Earthquake emergency medical rescue evidence-based decision-making is a typical case of real-world evidence deriving from real-world data, conducting real-world research, and producing real-world evidence for solving real-world problems. This article focuses on the use of evidence-based science in the real-world through a problem-oriented, evidence-based decision making way, as well as transferring of results to practice and continuing outcome evaluation.
This paper compares emergency medical rescue experience of West China Hospital of Sichuan University in the latest three earthquakes occurred in western Sichuan, and mainly introduces the experience in organization and coordination, rescue speed, treatment of the injured, and rescue characteristics in Jiuzhaigou earthquake, which can provide reference for future earthquake emergency medical rescue.
Objective To compare the medical emergency rescue systems used during earthquakes in America, Japan, Russia and China; so as to provide reference material for the establishment and improvement of such a system in China. Methods We searched the official websites of China, America, Japan and Russia, WHO.int, CNKI, OVID, The Cochrane Library and other authoritative sources to collect information involving the medical emergency rescue systems used during earthquakes. The mechanism, legal management, preventive measures and performance of each country’s medical emergency rescue system were summarized and compared. Results Crisis management, integrated action and legal support were highly emphasized in America, Japan and Russia. America and Japan have performed well in implementing routine preventive measures. The organizational structure of the medical emergency rescue system in China was similar to that of the other countries, but its performance was not satisfactory due to insufficient financial support, poor management, inefficient operational mechanism and poor preventive measures. Conclusion There is an urgent need for China to reinforce its medical emergency rescue system. Different models should be taken into account because of the different regional situations in China.
During the medical rescue of Wenchuan earthquake, in accordance with the instruction of the Chinese Ministry of Health, West China Hospital set up the Medical Supply Center for Medical Teams from Other Provinces, put up standard storehouses within 10 hours, performed professional purchase, precisely distributed medical materials according to relevant demands, and decided the scientific route based on the distribution of medical teams from other provinces, so as to ensure the medical materials’ being delivered to the medical teams safely, promptly and accurately.
ObjectiveTo explore the effect of occupational therapy by stages on the activities of daily living (ADL) in spinal cord injury (SCI) patients during Wenchuan earthquake. MethodsTwenty-six SCI patients during Wenchuan earthquake admitted into the People's Hospital of Mianzhu City from July 2008 to June 2011 underwent two-stage occupational therapy. The first stage therapy continued for three months and the second continued for three weeks. ADL was measured using the modified barthel index (MBI). ResultsThe MBI in SCI patients after first-stage therapy was 65.71±19.30, and the MBI in SCI patients after the second-stage therapy was 76.93±16.82. All MBI item scores during the second-stage therapy were higher than in the first stage therapy, and the ability of stool and urine control, and walking increased significantly (P<0.05). ConclusionEarly and continuous occupational therapy by stages can increase the activities of daily living in spinal cord injury patients during Wenchuan earthquake.
Objective To investigate the efficacy of interdisciplinary therapy in critically ill patients with gas gangrene in the 2008 W enchuan earthquake．Methods Four critically wounded patients with gas gangrene caused by Wenchuan earthquake were treated by interdisciplinary cooperation．Results Two patients received debridement and decompression were not amputated．Two amputated patients did not received futher amputation．Conclusions Interdisciplinary therapy of critically ill patients with gasgangrene in earthquake could limited the area of tissue necrosis，minimized the necessity of amputation and further amputation．
Objective To summarize our treatment experience for patients with chest injuries in “4•20” Lushan earthquake. Methods Medical records of 17 patients with chest injuries after 2013 Lushan earthquake who were admittedto the Department of Thoracic Surgery，West China Hospital were analyzed retrospectively. The diagnosis of chest injuries was mainly confirmed by medical history，physical examination，X-ray and CT scan of the chest. Clinical characteristics and treatment outcomes were analyzed. Among the 17 patients，there were 14 men and 3 women with their age of 57.3±16.1 years. Results There were 12 patients （70.6%）with crash injury of heavy objects，4 patients （23.5%） with fall injury and 1 patient with road traffic injury. Chest injuries were skin and soft tissue contusion in 17 patients （100%），rib fracturein 15 patients （88.2%） including 1 patient with abnormal respiratory movements，pulmonary contusion in 15 patients （88.2%），hemopneumothorax in 11 patients （64.7%），sternal fracture in 1 patient （5.9%） and bilateral pneumothorax with widespread subcutaneous emphysema in 1 patient （5.9%）. Thirteen patients （76.5%） had concomitant brain，abdominal，orthopedic or nerve injuries. One patient underwent left thoracotomy，clot removal and internal fixation of rib fractures for left coagulated hemothorax and left lower lobe atelectasis. All the 17 patients received timely and effective treatment and there was noin-hospital mortality. Conclusions Mechanisms of earthquake injuries are often complex，and patients often have multipleinjuries. The main types of chest injury are rib fractures and pulmonary contusion. Tube thoracostomy is a simple andeffective treatment strategy for them. Satisfactory pain management and bronchoscopy procedure can effectively help patientswith removal of respiratory secretions and maintenance of airway patency.
