突发公共卫生事件院前、院内急救护理

目的探讨突发公共卫生事件院前，院内急救护理体会。方法总结突发公共卫生事件院前急救护理观察重点，包括迅速建立静脉通道，妥善处理各部位伤口，严密观察生命体征，安全转运；院内急救护理包括认真做好准备工作，密切配合工作，保持呼吸道通畅，开放绿色通道，做好心理护理。结论突发公共卫生事件院前，院内急救护理，为病人赢得了抢救时机，提高了护理人员应对突发公共卫生事件救治护理能力。     

群体性急性毒鼠强中毒8例抢救成功报告

目的总结成功抢救的8例群体性急性毒鼠强中毒临床资料,以期探讨各有关部门如何有机衔接,应对突发公共卫生事件,院前及院内患者急救。方法对8例急性毒鼠强中毒患者从院前（包括运输途中）及院内抢救全过程进行回顾,并详细分析每位中毒患者临床资料。结果及时启动突发公共卫生事件应急预案,调动各相关部门人员积极参与,得以使8名中毒患者痊愈。结论建立有效的急救网络系统,各种救治预案的实施,配备完善的运输车辆及相关急救设备,是各类突发公共卫生事件抢救成功的基础。成立专职化的急诊急救医护队伍以及所拥有的娴熟急救技能,是各类突发公共卫生事件抢救成功的关键。     

4起突发公共卫生事件的急救救援体会

目的探讨突发公共卫生事件院前院内急救救援配合方法。方法通过对4起严重公共卫生突发事件的急救过程进行分析,提出相应救援措施。结果52例病人经120现场急救,院内抢救,全部治愈。结论院前院内急救救援配合可以提高对急危重病人的抢救成功率,降低伤残率及死亡率。     

加快我市院前医疗急救事业科学发展的思考

院前医疗急救事业的发展,体现着一个民族、一个国家的繁荣与富强.随着我国经济社会的快速发展,院前医疗急救事业也有了长足的发展,特别是2003年SARS在我国肆虐后,院前医疗急救事业更是被各级政府部门高度重视,国务院相继出台了<突发公共卫生事件医疗救治体系建设规划>、<突发公共卫生事件应急处理条例>、<突发公共卫生医疗救援应急预案>等有关建设和发展医疗急救的法律法规.加快了各地市院前医疗急救的建设,提高了院前医疗救治能力.据报道,在四川汶川地震中第一时间到达现场的是120急救人员,首先启动的应急预案也是医疗急救应急预案.我市乘此东风,筹建并成立了紧急救援中心,并于2008 年1月正式启动,运行一年来取得了一些经验,也发现了一些问题,现就加快我市院前医疗急救事业科学发展做些探讨.     

实施突发公共卫生事件应急预案演练 提高医院应对突发事件能力

目的模拟仿真突发公共卫生事件应急预案演练的方法,提高医院应对突发事件能力。方法每年对全院医务人员进行突发公共卫生事件应急预案学习及仿真模拟急救演练,即采用确定内容、制订计划、拟订演练方案、角色配置、现场实景模拟实施急救,演练结束后进行分析、总结、修订预案。结果全院医务人员应对突发公共卫生事件能力、急救综合能力和抢救成功率提高,成功组织并完成了多起突发公共事件的救援,取得了很好的社会效益和经济效益。结论模拟突发公共卫生事件应急预案演练是全面提高医务人员综合素质、急救能力和整体协调能力的有效方法。     

应急预案演练提高护士综合能力的效果评价

目的:提高急诊科护理人员应对突发公共卫生事件的能力和强化急救意识.方法:制定突发公共卫生事件应急预案,模拟演练突发公共卫生事件的应急处理流程,观察模拟演练前后护士的急救综合能力.结果:急诊科护士的临床护理急救技能考核成绩和医生对护理人员的抢救配合满意度均较演练前提高(P＜0.01).结论:突发事件应急预案情景演练,能够稳步提高护理人员的急救综合素质,更好地应对突发性公共卫生事件.     

