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《Anaesthesia and Intensive Care Medicine》2020,21(8):422-426
A major incident is one that causes casualties on a scale beyond the usual capabilities of the emergency and healthcare services usual ability to manage. Major incident planning and rehearsal is vital to ensuring an appropriate response. Delivery of a major incident response requires command and co-ordination within and between emergency services, hospitals and specialist charitable organizations. Casualty management will require the set up of major incident infrastructure on scene to effectively extricate, triage, treat and transport casualties to appropriate facilities. There is a role for specialist doctors within the pre-hospital phase of managing a major incident, either within the ambulance command structure or operationally. Debrief and reviewing previous major incidents may identify individual, local and systemic factors that could be altered to improve the response to a future incident. 相似文献
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无国界医生致力于应对天灾和战祸所引起的人道医疗危机。灾后实时爆发的人道医疗危机包括急性的外科创伤问题和基础医疗系统的破坏导致疫症发生。本文介绍了无国界医生的救援经验以及专业的备灾体系。 相似文献
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医疗扶贫是提高贫困人口健康的一个重要措施,也是社会公平性的具体体现。文章从医疗扶贫项目开展的社会需求、扶贫项目的组织与管理、扶贫资金的筹集、扶贫项目可利用的资源等诸多方面论证医疗扶贫项目的可持续性。分析结果认为,在我国继续开展医疗扶贫有其必要性和可行性。 相似文献
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Hiroki Sakamoto Masayuki Kitano Takeshi Nishio Yoshifumi Takeyama Chikao Yasuda Masatoshi Kudo 《Digestive endoscopy》2006,18(3):206-211
Endosonography‐guided celiac plexus neurolysis (EUS‐CPN) safely and effectively relieves pain associated with intra‐abdominal malignancies when the neurolytic is accurately injected. We applied contrast medium to evaluate the ethanol injection sites in patients who received EUS‐CPN due to abdominal pain caused by malignancies. We injected, under the guidance of endoscopic ultrasonography (EUS), ethanol containing 10% contrast medium into the celiac plexus of patients with intra‐abdominal pain due to malignancies. Immediately after the endoscopic therapy, patients underwent computed tomography (CT) to confirm the injection site. Images of distribution of injected solutions were classified into three groups. Injected solution dispersed in unilateral and bilateral anterocrural space was defined as ‘unilateral injection’ or ‘bilateral injection’, respectively. Injected solution located out of the anterocrural space was defined as ‘inappropriate injection’. Pre‐ and postprocedure pain was assessed using a standard analog scale. Before and 2, 4, 8, 12, and 16 weeks after the procedure, pain scores were evaluated. From April 2003 to May 2005, 13 patients were enrolled in this study. Improvement of pain score in the ‘bilateral injection’ and ‘unilateral injection’ groups was significantly superior to the change in the ‘inappropriate injection’ group. Although EUS‐CPN was effective in eight of 13 patients (61.5%), additional EUS‐CPN to the ‘inappropriate injection group’ increased the response rate to 84.6%. Injection of ethanol to the anterocrural space by EUS‐CPN produced adequate pain relief. Immediate examination by CT for confirmation of injection sites after EUS‐CPN would increase the likelihood of induction of pain relief. 相似文献
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目的探讨急非淋白血病完全缓解后巩固治疗与缓解期的关系。方法对30例坚持与未坚持完全缓解后巩固化疗的急非淋患者(每组15例)进行对照研究。比较两组患者的完全缓解期。结果两组患者入院时情况、治疗及达完全缓解时间经统计学处理无明显差异(P>0.05);而坚持巩固化疗组平均持续完全缓解期(19.8mo)明显长于对照组(8.4mo),统计学具有显著差异(P<0.01)。结论急非淋白血病达完全缓解后,坚持骨髓抑制性治疗对延长完全缓解期以达长期生存目的具有重要意义。 相似文献
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Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n = 561) and the September 11, 2001 terrorist attacks in New York (n = 1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events. 相似文献
7.
BACKGROUND: This study evaluated the role of conscious sedation in pain relief during termination of first trimester pregnancy by suction evacuation (SE) under local anaesthesia. METHODS: A hundred women undergoing SE before 12 weeks gestation were randomized by computer using the sealed envelope method to receive placebo (saline) or conscious sedation (2 mg midazolam and 25 microg fentanyl) i.v. 5 min before cervical dilatation. Paracervical block was given to all patients, 2 min later. Pain scores during and after SE, post-operative side-effects and satisfaction level were compared. RESULTS: No statistically significant differences in pain scores were found between the two groups. Post-operative side-effects such as dizziness (P = 0.015) and drowsiness (P < 0.001) were significantly more severe in the conscious sedation group. However, patients in the conscious sedation group reported better satisfaction levels than the control group (P = 0.003). CONCLUSION: The use of conscious sedation significantly improved patient satisfaction during termination of first trimester pregnancy by SE under local anaesthesia, despite a lack of improvement in pain relief and the presence of increased severe dizziness/drowsiness in the post-operative period. 相似文献
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对贫困人口实施医疗救助 总被引:26,自引:5,他引:21
本文在分析了我国城乡居民收入分配中的公平性加重、医疗保障水平降低、医疗费用大幅度上涨、个人负担比例增加和卫生保健等筹资的“供方投入”模式的不合理性以及贫困人口较差的健康状况和卫生服务利用水平、贫困人口的主要健康问题、“需方投入”模式对供方的激励作用的基础上,认为对贫困人口实施医疗救助不仅符合公平原则,而且符合效率原则。医疗救助计划应该成为我国目前正在步步深入的卫生改革的重要组成部分。作者分别以我国 相似文献