三甲医院应对突发大规模群体性创伤的策略和方法:附南京7.28丙烷爆炸案急救报告

Coping strategies and methods for mass casualty incidents in Grade Ⅲ-A hospitals:report of the propane explosion event on July 28,2010

目的探讨大型综合性医院应对突发性大规模群体性创伤的策略和方法。方法回顾南京7.28爆炸案大规模群体性创伤伤员救治过程,总结大规模创伤救治的经验。结果急诊科2小时45分钟共救治124人,其中严重多发伤及复合伤(ISS≥16)34人(27.4%)。行清创手术118人次,损害控制性手术10例(8.1%)。死亡1例(0.8%),严重创伤抢救成功率97.1%。结论突发性大规模群体性创伤的急救需针对伤员多、伤情重、急救资源需要量大的特点构建相应的急救预案、流程和物资的保障体系,特别是伤员分诊、损伤控制和抢救资源配置至关重要,全盘统筹才能最大程度地抢救伤员的生命,降低死亡率和致残率。

Objective To investigate the coping strategies and methods for mass casualty incidents in emergency department of large general hospital.Methods We reviewed the rescue process of wounded patients in the explosion event on July 28,2010 and summarized the management experiences of mass casualty incidents.Results There were 124 patients rescued in emergency department within the period of 2 hours and 45 minutes,and 34 out of them were severe multiple trauma or combined injury（ISS≥16）.A total of 118 patients received debridement and 10 patients underwent damage control operation.There was 1 case of death,with the successful rescue rate of 97.1%.Conclusion There are too many severe wounded patients at short period in mass casualty incidents.In order to rescue the life of the wounded and decrease the mortality and disability,the emergency plan,process and material supply assurance system should be designed in advance.In addition,coping with mass casualty incidents in combination with triage,damage control and resource allocation is very important.