通过突发公共卫生事件应急预案演练提高急救中心对突发事件的处置能力

目的通过对突发公共卫生事件应急预案的演练提高急救中心对突发事件的处置能力。方法每年对医务人员采用确立内容,制订计划、演练方案、配置角色、现场模拟实景实施急救等步骤进行突发公共卫生事件应急预案学习和模拟仿真急救演练,演练结束后对预案总结、分析、修订。结果使所有医务人员的突发公共卫生事件处置能力、综合急救能力和抢救成功率得到了提高,并成功完成了多起突发公共事件的救援,获得了良好的社会和经济效益。结论突发公共卫生事件应急预案的演练是一种有效的方法,使得急救中心对突发事件的处置能力得到了极大的提高。     

突发公共卫生事件院前急救探讨

随着经济快速增长,各类突发公共卫生事件频发,对人类生命健康安全构成重大威胁。公共卫生事件社会关注度高,影响大。为有效应对各类突发公共卫生事件,提高处置突发事件的能力,卫生医疗急救机构应在事故发生后迅速做出反应,启动突发公共卫生事件院前急救应急预案,科学调度,及时到达事故现场展开急救,合理分流、科学转运,保障人民群众的身体健康和生命安全。     

混合式教学应用于培训护士突发公共卫生事件应急处置的效果

目的：探讨混合式教学应用于培训护士突发公共卫生事件应急处置的效果。方法：按照计算机分组法将我院2020年7月—2022年6月工作的60名护士分为两组,对照组30名给予常规培训,观察组30名给予混合式教学,观察两组急救效率、应急态度、应急能力及职业认同水平。结果：培训3个月后,观察组院前接诊、院内接诊、检查、诊断、见效及平均收住时间均短于对照组(P<0.05);观察组应急态度各维度评分均高于对照组(P<0.05);观察组应急能力各维度评分均高于对照组(P<0.05);观察组职业认同评分高于对照组(P<0.05)。结论：将混合式教学用于护士突发公共卫生事件的应急培训中,有利于增强护士职业认同感,改善应急态度,以提高其应对突发公共卫生事件的能力,显著缩短急救过程执行时间。     

实施应急演练的做法和体会

为了提高医务人员应对突发公共卫生事件的能力、急救能力和整体协调能力，规范应急处置抢救程序，增强医务人员对突发公共卫生事件的报告意识和处置能力，我院于2009年起实行场景模拟应急演练，取得了较好的效果。现报告如下。     

Emergency contraception for sexual assault victims in North Carolina emergency departments

INTRODUCTION: One in 5 women is a victim of sexual assault. This study examines the administration of emergency contraception to victims of sexual assault in North Carolina hospital emergency departments. METHODS: One hundred seventeen surveys were mailed to hospital emergency departments across the state to determine their emergency contraception practices for victims ofsexual assault. The survey contained 11 questions about emergency contraception practices for victims. RESULTS: Of the 117 surveys, 103 were returned revealing that just over 50% of the hospitals in North Carolina treated victims with emergency contraception without exception. Both dispensing emergency contraception and providing information about emergency contraception were significantly associated with having a sexual assault nurse examiner program. CONCLUSION: Results from this study demonstrate inconsistent provision of emergency contraception to victims of sexual assault; however, there is greater consistency of emergency contraception use by emergency departments using sexual assault nurse examiners.     

手部爆炸伤二种创面的不同处理

目的回顾性分析15例手部爆炸伤的临床处理。方法根据手部爆炸伤污染程度不同,采用急诊清创一期皮瓣修复7例,创面敞开换药或清创延期行皮瓣修复5例,一次彻底清创缝合闭合创口2例,一期全厚皮片打包植皮1例。结果随访6～12月,2例患者术后患指慢性炎症长时间肿痛,最后二期手术行病灶清除皮瓣修复症状消失;1例患者因腱鞘内感染,给予切开引流并应用抗生素后痊愈;其余均痊愈。结论对于烟花爆竹及矿山爆炸所致的手部外伤,应根据患者创口创面的不同特点,采用不同的清创修复重建方法,严格彻底的清创直接关系到患者的愈合。     

