ObjectiveTo evaluate the effectiveness of mass vaccination campaign of hepatitis A vaccine (Hep A) and Measles-Mumps-Rubella live attenuated vaccine (MMR) vaccine in children in stricken regions of 4.20 Lushan earthquake in Sichuan province. MethodsAs the requirements of Sichuan Provincial Health Bureau, the mass campaign was implemented in Lushan county, Baoxing county and the victim settlement localities of other 6 counties during May 6th to 12th, 2013. Hep A and MMR were vaccinated, which targeted children aged from 18 months to 14 years and children aged from 8 months to 14 years, respectively. The vaccination rates were evaluated through reports and on-site rapid review of earthquake regions. ResultsAs of May 16th, 2013, 38 988 doses of Hepatitis A vaccine and 38 696 doses of MMR vaccine were vaccinated in 8 counties of Ya'an. Based on reports, the vaccination rates of Hep A and MMR vaccine of Ya'an were 99.01% and 98.87%, respectively. Based on reviews, vaccination rates of Hep A and MMR vaccine of Lushan and Baoxing were 97.40% and 97.06%, respectively. ConclusionMass vaccination campaign of Hep A and MMR in children in stricken regions of 4.20 Lushan earthquake in Sichuan province yields expected results. The mass campaign is wellorganized and implemented effectively, and the coverage matches the requirements. Timely decision, assistance from associated prefectures and the establishment of Childhood Immunization Information System play an important role in the campaign.
Objective To assess the acute high altitude sickness (AHAS) and its risk factors among public health emergency responders, so as to provide scientific proof for guaranteeing the safety and health of emergency rescue workers. Methods?The self-administered questionnaire aim at learning AHAS occurrence and its risk factors were distributed to 67 members from 4 teams at different altitudes selected among 35 rescue teams. The AHAS could be diagnosed by a total score of more than or equal to 5 within 3 days since arrival, as in the following detail: 1-3 score could be assigned in accordance with the following symptoms in degrees of the mild, moderate or severe, respectively: headache, nausea or vomiting, lassitude, dizziness and blurred vision, and sleep disorder; and 1 score could be assigned for each of the following symptoms: palpitation, shortness of breath, nosebleed, chest distress, diarrhea, constipation, cyanochroia of the lips, numbness in hands and feet, and dry cough. Results?A total of 54 among 67 (81%) responders completed the questionnaire, among whom 93% were males and the median age was 36 with the scope from 24 to 55, and 63% (34 respondents) developed AHAS. The univariate analysis showed that the altitude of the responders’ original residence (10 score for “lt;100 m” vs. 5.2 score for “gt;1 000 m”, P=0.005), experiences in high altitude areas (10 score for “having not” vs. 6.4 score for “having”, P=0.039), length of stay in an area over 2 000 m altitude before arrival (9.4 score for “≥3 days” vs. 5.7 score for “≤1 day”, P=0.011), luggage weight (9.8 score for “≥25 kg” vs. 5.5 score for “lt;25 kg”, P=0.002) were correlated with AHAS severity. The multivariate linear regression indicated that the lower altitude of the responders’ original residence and the short stay in an area over 2000m altitude before arrival were the factors influencing the severity of AHAS. The linear regression formulation was Y= 2.89 - 0.187 × the altitude of the responders’ original residence (pre 100m) + 2.43 × the length of stay in an area over 2000m altitude before arriving at Yushu (day). Conclusions?The past experiences and the pre-arrival preparation are critical factors of AHAS. Measures should be taken to protect the safety and health of responders dispatched to high altitude areas.
