Objective By analyzing the data of medicine use in a temporary trauma center, which set up by the national emergency medical team of General Hospital of Chengdu Military Region right after the 2015 Nepal earthquake in Kathmandu, to provide reference for the development of medicine emergency plan. Methods All 103 drugs (specifications) are divided into five categories: topical drugs, oral drugs, injectable drugs, drug use in the operating room, disinfectants and infusion. Sorting patient drug consumption, in order to determine whether the drug carries reasonable. Results Within 18 days, 267 patients received treatment, in which 132 patients received debridement, 71 patients were hospitalized, and 35 fractures underwent orthopedic surgery. All of the medicines shipped from China with the medical team, only one exception. Twenty drugs' consumption rates reached 100%, 37 drugs' consumption rates were more than 70%, 60 drugs' consumption rates were more than 50%, only 10 drugs’ consumption rates were zero. Conclusion Before the rescue mission, the preparation of medicine is reasonable. The basic composition of medicine emergency plan should be based on the different rescue mission. And do some adjustments according to the local climate and natural environment.
Objective To use Kaiser model, three-dimensional risk matrix and Borda ordinal value method comprehensively to analyze the vulnerability of disasters, and identify the key prevention and control risks of the hospital. Methods From June to December 2020, a disaster vulnerability analysis was conducted on a tertiary hospital in southwest China. The risk event evaluation index system was established by referring to the Kaiser model, and the evaluation indexes were classified into three aspects: possibility, controllability and harmfulness. The three-dimensional risk matrix was used to calculate the risk score to determine the risk level. The Borda ordinal value was used to compare the ranking of risk events in the same risk level. Result “Violent medical injuries” “terrorist attacks” and “explosions” were the highest ranked risk events, which needed to be prioritized and targeted for improvement. Conclusions Disaster vulnerability analysis is an important means of emergency management in hospitals. Managers should dynamically assess hospital risks, take effective preventive measures for high-risk events, conduct emergency plan drills, continuously improve risk warning mechanisms, and enhance emergency management capabilities.
This paper expounds the experiences and thinking of enclosed emergency management under emergency coronavirus disease 2019 (COVID-19) epidemic in a Grade A tertiary hospital in Shanghai. The main emergency prevention and control measures included accurately controlling information of all people in the hospital, implementing strict hospitality prevention and control programs, providing strongly logistics support services, ensuring the safety of medical services, stabilizing mood of all people in the hospital, and guiding the correct public opinion. During the enclosed management period, the hospital worked smoothly and orderly, and no infection or transmission ocurred. Practice shows that the use of enclosed emergency management model is an effective way to respond to emergency COVID-19 epidemic, which can provide scientific reference for the hospital facing public health emergencies.
Objective To analyze the current situation and demand of emergency and critical care training for medical staff in plateau areas, and to provide a reference for further emergency and critical care training for medical staff in plateau areas. Methods From July 1, 2018 to July 30, 2020, medical staff (including physicians, nursing staff, and other medical staff) from hospitals in various regions of Tibet were surveyed anonymously, to investigate the content and demand of medical staff in plateau areas receiving emergency and critical care training. The content and demand of medical staff from different levels of hospitals receiving emergency and critical care training were further compared. Results A total of 45 questionnaires were distributed in this study, and a total of 43 valid questionnaires were collected, with an effective response rate of 95.6%. The average age of medical staff was (35.67±9.17) years old, with a male to female ratio of 1∶1.5. The proportion of tertiary, secondary, and lower level hospitals to which medical staff belong were 23.3%, 27.9%, and 48.8%, respectively. The number and proportion of medical staff receiving training on chest pain, heart failure, stroke, gastrointestinal bleeding, respiratory failure, metabolic crisis, and sepsis diseases were 25 (58.1%), 25 (58.1%), 24 (55.8%), 23 (53.5%), 20 (46.5%), 14 (32.6%), and 12 (27.9%), respectively. The number and proportion of medical staff who believed that training in the heart failure, respiratory failure, metabolic diseases, stroke, gastrointestinal bleeding, chest pain, and sepsis needed to be strengthened were 38 (88.4%), 36 (83.7%), 35 (81.4%), 34 (79.1%), 34 (79.1%), 33 (76.7%), and 29 (67.4%), respectively. Thirteen medical staff (30.2%) hoped to acquire knowledge and skills through teaching. There were no statistically significant differences in gender, age, job type, professional title, and department type among medical staff from tertiary, secondary, and lower level hospitals participating in the survey (P>0.05). The proportion of medical staff in hospitals below secondary receiving training on chest pain was lower than that in second level hospitals (38.1% vs. 91.7%). The proportion of medical staff in hospitals below secondary receiving training on heart failure was lower than that in secondary and tertiary hospitals (38.1% vs. 75.0% vs. 80.0%). The proportion of medical staff in hospitals below secondary receiving training on respiratory failure was lower than that in tertiary hospitals (28.6% vs. 80.0%). The demand for sepsis training among medical staff in hospitals below secondary was higher than that in tertiary hospitals (85.7% vs. 30.0%). There was no statistically significant difference in the other training contents and demands (P>0.05). Conclusion The content of critical care training for medical staff in plateau areas cannot meet their demands, especially for medical staff in hospitals below secondary. In the future, it is necessary to strengthen training support, allocate advantageous resources to different levels of hospitals, expand the scope of training coverage, and enrich training methods to better improve the ability of medical personnel in plateau areas to diagnose and treat related diseases.
