玉树地震废墟现场医疗急救分析

Field emergency medical treatment on ruins after Yushu earthquake

目的探讨高原地震救援中废墟现场急救策略。方法 2010年4月14日-25日国家地震灾害应急救援队共在青海玉树地震废墟现场救治伤病员58人,男33例,女25例;年龄13-69岁,平均36.4岁;四肢骨折8例,脊柱骨折4例,头部外伤16例,胸部外伤12例,软组织损伤38例,失血性休克2例,急性肺水肿3例。现场进行检伤分类后,根据不同病情对伤病员进行止血、包扎、固定及后送,对于重症伤病员予吸氧、心电监护、止痛、补液、控制休克等综合治疗。结果本组5例重症伤病员经治疗后生命体征稳定,无一例死亡,顺利转送至后方医院继续治疗,其余伤病员均病情平稳并康复。结论快速准确的检伤分类是提高救治效率的保障,对骨折的现场固定处理可避免继发损伤,对于急性肺水肿应早期给氧并给予激素、氨茶碱等综合治疗。

Objective To study the field emergency medical treatment on ruins after highland earthquake.Methods Fifty-eight patients（33 males and 25 females） at the age of 13-69 years（mean age of 36.4 years） were diagnosed and treated by the State Earthquake Emergency Rescue Team in April 14-25,2010,including 8 with extremity fracture,4 with spine factures,16 with head injuries,12 with thoracic traumas,38 with soft tissue injuries,2 with hemorrhagic shock,and 3 with acute pulmonary edema.The patients were sorted on the spot and evacuated after hemostasis,dandaging,fixation of their fractures.The critical patients received treatment in combination with oxygen inhalation,electrocardiographic monitoring,fluid supplement,and shock control,etc. Results The vital signs of the 5 critical patients became stable shortly after treatment with no death occurred.The patients were evacuated to the rear hospitals for further treatment.The other patients with a stable condition were recovered.Conclusion Rapid sorting of patients triage can increase the rescue efficiency.Simple fixation of fractures can avoid secondary injuries.Acute pulmonary edema should be treated in combination with oxygen inhalation,hormones and aminophylline.