中国国际救援队在汶川地震搜救现场的医疗组织与急救

First aid and medical organization of China International Search and Rescue Team （CISAR） in the Wenchuan earthquake search and rescue site

目的探讨有效的地震搜救现场医疗组织与现场急救搜救方法。方法回顾分析首批进人地震灾区的外地救援队——中国国际救援队在汶川地震搜救现场医疗组织与现场急救搜救工作中的经验与不足。中国国际救援队有医疗队员22名，分别来自急诊科、心内科、骨科等科室，携带药品、耗材、器械、设备达280大类，1000多个品种。发现幸存者时在给予医疗救援的同时进行心理疏导。结果中国国际救援队在地震后9h内达到倒塌现场，并搜救出49名幸存者，其中男21例，女28例；年龄7-61岁，其中18岁以下30例，18—39岁8例，40～59岁8例，60岁以上3例。地震后受压72h内得到救护的39例，超过72h的10例。其中头部损伤8人次，胸部损伤12人次，腹部损伤15人次，脊柱损伤3人次，骨盆伤5人次，四肢损伤48人次。均有中重度脱水。通过现场的补液、吸氧、包扎、固定等急救后幸存者被成功救出并送入医院继续救治，49名幸存者无一人死亡。结论搜救现场有效的医疗组织与准确的现场急救可避免救援现场混乱；现场准确判断伤情，及时治疗及心理疏导，加强转运途中监护，可减少灾难事故中幸存者的伤残率和病死率。

Objective To approach the validity of the first aid and medical organization of earthquake. Method China International Search and Rescue Team （CISAR） first arrived Wenchuan earthquake area. The problems of medical organization and emergency treatment on spot were retrospectively analyzed. Twenty-two members from different departments, including department of emergency medicine, department of cardiology and orthopaedics, etc, took 280 species of medicine, consumable material, equipment and device, totally more than 1000 kinds. When finding survivors, the members of medical team gave both medical rescue and psychological inter ven- tion to them. Results After members of CISAR searched 9 hours, they found and treated 49 survivals, including 21 males and 28 females in collapse field of Wenehuan earthquake. Survivals were 7 - 61 years old,30 eases 〈 18 years old,8 cases 18 -39 years old,8 cases 40-59 years old, 3 eases 〉60 years old. And 39 cases were found and treated within 72 hours, 10 eases over 72 hours. Eight eases had head injuries, 12 eases chest injuries, 15 eases abdominal injuries,3 eases spinal injttry,5 cases pelvic injttry, 48 eases limb injttry,and all eases had medium or severe dehydrate. Forty-nine survivals were rescued with fluid infusion, oxygen inhalation, bandaging, fixation and transported to hospitals, and none of the 49 eases died. Conclusions The effective medical organization and first aid on spot can avoid the rescue chaos on emergency treatment, and reduce the rate of disability and case fatality in disaster.