急救医疗保障机制在户外极限运动赛事中的系统化构建

Extreme sports events: A mechanism for emergency medical support

目的探讨户外极限运动赛事和极端环境中构建急救医疗保障机制所应覆盖的范畴,为此类特定环境下构建急救医疗保障机制提供参考依据、样本数据及改进建议。方法收集2017年第12届"玄奘之路"戈壁挑战赛中救援人员部署、救援物资配备、救援力量监控等数据和实际救援情况、应急预案及相关规章的设置、相关培训情况等急救医疗保障机制的各环节构成,并对其数据进行分析。结果 (1)此次正式参赛选手共计1 470人,共计医疗处置2 959次,较前次分别增长了24.7%和163.5%,且医疗需求的增长明显高于选手数的增长。(2)本次户外极限运动赛事中最常见的症状包括足部皮肤软组织损伤、眼内异物和中暑,其中需入医疗营帐观察的为中暑(46.8%)、骨骼肌肉等运动损伤(19.4%)、皮肤疾患(12.1%)。(3)本次赛事保障采用了"利用属地化资源的核心团队集约化管理模式",承担本次赛事保障任务的核心医疗团队人员仅占保障团队人数的4.5%,经过系统化培训的急救志愿者占77.4%。(4)因地制宜采用具备随车急救单元(emergency medical unit,EMU)的改制越野救援车(65.4%)与普通救护车(19.2%)相结合的多车种救援转运模式。(5)经专家组和技术组可行性论证后投入使用的120种20 000余件医疗物资和近300台的通讯定位设备从硬件层面对赛事给予了保障。结论户外极限运动赛事和极端环境中的急救医疗保障机制的构建需关注和覆盖赛事及环境相关疾病的流行病学特点、保障团队的运作模式、人员配备及适任性培训、医疗保障物资的配备及部署、通讯转运能力的部署与配合、合理的保障预案等多种因素,并结合赛事特点、环境局限等相关因素不断完善。

Objective The objective of this study was to discuss what a mechanism should contain for emergency medical support in the case of extreme sports events and extreme conditions and to provide evidence and data for improving such a mechanism.Methods The data of the2017Xuanzang Route Ultra-Trail Gobi Race,which included the deployment of rescue workers and emergency supplies,the tracking and monitoring of rescue forces,the actual rescue efforts,emergency plans,and the related regulations and trainings,were collected and analyzed.Results(1)In this event,there were1470contestants and2959treatment cases,an increase of24.7%and163.5%,respectively,compared with the previous event.(2)The most common cases in this event were foot soft tissue injuries,intraocular foreign bodies,and heat stroke;of the patients admitted into medical examination tents,heat stroke accounted for46.8%,skeletal muscle movement injury for19.4%and skin disorders for12.1%.(3)This event adopted an intensive management model combining local resources with a core medical team for this event.The core team only accounted for4.5%of event service staff in terms of the number of people,while trained emergency volunteers accounted for77.4%.(4)The rescue transport vehicles consisted of regular ambulances(accounting for19.2%)and customized off-road rescue vehicles(accounting for65.4%)equipped with emergency medical units.(5)Following a feasibility study by experts,120types of medical supplies(totaling20000items)and300sets of communication and positioning equipment were put into use in this event.Conclusions When building a mechanism for emergency medical support in the case of extreme sports events and extreme conditions,we should take into account the characteristics of event and environment-related diseases and epidemics,the composition,operation and training of event service staff,the allocation and deployment of medical supplies,communication and transport capacity,and emergency plans.Based on the event characteristics and environmental constraints,such a mechanism can be continuously improved.