ObjectiveTo analyze injury sites and radiologic features of 60 patients with severe earthquake trauma in Min-Zhang earthquake in 2013. MethodsWe retrospectively collected clinical data of 60 patients with severe earthquake trauma who were sent to major hospitals in Lanzhou city within 7 days after the earthquake. The software of Excel was used to input and analyze clinical data. ResultsAmong 60 patients with severe earthquake trauma, there were 20 cases with single-site injury and 40 cases with multi-site injury, amounting to 120 injury sites. A total of 41 cases were injured in the limbs, involving 53 parts of fracture, of which, 11 cases were injured in the upper limbs (12 sites) and 34 cases in the lower limbs (41 sites). A total of 14 cases were injured in the skull (16 sites). 13 cases were injured in the spine involving a total of 14 vertebrae, 20 sites, of which, 10 cases were accompanied by injuries in the brain and spinal cord. A total of 17 cases were injured in the chest, of which 6 cases were accompanied by rib fracture, amounting to 27 sites. A total of 7 cases were accompanied by visceral injury, involving four sites of the abdomen. ConclusionMulti-site and multi-organ injuries are the most after the earthquake, of which, limb fracture is frequently-seen and abdominal injuries are rare. Imaging examination is very useful in screening injuries caused by the earthquake and in treatment based on categorization.
ObjectiveTo carry out an investigation on the life quality of amputees in the “5·12” Wenchuan earthquake before and after rehabilitation of one year (short term), three year (intermediate term) and five year (long term) and find out the best program of recovery. MethodsIn September 2008, 52 patients who were treated in the higher-level hospital and came back to the Second People’s Hospital of Mianzhu City for rehabilitation were divided into two groups: group A and B with 26 patients in each. Phased rehabilitation program was adopted for group A while traditional program was chosen for patients in group B. “The Personal Information Table of Amputees of Deyang City” and The Life Quality Measurement Table of World Health Organization were chosen as the research tools before the program and one year, three years and five years after the program. ResultScores of the life quality of both groups showed a general rising tendency, while group A was higher than group B in each single phase, especially in the longterm one. For positive feeling, group A got a score of 193.0±12.3 and group B got 126.0±11.2; for ability to work, group A had a score of 62.0±5.2 and group B had 41.0±2.3; for life satisfaction, group A achieved 150.0±2.1 and group B achieved 101.0±6.2; for ability of action, the score of group A was 17.0±2.6 and group B was 11.0±5.2. The differences were statistically significant (P ＜ 0.05) . ConclusionCompared with conventional rehabilitation program, phased rehabilitation program can better enhance and consolidate the amputees’ quality of life and promote their returning to family and society, which can make up for the deficiency of the existing rehabilitation programs and is worth popularization and application.
ObjectiveTo evaluate prehospital treatment strategies of rescuers and first-line hospitals for thoracic trauma victims after Lushan earthquake, and provide reference for making emergency response plans, staff training, and preparedness of material and human resources for future disasters. MethodsClinical data of 365 victims in Lushan '4.20' earthquake who received treatment in West China Hospital were retrospectively analyzed. Among them, 63 victims had thoracic trauma, including 40 males (63.5%)and 23 females (36.5%)with their age of 49.08±19.10 years. There were 244 victims with orthopedic trauma, including 133 males (54.5%)and 111 females (45.4%)with their age of 41.59±22.74 years. Prehospital treatment methods (including specific treatment and general treatment)were compared between thoracic trauma victims and orthopedic trauma victims. ResultsAmong all the thoracic trauma victims, 51 victims required specific pre-hospital treatment, but only 10 (19.6%)victims actually received it. Among all the orthopedic trauma victims, 220 victims required specific prehospital treatment, but actually 162 (73.6%)victims received it. The percentages of thoracic and orthopedic victims who received specific prehospital treatment were statistically different (P < 0.01). There was no statistical difference in the percentage of victims who received general treatment between thoracic and orthopedic trauma victims (P > 0.05). ConclusionsThoracic trauma victims receive less specific prehospital treatment than orthopedic trauma victims from rescuers and first-line hospitals after Lushan earthquake. More specific prehospital treatment is needed for thoracic trauma victims in disaster rescue in the future.
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.
During the medical rescue of Wenchuan earthquake, in accordance with the instruction of the Chinese Ministry of Health, West China Hospital set up the Medical Supply Center for Medical Teams from Other Provinces, put up standard storehouses within 10 hours, performed professional purchase, precisely distributed medical materials according to relevant demands, and decided the scientific route based on the distribution of medical teams from other provinces, so as to ensure the medical materials’ being delivered to the medical teams safely, promptly and accurately.
