ObjectiveTo analyze the cases of surgical wounded characteristics after Lushan county 7.0 earthquake for government departments to formulate relevant policies to provide references for future decision-making. MethodsThe data of surgical wounded were collected from various hospitals in Sichuan province. Origin, operation time and the injured area were counted according to gender and operation time was counted according to origin. In the descriptive statistics the frequencies and proportions were used to describe categorical data and x±SD was used to describe quantitative data. SPSS 13.0 software was used to analyze the data. ResultsA total of 975 cases of surgical wounded included 586 cases of male (accounting for 60.10%) and 389 cases of female (accounting for 39.90%). The average age of the surgical wounded was 40.42±20.06 years. Ya'an city had completed the largest number of surgical cases. Medical institutions completed 53.85 percent of the surgery in the first three days, 41.03 percent of the surgery from four days to seven days after the earthquake. They completed 94.88 percent of surgery in one week after the earthquake. Ya'an city was the largest city in the number of surgical cases within 3 days after the earthquake. Medical institutions directly under the province and the Ministry of Health medical institutions in Sichuan were the largest medical institutions in number of surgical cases from four days to seven days after the earthquake. The largest number of cases was wounded ankle and foot injuries, followed by the abdomen, lower back, lumbar spine and pelvis injuries, once again the knee and calf injuries, and finally the head injury. ConclusionIn the face of natural disasters like earthquakes, the health care system should establish a reasonable and effective medical emergency response mechanisms and plans, and establish a scientific and rational triage mechanism. Multi-disciplines such as orthopedics and surgery should be ready ahead of first aid equipment and emergency medicine, so as to rationalize the allocation of medical resources, achieve maximum utilization of medical resources, reduce morbidity and mortality, and save surgical treatment time for more wounded.
ObjectiveTo investigate the effects of early rehabilitation on function of patients undergoing complex lower limb amputation caused by injuring in "4·20" Lushan earthquake. MethodsFrom April 20th to June 30th, 2013, we carried out comprehensive rehabilitation intervention for two patients who had undergone complex lower limb amputation, including physical treatment, exercise treatment, psychological treatment, wound dressing, rehabilitation program, and multiple rehabilitation nursing care. ResultsThrough early comprehensive rehabilitation intervention, patients' pain was relieved, and their muscle strength, activities of daily living (ADL), and balance function had been improved greatly, achieving the goal of installing artificial limb. ConclusionEarly rehabilitation intervention treatment is effective in relieving pain in patients undergoing lower extremities amputation, and improving their muscle strength, ability of ADL and balance function, which can make the patients return to society much better and faster.
Objective To report the screening, prevention and treatment of venous thrombosis for Lushan earthquake victims in the West China Hospital of Sichuan University. Methods Among the Lushan earthquake victims screened by vascular color Doppler, those with detected venous thrombosis were treated reasonably, and those without detected venous thrombosis were prevented early. Results There were total 235 Lushan earthquake victims in the hospital as of the 11th day after earthquake, and they were screened by vascular color Doppler. Among 26 cases with detected venous thrombosis, 25 were lower limb venous thrombosis, and the other one was upper limb venous thrombosis. Three cases were treated by rehabilitation intervention alone, three cases were treated by drug intervention alone, and the other 20 cases were treated by both rehabilitation and drug intervention. As of 30 days after the earthquake, the reexamination results of 26 victims with venous thrombosis showed that: 11 cases improved, including 5 completely recanalization and 6 incompletely recanalization. Among the three cases with drug intervention alone, one got completely recanalization, accounted for 33.33%. Among the three cases with rehabilitation intervention alone, one got incompletely recanalization, accounted for 33.33%. Among the 20 cases with both rehabilitation and drug intervention, four got completely recanalization, accounted for 20.0%, and five got incompletely recanalization, accounted for 25.0%. Conclusion Most Lushan earthquake victims with venous thrombosis are the elderly and women, stay in the ICU, and suffer from fractures in different degrees. The timely prevention and treatment can relieve local pain, promote early entry in the rehabilitation treatment, and prevent pulmonary embolism and other risks. The rehabilitation intervention and/or drug intervention should be adopted to the victims with detected venous thrombosis as well as the victims without detected venous thrombosis but have high risk factors, for it can effectively prevent and treat the further thrombosis and other bad consequences of the detachment of thrombus.
