, 439 items of information have been released, 6675 photos covering 159 topics and 30-hour video records covering 100 topics have been collected. In addition, 5-hour video records and over 1000 photos have been provided to more than 20 medical teams or individual from other provinces.
ObjectiveTo systematically evaluate the influencing factors of disaster resilience for medical rescue workers. MethodsPubMed, Cochrane Library, Web of Science, CINAHL, APA PsycInfo, EMbase, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the influencing factors of disaster resilience for medical rescue workers from inception to November 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 36 studies involving 7 974 medical rescue workers were included. The meta-analysis results showed that personal influencing factors, including active coping, rescue confidence, disaster preparedness, knowledge attainment, physical health, and exercise were positively correlated with the disaster resilience of healthcare workers. However, depression, anxiety, stress, and a history of mental illness were negatively related to the disaster resilience of medical rescue workers. Environmental and background factors, including social support, relief supplies, disaster training, economic condition, rescue experience, length of service, and technical title, were positively correlated with the disaster resilience of medical rescue workers. ConclusionCurrent evidence shows that the disaster resilience of medical rescue workers is affected by a variety of personal factors and environmental/background factors. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective?To summarize the experience of medical rescue conducted in Aba prefecture after the Wenchuan earthquake in order to provide information for similar tasks in seismo-active regions. Methods?We participated and witnessed the whole process of medical rescue through 100 days after the quake. Data regarding the medical rescue work, work mode, performance and problems were collected and analyzed. Results?Twelve counties out of the 13 counties in Aba prefecture were affected by the earthquake, including 2 most-hit counties and 5 most-hit areas. A total of 20 233 people died and 7 873 disappeared. Aba Prefectural Headquarters for Earthquake Resistance and Disaster Relief was set up and medical rescue teams were dispatched to the disaster area immediately after the quake: ① From May 12 to May 15 2008, 20 local medical teams comprising 138 healthcare professionals and 14 teams involving 428 professionals from other regions arrived at the most-hit areas. Through 7 days after the quake, medical treatment was provided for 6 285 patient-times. ② A total of 1 444 healthcare professionals participated in the medical rescue work. Through August 20, 355 579 outpatients and 7 028 inpatients were treated in the prefectural medical institutions and on-site medical centers. Of those, 6 726 were discharged, 604 were severely wounded, 20 died and 456 were transferred to other regions for further treatment. 2 703 operations were performed for the wounded and psychological treatment was provided for 4 630 person-times. Conclusion?The medical rescue work in Aba prefecture after the Wenchuan earthquake was effective and efficient. Management of human resources and medical devices should be strengthened to enhance the ability of emergency response.
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.
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.