Objective To investigate the mass casualty triage system and its application, to provide evidence and advice for its future standardized use. Method Based on the principles and methods of systematic reviews, we searched MEDLINE (1950 to 2008), The Cochrane library (Issue 2, 2008) and CBM (from establishment to May 2008) to identify papers written in English of Chinese which described mass casualty triage systems or triage systems specific to the aftermath of earthquakes. We extracted information on name, grades, criteria, main characteristics and application of each triage system from the papers involving mass casualty triage systems. We also extracted information on setting, personnel performing the triage, grades, and characteristics from those papers describing any specific triage system for earthquake. We compared the colour of tags, codes and other materials used in different triage systems. Result We included 38 English and 6 Chinese papers. For mass casualty triage systems, we identified 7 primary triage methods with 4 grades.Three of these had relevant application reports. There were 6 secondary triage methods with 3-5 grades, and none had relevant application reports. Four tag methods were identified. Seven papers, 2 of which were published in China, reported specific secondary triage methods for earthquakes. Conclusion Based on the current evidence, there is no universally accepted mass casualty triage system with documented reliability and validity. No triage system has been developed specifically for the wounded in earthquakes. There are large differences between the triage methods for earthquake and other mass casualty incidents. Future research should focus on the development of a reliable and valid mass casualty triage system, aimed at maximizing the capacity for medical rescue.
ObjectiveTo construct a health in all policies (HiAP) evaluation index system for earthquake-stricken areas based on national health policies.MethodsFrom April to December 2020, this study combined the methods of comprehensive review of relevant literature, on the foundation of the evaluation indicators pool was preliminarily constructed. The Delphi method and analytic hierarchy process were adopted to construct the evaluation indicators system in earthquake-stricken areas and analyzed the weights of indicators.ResultsA total of 5 first-level indicators (investment, action, short-term effect, medium-term effect, long-term effect), 15 second-level indicators, and 44 third-level indicators with satisfactory logical consistency of HiAP evaluation indicators system in earthquake-stricken areas had been constructed.ConclusionsThe HiAP evaluation indicators system constructed in this study can be used to comprehensively evaluate the implementation of HiAP earthquake-stricken areas.
Shortly after Wenchuan earthquake, the leader group of the West China Second Hospital accurately defined the role of the hospital during the medical rescue work and ensured the safety of the inpatients. It cooperated with West China Hospital, going to the main battlefield to rescue the injured people, congregating the main medical resources to the disaster areas for medical rescue. The model of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of the resources were ensured to meet the ever-changing demands from all levels of rescue work. Assembling the elite, 12 medical teams and 148 medical staff in all were dispatched to Beichuan, Mianyang, Shifang and Dujiangyan as well as other severe disaster areas. Up to June 2nd, 329 patients from the disaster area had been treated, of whom 132 were admitted into the inpatient department, no one died. Moreover, even during such a period of time, the routine medical service had been offered as regular to patients other than the wounded in the disaster.