创伤评分在急诊地震伤员中的应用及评价

目的 探讨创伤评分（trauma score TS）在急诊救治地震伤员中的有效应用.方法 对2013年4月20日~2013年4月26日我院急诊科救治的241例地震伤员应用创伤评分判断伤情,快速分级,并采取相应急救措施.最后比较各级别患者的抢救率、手术率、死亡率、误分率.结果 创伤评分为1~3分（极重度伤）0例,4~13分（重伤）的为22例,14~16分（轻伤）的为219例,根据伤情级别,快速分诊制定及时有效的治疗方案,救治率达100%,手术84例,误诊13例,无1例死亡.结论 地震伤、群体伤的伤情评估在急救流程中至关重要,运用创伤评分能更加客观有效地判断伤情,及时分诊,提高地震伤员的急救效率.     

Ethical challenges in conducting research in humanitarian crisis situations

Research is vital to accurately describe phenomena in humanitarian emergency situations and to evaluate the effectiveness and appropriateness of interventions. Although the ethical principles of justice, beneficence and respect for autonomy/ respect for persons should be upheld in research, their application in emergency situations may differ from non-emergency situations. Just like in non-emergency situations, research in emergency situations should be conducted in the best interest of the victims or future victims. The research should not unnecessarily expose human subjects and the researcher to careless harm, and should be of adequate scientific rigor. Victims of emergency situations are vulnerable populations that need special protection from exploitation. Technical competency to conduct research in emergency situations should include the ability to conduct a fair risk-benefit assessment in order to come up with a risk management plan, and being culturally sensitive to the needs of the victims of the humanitarian crisis. In emergency situations, the roles of Institutional Review Boards (IRBs) may have to be modified without compromising the ethical standards that health researchers have globally attempted to achieve.     

Blast injury

Individuals with a blast injury are the victims most likely to be seen by any healthcare professional. An awareness of the potential injuries is important. Individual care should follow standards established for all trauma patients.     

严重烧伤院外和急诊处理策略

目的 探讨严重烧伤院外和急诊处理的简单而有重点的策略。方法 参考国内外目前关于烧伤院外处理和急诊急救的方法，结合我们的急救经验，提出实用、简单的院外处理和急诊急救策略。结论 总结出有序、系统的急救策略，简化了急救的程序。结论 简化的程序重点突出，可以降低患者的伤残率和病死率。     

设立创伤急诊势在必行

我国城乡每年有大量创伤患者,其中多发伤患者,如严重交通伤患者死亡率较高。现行创伤急救体系的缺陷,如缺乏专职的创伤医师是造成多发伤高死亡率的根本原因之一。建立由创伤专职医师组成的完善的创伤急诊系统是非常必要的。     

Scorpaenidae envenomation. A five-year poison center experience

This article describes 51 cases of Scorpaenidae envenomation, 45 of which were lionfish stings to aquarists or fish handlers. The primary manifestation of envenomation in all victims was intense local pain. Various other local and systemic symptoms were also noted. Immersion in hot water produced either complete (80%) or moderate (14%) symptomatic relief in 94% of the victims. This simple and effective treatment was generally unknown to emergency personnel treating these patients.     

Management of acute adult sexual assault

An estimated 13% of women and 3% of men worldwide report sexual assault in their lifetime. Although managing sexual assault may appear daunting, some victims want medical care only. After disclosure, discuss forensic assessment. If a complaint to the police is possible, give the first dose of emergency contraception if required, and refer for forensic assessment. If medical care only is desired, determine the timing and type of assault and current contraception, manage general and genital injuries and perform relevant tests. After unprotected vaginal rape, offer emergency contraception, chlamydia prophylaxis and vaccination against hepatitis B virus. Counselling is important for all victims of sexual assault, as psychosocial consequences are more common than physical injuries. Management by a sympathetic, non-judgmental health practitioner helps the victim to regain control.