The West China hospital of Sichuan university has underwent four times emergency medical rescue (EMR) of earthquakes, measuring 5.7 Ms to 8.0 Ms on the Richter scale, happened at Wenchuan, Yushu, Yiliang and Lushan in recent 5 years, which gradually improved and supplemented Wenchuan experience. After Lushan earthquake, a total of 392 patients were received during 2 weeks. Among 321 hospitalized patients, there were 39 (12.15%) patients with critical injury and 14 (4.36%) patients who needed intensive care. 184 operations were performed. Based on the experiences of resource centralization, multidisciplinary cooperation, and hierarchical management, zero death, a new medical record, has been achieved among 43 patients with critical injury after centralized admission and treatment. A total of 12 medical rescue teams involving 88 healthcare workers were sent to the epicenter to join and guide EMR. Besides, rehabilitation and psychological experts came to Lushan on the first day of earthquake, and started clinical intervention of mental and physical health for people needed on the second day.
Objective To assess the impact of earthquake magnitude scale on injury characteristics of patients admitted to an earthquake rescue hospital，and provide references for rescue strategy formulation and medical resourceallocation. Methods We retrospectively analyzed clinical data of patients injured in 2008 “5 ? 12” Wenchuan earthquakeand 2013 “4 ? 20” Lushan earthquake who were admitted to West China Hospital of Sichuan University. Patient gender，age，time of admission，mechanisms，types and severity of injury and their prognosis were compared between the 2 groups.Results A total of 1 856 patients who were injured in Wenchuan earthquake，including 974 male and 882 female patients with their age of 45.8±22.7 years，and 316 patients who were injured in Lushan earthquake，including 174 male and 142 female patients with their age of 43.0±23.1 years，were enrolled in our study. No significant difference was found in genderor age between these 2 groups （P＞0.05）. Peak time of admission of Wenchuan earthquake patients was significantlylater than that of Lushan earthquake patients，and transfer duration of Wenchuan earthquake patients was significantly longerthan that of Lushan earthquake patients. The percentage of patients with crash injury of heavy objects or buried trauma ofWenchuan earthquake patients was significantly higher than that of Lushan earthquake patients. Injury severity and in-hospitalmortality of Wenchuan earthquake patients were significantly higher than those of Lushan earthquake patients. The proportionof patients with chest or cerebral injury of Lushan earthquake patients was significantly higher than that of Wenchuanearthquake patients. Conclusions Earthquake magnitude scale has a significant influence on mechanisms，types andseverity of injury of patients injured in earthquakes，as well as their timely transfer，management and prognosis. In earthquakeswith a comparatively lower magnitude scale，more thoracic surgeons and neurosurgeons are needed to ensure timelymanagement for patients with chest or cerebral injury.
Objective To analyze the injury characteristics and the rescue process and effects for the victims admitted in the People’s Hospital of Deyang City within 72 hours after 4.20 Lushan earthquake, so as to discuss how to adopt the emergency program to implement medical rescue in disaster relief. Methods The data of 25 earthquake victims admitted in the hospital from April 20th, 2013 to April 23rd, 2013 were collected to analyze age, gender, the location of injury, the injury state of different age groups, and the prognosis of victims. Results Of the 25 victims with injuries on 32 locations of the body, there were 20 cases with single injury (80.00%) and 5 cases with multiple injuries (20.00%). Most injuries were seen in four limbs, body surface, and soft tissues; and the incidence of single injury was higher than that of multiple injuries. The number of admitted victims was largest on the first day after earthquake, accounted for 92.00%, which was obviously higher than that on the second and the third day. Victims aged from 19 to 45 years old was more than those of other ages. Conclusion Scientific emergency command system and disaster emergency program play an high-efficient command role in disaster rescue, shorten the time of emergency response, and improve the ability of disaster rescue. The comprehensive capacity of self-rescue and well-organized rescue for disaster area can be improved as long as the general public is educated about the disaster emergency program and cooperative emergency drill. Meanwhile, smooth traffic and unobstructed communication are guaranteed in the disaster area, and the cooperative efforts are made by all walks of society.
