综合性医院急诊科应对大型地震灾害的策略探讨

Coping strategies for major earthquake of emergency department of general hospital

汶川地震后3周内成都铁路中心医院急诊科收治479名伤员，本文对灾害中的救治经验进行总结。在最初阶段，从应急预案启动到开始收治伤员，应立即开展应急方案，并根据实际情况不断调整常规处置程序。而且灾害的状况必须由决策者评估。第二阶段从确认救治人员到转省外治疗，整个过程中应不断总结经验改进应急程序。医疗资源，包括人力资源，应合理组织利用，并培训志愿者转送伤员。第三阶段从转送外省治疗到初步医学救援基本完成，患者数量急剧增加，急诊科必须进行筛查和转运伤者并加强消杀措施。随变化合理统筹安排非常重要。

During the Wenchuan Earthquake the Department of Emergency, Chengdu Railway Central Hospital, received 479 wounded persons. The experience how to deal with the catastrophe was summarized. The period of 3 weeks after the Massive Wenchuan Earthquake could be divided into 3 stages. During the first stage, from the starting up of the emergency pre-plan till admission of the wounded, an emergency medical rescue plan developed in advance should be set in motion immediately. The conventional treatment process should be readjusted based on the actual situation. The disastrous conditions should be judged mainly by the decision-makers. The second stage, since the admission of the wounded persons until they were diverted to other provinces, was the longest. Experience should be summarized regularly so as to continuously improve the emergency medical process. Medical resources, including human resources, should be organized and utilized rationally. Training on transfer of patients should be organized for the volunteers. In the third stage, since the diversion of the wounded to other provinces till the primary accomplishment of the medical rescue declared by the Provincial ＂Health Department in this specific event, the number of admitted patients and the wounded increased sharply. The department of emergency were involved in the screening and transfer of the wounded Communication with the departments concerned on the transportation of the wounded and sterilization should be strengthened. Rational arrangement of shifts is very important.