昆山“8·2”特大爆炸事故紧急救援期三级救治分析

Analysis on Tertiary Care of Kunshan“8·2”Explosive Accident Victims during Emergency Relief Period

目的探讨特大爆炸事故医学救援中的三级救治。方法以昆山市急救中心在爆炸事故中采取医学救援的院前急救实践为基础,回顾分析医学救援中的三级救治。结果爆炸发生即刻昆山市急救中心迅速开展对现场伤员的院前急救,急救指挥调度中心1 h内调派车次34次,转运伤员分别送至昆山市区医院;二级救治(早期救治):昆山市区医院共接诊伤员194名,1 h内完成气管切开和建立静脉通道124例,保证伤员基础生命体征;三级救治(专科救治):妥善分流危重伤员174名,确保得到烧伤专科救治和集中管理。结论三级救治是昆山特大爆炸事故救治工作的主要模式,其中一、二级救治是关键环节,三级救治依托周边城市急救中心的驰援协助,圆满完成爆炸事故危重伤员分流救治。救援过程指挥得当、反应迅速、配合紧密,彰显政府在突发灾害时刻紧急救援的组织、协调、应急能力和各级医疗急救单位的急救精神。

Objective To discuss the process and function of tertiary care in the medical relief of extraordinary explosive acci- dent. Methods Tertiary care was retrospectively analyzed on the basis of prehosptial practices adopted during medical relief in Kun- shaM extraordinary explosive accident happened on August 2nd, 2014. Results Emergency center of Kunshan city at once exhibited pre-hospital emergency cure and managed to ask dispatching center for sending ambulance 34 times within an hour, transferred patients to hospitals of Kunshan city. Secondary treatment （early treatment） ： Hospitals of Kunshan city accepted 194 patients and accomplished 124 cases for tracheotomy and establishing intravenous access to protect lives of affected people. Tertiary care （specialized treatment） ： 174 cases of severely injured people were distributed appropriately so as to get specialized burn treatment and intensive management. Conclusions Tertiary care is the major mode in this relief, together with the first and secondary treatment as key process which assis- ted by tertiary care. As a result, tertiary care is well achieved during the emergency accident. Proper conduct, rapid response and close corporation have shown Jiangsn provincial government＇ s competence of arrangement, collaboration, emergency response and the spirits of first aid embedding in emergency medical units at all level.