Objective To explore the allocation of necessary living goods for the emergency medical rescue teams at Lushan earthquake sites. Methods The living goods requirements of 59 emergency medical rescue members at Lushan earthquake sites were investigated using a questionnaire and then analyzed, in order to provide references for the allocation of necessary living goods for emergency medical rescue teams in future. Results The top five necessary living goods for emergency medical rescue members at earthquake sites were food, drinking water, toilet, communication product, and bedclothe. The needs of bath of the members who stayed longer than 3 days were more than the members who stayed shorter than 3 days, with a significant difference (Plt;0.05). The number of living goods that female members need were more than that male members need (Plt;0.05). Conclusion For improving the work efficiency and quality of life, emergency medical rescue teams need to be equipped with not only the medical supplies, but also necessary living goods based on the length of stay and the ratio between male and female.
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.
Objective We evaluated effectiveness and performance of medical rescue after Lushan earthquake during 2 weeks, and enriched Wenchuan lessons to provide useful references for emergency medical rescue (EMR) after similar earthquake worldwide. Methods We collected and analyzed official information, public documents, news release, and relevant information from websites, and then we systematically reviewed and descriptively analyzed all included literature of EMR after earthquake (domestic and foreign). Results Learned from Wenchuan earthquake, EMR for Lushan earthquake were characterized as: a) Assess the situations of quake damage and injuries were scientifically assessed; human resources, funds and materials were reasonably distributed; and the EMR relied mainly on regional rescue power of Sichuan province. b) Patients’ with critical injuries were treated using “Four concentration treatment principles”, which resulted in a new medical record of zero death, 14 days after the earthquake. c) The experience of EMR after Lushan earthquake verified, enriched and improved lessons from Wenchuan, Yushu and Yiliang earthquake, which provided first-hand references of evidence-based decision making for earthquake EMR worldwide.
Objective To evaluate the performance of emergency medical rescue (EMR) within 1 month after Lushan earthquake, and to prove and enrich the experience from Wenchuan earthquake, so as to provide useful references for global earthquake EMR with regard to decreasing death and disability rates. Methods All the following date published within 1 month after 4.20 Lushan earthquake were collected and analyzed, including official information, public documents, news release, relevant information from websites and victims’ medical records in the West China Hospital, then the relevant domestic and foreign literature about EMR (including EMR of Wenchuan earthquake). And then comparative analysis was conducted to evaluate the performance of EMR in Lushan earthquake. Results a) Being 87 km apart from each other, the main seismic zones of Lushan and Wenchuan located in the south west and middle north of Longmenshan fault zone, respectively. Although only 1 earthquake magnitude differed between them, the disaster area, and the number of affected population, deaths, disappearances, injured, severe injured and migration population in Wenchuan earthquake were 40, 23, 353, 853, 27, 14 and 51 times higher than those in Lushan earthquake, respectively. b) Learned from Wenchuan experience, the manpower scheduling in Lushan earthquake was quicker: the assembled medical personnel peak of Lushan vs. Wenchuan was 87.62% vs. 56.06 % in golden 72 hours post-quake. c) Supplies scheduling was more rational: the utilization rate was higher under the guidance of accurate information of demand. d) Medical treatment was more rational and efficient: the critical injured were treated following “Four concentration treatment principles”; saving life and restoring function at the same time; treatment and physical-mental rehabilitation at the same time; treatment and evidence production and implementation at the same time. e) Medical institutions and service returned to normal in time: 96.7% (440/455) of government owned township medical institutions in 21 affected towns returned to normal and provided medical services at their original sites. Conclusion By learning form Wenchuan experience, the following performance is implemented in Lushan earthquake: medical rescue guided by the accurate information; supplies scheduling guided by the accurate demand; both critical injured treatment,and physical-mental rehabilitation guided by the accurate assessment of injuries. So the medical rescue within 1 month after Lushan earthquake is quicker, more rational and efficient. After 20 days post quake zero death of critical injured was achieved. The early physical-mental rehabilitation fastens the functional reconstruction of the injured and helps them return to the society. So it suggests that the Lushan EMR enriches and develops the reference value of EMR experience of Wenchuan earthquake.