Objective To elucidate the effect of first-aid fast track in triaging earthquake trauma patients by studying the earthquake trauma patients staying in the Emergency Department of West China Hospital after “5?12 Wenchuan Earthquake” so as to accumulate experience in the treatment of disaster traumas. Methods A retrospective study was done on earthquake trauma patients staying in the Emergency Department of West China Hospital after “5?12 Wenchuan Earthquake” from 14:28 May 12, 2008 to 14:27 May 15, 2008. Differences in care given during the time period were analyzed. Results There were 536 earthquake trauma patients in West China Hospital within 72 hours after the earthquake. Twohundred and seven earthquake trauma patients staying in the Emergency Department had an average stay of 129 minutes during the 24 hours after the quake; 104 earthquake trauma patients staying in the Emergency Department had an average stay of 97 minutes in the second 24 hours; and 226 earthquake trauma patients staying in the Emergency Department had an average stay of 86 minutes in the third 24 hours. Each consecutive day showed shorter average stays. Conclusion The first-aid fast track not only guarantees earthquake trauma patients are saved as soon as possible but also shortens the time in the Emergency Department.
After 5?12 When Chuan earthquake,The third hospital of Mianyang which is the nearest hospital of severely afflicted area recived 1 804 wounded persons.We aimed to summarize the achievement and limitation in management of medical rescue, medical treatment of the wounded and logistical support. Hospital shouled set up a special medical rescue system to relieve the sufferings of victims of unexpected natural calamities which include staff training, reserve supplies,psychological intervention of the wounded and safeguard of the rescuers.
ObjectiveTo provide recommendations for the management of intensive care unit patients without novel coronavirus disease 2019 (COVID-19).MethodsWe set up a focus group urgently and identified five key clinical issues through discussion. Total 23 databases or websites including PubMed, National Guideline Clearing-House, Chinese Center for Disease Control and Prevention and so on were searched from construction of the library until February 28, 2020. After group discussion and collecting information, we used GRADE system to classify the evidence and give recommendations. Then we apply the recommendations to manage pediatric intensive care unit in the department of critical care medicine in our hospital. ResultsWe searched 13 321 articles and finally identified 21 liteteratures. We discussed twice, and five recommendations were proposed: (1) Patients should wear medical surgical masks; (2) Family members are not allowed to visit the ward and video visitation are used; (3) It doesn’t need to increase the frequency of environmental disinfection; (4) We should provide proper health education about the disease to non-medical staff (workers, cleaners); (5) Medical staff do not need wear protective clothing. We used these recommendations in intensive care unit management for 35 days and there was no novel coronavirus infection in patients, medical staff or non-medical staff. ConclusionThe use of evidence-based medicine for emergency recommendation is helpful for the scientific and efficient management of wards, and is also suitable for the management of general intensive care units in emergent public health events.
The Rapid Advice Guidelines (RAGs), prepared in the form of evidence-based guidelines for responding to public health emergencies in a short period, are characterized by their capability to significantly reduce the time for the development of guidelines to the maximum extent while ensuring quality. Therefore, the RAGs are primarily used to guide and respond to public health emergencies. This article will introduce the definition, characteristics, current situation, applicable situation, development methods, advantages and limitations of the RAGs. Our study proposes several suggestions for RAGs developers and researchers to improve development of RAGs in China.
Emergency medical rescue system is an important part of public health and urban security system. Based on the emergency medical rescue practice of" 6·24”sudden high mountain collapse disaster in Diexi town of Mao county, this article mainly analyzes, summarizes and puts forward the countermeasures and suggestions for the emergency medical rescue system, which has been sharpened, explored and established in numerous disasters in Sichuan province.
ObjectiveTo acquire the flow law of outpatient and emergency visits in a large general hospital. MethodsBy sampling monthly amount of outpatient and emergency from January 2005 to December 2013 of a large general hospital in Guangzhou, the trend of the time series was analyzed and calculated the seasonal index of the amount of hospital outpatient and emergency visits with the use of long-term trends method. ResultThe flow law of patients in the hospital outpatient and emergency was significantly affected by seasonal factors, and different month had its own variation characters. The seasonal indexes were the highest in March, July, August, November and December (seasonal index >105%), while the lowest in January, February, October (seasonal index <95%). ConclusionBased on analysis of the outpatient and emergency visits and causes with hospitals, decision makers and hospitals should make reasonable allocation of medical resources and provide evidence for the scientific decisions of hospital management. Thus, ensure the safety of patients.