"5·12"汶川特大地震灾害前沿医院"紧急综合救治区"的建立与管理

目的 由于短时间内接受大量地震伤员,且医务人员缺乏,无法按专业划分收治伤员,笔者所在医院建立了紧急建立"紧急综合救治区".方法 紧急建立"紧急综合救治区",区内划分"外科创伤综合救治区"、"外科普通综合区"和"内科普通综合区".抽调绝大多数医护人员进入"外科创伤综合救治区",负责收治各类伤情的灾害伤病员,同时设置预检、污染、手术、隔离、监护等区域,并将帐篷逐一编号、标名."内、外科普通综合病房"由少数医护人员承担诊疗工作,负责收治非灾伤患者.采用不干胶贴作标识贴,写明伤员姓名、性别、年龄、诊断、经治医师及V网通讯号码,然后贴于伤病员手背,并用红色笔在标识贴上画三角符号或用红、黄、蓝不同颜色的腕带,区分重、中、轻伤.将感染伤员和非感染伤员分区管理,并建立了隔离帐篷,严防院内感染传播.结果 医院于震后3 d内收治伤员达1000余人,两周内收治伤员达1500多人,因伤势严重死亡28人,死亡率仅1.8%.结论 "紧急综合救治区"的应急管理模式与机制,既集中了专科优势,又加强了综合服务功能,在有限的医疗资源上,发挥了最大的救治能力.

The hospital emergency management for a large number of earthquake patients in 2008 Sichuan Wenchuan Earthquake, China

Objective A large number of injured earthquake patients were accepted by the hospital whilethe professional surgeons were relatively lack. This article introduced the hospital emergency management in 2008Sichuan Wenchuan Earthquake, China. Method Within 3 days, Central Hospital of Mianyang accepted andtreated over 1000 patients after Wenchuan Earthquake jolted on 12 May 2008,and within 2 weeks, the number ofpatients reached 1500. The hospital carded out emergency management plan: (1) emergency comprehensive treat-ment district was established, which was divided into traumatic surgery district, general surgery district, and gen-eral medical district. Traumatic surgery district is responsible for treating traumatic patients, and most doctors andnurses were in this district. The district also had preview, contamination, operation, isolation, monitoring sec-tions, and the tents were numbered and labeled. General surgery district and general medical district were responsi-ble for patients not from earthquake, and only few doctors and nurses were in the two districts. According to the in-jury degree, all the wounded were classified into acute and severe, moderate and minor injuries, and wore red,yellow and blue label on the wrists, respectively. The name, gender, age and diagnosis of each patient and thename of doctor were written on the label. The infectious patients and non-infectious patients were separated.Results Near 200 operations and near 300 operations were performed at one night and at one day, respectively.Within one week, only 1 patient had the lung infection, and one patient with gangrenous emphysema was effective-ly treated. In-hospital cross infection and epidemic of infection disease didn't happen. Conclusions Emergencymanagement model and mechanism, which referred to the model of the battlefield ambulance, played an importantrole in treating a large number of injured patients.