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.
摘要:目的:探讨地震伤员中膝关节损伤的机制、类型及处理方法。 方法:对我院收入住院的2728例 5·12汶川特大地震伤员伤情特点进行分析,筛选出有膝关节损伤的病例进行分析。 结果: 膝关节损伤前三位分别是髌骨骨折(42.15%)、胫骨平台骨折(21.05%)、股骨髁骨折(13.16%),这与人们在地震时奔跑摔伤以及被房屋倒塌砸伤有很大关系。结论:地震后膝关节损伤其发病率、受伤机制、损伤类型、合并伤情况及治疗处理均有其特点,总结这些特点和规律将对地震伤膝关节损伤患者的处理产生积极作用。Abstract: Objective: To investigate the knee joint injury mechanisms, types and treatment of the earthquake wounded. Methods: Analysis the characteristics of the 2728 cases of West China Hospital from 5.12 Wenchuan earthquake wound, screen out the cases of knee joint injury. Results: Patellar fracture (42.15%),tibial plateau fracture(21.05%), femoral condyle fracture (13.16%), were the top three of knee joint injuries, which have a great relationship with falling down and (or) injured by collapsed houses when people were running in the earthquake. Conclusion: After the earthquake the knee joint damages its disease incidence rate, is injured the mechanism, the damage type, the merge wound situation and treatment processing has its characteristic, will summarize these characteristics and the rule damages patient’s processing to the earthquake wound knee joint to have the positive role.
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.
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).
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 evaluate the psychological trauma incurred by the people in wenxian after the Wenchuan earthquake so as to provide relevant information for psychological and medical interventions. Methods Thepsychological state of the people after the earthquake was investigated using a mental health self-assessment questionnaire, self-rating anxiety scale, and self-rating depression scale. Results We found: 56.0% of the respondents were not happy, 39.6% often cried bitterly, 56.7% felt pain, 40.7% lost interest, 69.2% felt uneasy, nervous, or worried, and 27.0% would like to end their lives; the SDS scores (56.48±110.43) and SAS scores (39.88±11.38) of the people were significantly higher than those of the national norms (Plt;0.001). The following symptons appeared: 59.3% had headache, 50.5% poor appetite, poor sleeping 56.0%, 58.2% were easily frightened, tremors 29.7%, 50.5% dyspepsia, 42.9% thoughts fuzzy, 60.4% stomach discomfort, fatigue 85.7%. Conclusion The earthquake disaster brought about serious psychological harm to people. It is necessary to strengthen post-earthquake psychological relief and strengthen interventions in order to reduce the psychological suffering of victims.
Objective To assess the public health impacts and needs, to evaluate performance of anti-epidemic efforts after Lushan earthquake, so as to provide references for the following anti-epidemic work. Methods The day of earthquake occurrence was defined as the first day after earthquake. We collected information and data from the Sichuan Provincial Government, the National Health and Family Planning Commission of the People’s Republic of China, the Health Department of Sichuan Province, Sichuan Center for Disease Control and Prevention, and then we compared the situations of disaster, public health situation in stricken area, emergency response, resource deployment, etc. with those after Wenchuan earthquake in 2008, in order to evaluate the performance of anti-epidemic response during 2 weeks, clarify current situations and demands, and offer a proposal for the following work. Results Emergency response was conducted immediately after the Lushan earthquake. The counterpart assistance was considered at the beginning of team arrangement. The number and professional structure of rescue participants were planned according to needs. Three days after earthquake, anti-epidemic staff arrived at every involved county, town, and even village, which achieved full rescue coverage of locations and interventions. The staff helped reconstruct disease surveillance system, protect source of drinking water and environmental hygiene, etc., which resulted in progressive achievement. Two weeks after the earthquake there were no outbreak and public health emergency event occurred in stricken area. Conclusion The anti-epidemic efforts after Lushan earthquake inherit and develop the lessons from Wenchuan earthquake in 2008. Emergency response is timely, orderly, scientific, and moderate. The deployment of policies, technologies and resources has already been completed during two weeks. Anti-epidemic efforts achieve preliminary results. We suggest that key issues of further work should be the implementation of policies, strategies and measures, such as health management at relocation sites, water and food hygiene, disease monitoring, prevention and control, mass vaccination, scientific disinfection, and health education, in order to improve long-efficacy mechanism and stabilize work performance.
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.
ObjectiveTo explore the possible association between early injury assessment indexes and the length of stay (LOS) in first-line hospitals, in order to help the hospitals take advantage of resource effectively and transfer victims reasonably during earthquakes. MethodWe retrospectively analyzed the medical information of 3 576 traumatic patients injured in the Wenchuan Earthquake who were transferred to 242 first-line medical institutes between 14:28, May 12th and 14:30, May 19th in 2008. Three kinds of 15 variables were extracted for the analysis, including gender, age, heart or lung disease, pre-hospital time, head injury, trunk injury, open injury, crush injury, asphyxia, body temperature, heart rate, respiration, systolic blood pressure, diastolic blood pressure, and Glasgow coma score. Multiple stepwise linear regression analysis was performed to identify the factors associated with LOS. ResultsThe multiple linear regression analysis showed that age as well as other six factors affected LOS significantly (P<0.05). The partial regression coefficients of age, pre-hospital time, head injury, trunk injury, crush injury, complication of cardiac or pulmonary disease, and Glasgow coma score were -0.062, 0.157, 3.703, 4.111, 12.602, 14.762 and -1.312, respectively. ConclusionsEarthquake trauma patients with older age, long pre-hospital time, head injury, trunk injury, heart or lung disease, crush injury, and lower Glasgow coma score are at increased risk for extended LOS.
Objective We analyzed the emergency management of medical supplies of People’s Hospital of Deyang City in the first week after the Wenchuan earthquake o provide first-hand evidence concerning the management of medical supplies in a public emergency. Methods Retrospective statistical analysis was used to analyze the surgery related demand in the first week after earthquake, including the demand, the supply, donations and the inventory of the pre-3 demand. Results The demand during the first day after the earthquake was the largest, But some of the supplies were not enough because of the lack of supply in the first 1-2 days. During the first 3-4 days after the earthquake, emergency procurement and supplies donated just met the supply gap. One week after the earthquake because of a lag inthe supply chain and a reduction in surgeries, there was an excess of some supplies. Conclusions China should accelerate establish a medical consumables supply and demand instant information feedback system, as well as building a public emergency material platform and a guide for society to promply donate materials.