Objective To summarize our treatment experience for patients with chest injuries in “4•20” Lushan earthquake. Methods Medical records of 17 patients with chest injuries after 2013 Lushan earthquake who were admittedto the Department of Thoracic Surgery，West China Hospital were analyzed retrospectively. The diagnosis of chest injuries was mainly confirmed by medical history，physical examination，X-ray and CT scan of the chest. Clinical characteristics and treatment outcomes were analyzed. Among the 17 patients，there were 14 men and 3 women with their age of 57.3±16.1 years. Results There were 12 patients （70.6%）with crash injury of heavy objects，4 patients （23.5%） with fall injury and 1 patient with road traffic injury. Chest injuries were skin and soft tissue contusion in 17 patients （100%），rib fracturein 15 patients （88.2%） including 1 patient with abnormal respiratory movements，pulmonary contusion in 15 patients （88.2%），hemopneumothorax in 11 patients （64.7%），sternal fracture in 1 patient （5.9%） and bilateral pneumothorax with widespread subcutaneous emphysema in 1 patient （5.9%）. Thirteen patients （76.5%） had concomitant brain，abdominal，orthopedic or nerve injuries. One patient underwent left thoracotomy，clot removal and internal fixation of rib fractures for left coagulated hemothorax and left lower lobe atelectasis. All the 17 patients received timely and effective treatment and there was noin-hospital mortality. Conclusions Mechanisms of earthquake injuries are often complex，and patients often have multipleinjuries. The main types of chest injury are rib fractures and pulmonary contusion. Tube thoracostomy is a simple andeffective treatment strategy for them. Satisfactory pain management and bronchoscopy procedure can effectively help patientswith removal of respiratory secretions and maintenance of airway patency.
In the hospital where centralized treatment was applied for the victims after Yiliang earthquake (on 7th September, 2012), a holistic rehabilitation service mode which centred on supportive psychological intervention promoting was developed by the Yiliang psychological crisis intervention team designated by the National Health and Family Planning Commision of the People’s Republic of China. The pattern takes psychological nurses as liaison, bases on the integrity and continuity of medical service, roots in comprehensive health assessment and key assessment of mental trauma stress, emphasizes on solving realistic problems for patients and their caregivers, provides supportive psychological intervention, and encourages psychological nurses to offer psychological support for earthquake victims with the help of quantitative self-assessment of social psychological support service. In practice, the mode of psychological services, which could be contiuously conducted, is welcomed by hospital managers, work staff, and earthquake victims and their caregivers.
ObjectiveTo explore fibrinogen (Fbg) variety in the patients wounded in Lushan and Wenchuan earthquake. MethodsAs the research subjects, 276 Lushan earthquake victims (from April 20th to 24th, 2013) and 503 Wenchuan earthquake victims (from May 13th to 17th, 2008) were divided into five groups according to the admission date, and then the Fbg variety in those earthquake victims were analyzed. We carried out pairwise comparison among these groups in the Lushan earthquake and Wenchuan earthquake respectively on the Fbg variety. Ninety-one fracture patients in the Lushsan earthquake and 130 fracture patients in the Wenchuan earthquake were divided into two groups according to clinical diagnosis:multiple fracture and single fracture, and then we evaluated the Fbg values in patients with different degrees of disability. ResultsThe whole Fbg level[(2.70±1.15) g/L] in Lushan earthquake was below the level[(4.47±1.94) g/L] in Wenchuan earthquake, and the difference was statistically significant (P<0.01). The Fbg level in the patients whose admission date was within 48 hours was significantly different with that in patients whose admission date was more than 48 hours (P<0.01). The Fbg level in Lushan earthquake was below the level in Wenchuan earthquake, not only in the multiple fracture group but also in the single fracture group[in Lushan earthquake, the former was (2.21±0.76) g/L, and the latter was (1.98±0.85) g/L; in Wenchuan earthquake, the former was (3.35±1.48) g/L, and the latter was (3.11±1.05) g/L], and the difference was statistically significant (P<0.01). ConclusionBlood coagulation, especially Fbg level, has different degrees of changes in acute stress caused by emergency and in different treatment times, and it is better to take preventive measures.