医院接诊灾后批量伤员的流程和模式探讨

Admission procedure and model of batch transferred wounded in rear-area hospital after earthquake disaster

目的探讨地震灾害后伤员成批后送转诊过程中后方医院的接诊流程和模式。方法对汶川地震灾害后本院3次成批接诊139例伤员转运和初步收治的流程及模式进行回顾性分析。结果139例转院伤员中,入院时危重患者37例(26.6%),中至重度患者98例(70.6%),轻症患者4例(2.8%);感染观察病房收治病例23例(16.5%);入院当天急诊手术9例(6.5%);所有患者均根据病情轻重和分类得到及时有效的救治,无1例发生转运和收治途中死亡,无院内感染发生。结论建立地震灾害后后方医院成批伤员接诊模式有利于伤员的及时有效救治。建立模式的关键是:及时评估,确定应对等级;明确职责,合理组织人力资源;各环把关,强化院内感染控制和规范流程,保证处置及时。

Objective To explore the admission model of batch transferred wounded from Wenchuan seismic area in rear-area hospital. Methods We retrospectively analyzed the transportation and admission procedures of three batch of patients （139）,from Wenchuan seismic area. Results All of the wounded were triaged by traumatic severity and infection conditions,all of them received therapy timely and anti nosocomial infection actively; none of the death and the in-hospital infection was observed during the transferring and reception process; there were 37 cases（26.6% ）classified as critical wounded, 98 cases（70.6%） severe to moderate and 4 cases（2.8% ）mild injured. On admission, 23 cases were admitted to the infection observation ward; there were 6 emergency operation preformed shortly after admission,including g cases fracture fixation,2 cases of thoracic closed drainage, 1 cases of tracheotomy. Conclusion It is important to establish the admission model of batch transferred wounded in rear area hospital after seismic. To do these,there are four basic elements needing our attention： timely evaluation to chose the response level appropriately, identify staffs abilities to organize human resource more effectively, pay attention to every details to prevent in-hospital infection actively, and standardize the admission procedures to insure the therapy more comprehensively.