Between the Craft and the Mud:An Analysis of the Work and Health Relationship of Firefighters in the Breach of the Córrego do Feijão Dam-Brumadinho/MG

Faced with the rupture of the Vale S.A.tailings dam that hit the city of Brumadinho(MG),the article sought to better understand the organisation of work of military firefighters who participated in the search and rescue operation and the relationship between work and health present in this scenario.This is qualitative research with a focus on the subjective production of the speeches of seven firefighters who were interviewed individually with a semi-structured script,using as a basis of analysis the ergological perspective and the productions of the psychodynamics of work.The firefighters experienced a scenario with risks of injury,contamination,and even death.In the interviews,they showed that the more than twelve hours of work were responsible for sleep problems during and after the performance,as well as the food provided and the lack of time for physical exercise proved to be aggravating factors for their health.Working in the tailing’s mud combined the development of musculoskeletal problems and anxiety,due to the possibility of contamination by metals present in the mud.The work relationships show a high degree of trust and recognition between the firefighters and the affected population,which helped in the motivation and continuation of the operation until the present moment.The work in this operation that gained national prominence was responsible for the feeling of pride and for feeling more capable and prepared to act in other disasters.This research is expected to broaden the discussion about the work-health relationship of military firefighters exposed to disasters,as well as serve as a subsidy to encourage the creation of public policies focused on the health of these workers.

China Medical Team： Medical rescue for ＂4.25＂ Nepal earthquake

In recent years, global natural disasters have been frequent and resulted in great casualties and property loss. Since Wenchuan earthquake, the disaster emergency rescue system of China has obtained considerable development in various aspects including team construction, task scheduling, personnel training, facilities and equipments, logistics, etc. On April 25, 2015, an earthquake that measured 8.1 on the Richter scale attacked Nepal. Chinese government firstly organized a medical team, named China Medical Team, and sent it to the attacked region in Nepal to implement medical rescue. The medical team completed the rescue mission successfully and creatively based on their experiences.

Retrospective analysis： the earthquake-injured patients in Barakott of Pakistan

Objective： To provide the experience on medical rescue and care for any giant earthquake by analysing the patients treated by the Chinese Medical Rescue Team in the Barakott earthquake of Pakistan. Methods： On October 8, 2005, a giant earthquake （7.8 Richter scale） earthquake occurred in the northwest Pakistan. We belonged to the Chinese Medical Rescue Team and worked in the earthquake-affected town-Barakott from October 28, 2005 to November 17, 2005. The patients were classifted into upper respiratory tract infection, diarrhea, trauma and other diseases. All the data of patients who were injured during the earthquake were analysed. The difference was analyzed by x^2 test. Results： Of the 2 194 patients treated by the Chinese Medical Rescue Team, trauma patients only accounted for 29%, diarrhea patients for 4%, upper respiratory infection patients for 14%, and other types of diseases for 52%.Among the 630 trauma patients, 426 patients were injured during the earthquake. Of the 426 patients, 291 （68%） patients were found having open wounds, 85 （20%） patients mainly complained of soft tissue pain without any wound or fracture, and 76 （18%） patients had fractures with or without open wound. The most frequent site of wound was lower extremity. Head injury in children was 30%, obviously higher than that in the adults. Wound infection was common among the injured patients, with the rates of 72%, 64% and 78% in male, female adult patients and children, respectively. Conclusions： Prevalence of common diseases, trauma, wound infection and fracture are main problems presented at late stage of the giant earthquake. Great attention should be paid to head and lower extremity injuries.

First aid strategy for severe traumatic patients in hospital

Objective： To study the emergency management principles of severe trauma in hospital （injury severity score ≥ 16）. Methods： We used ＂ ATP principle＂ to manage severe traumatic patients. The ATP principle is composed of： 1 ） attending surgeons offering initial management （A） ; 2 ） teamwork commencement immediately after patients admitted to hospital （ T ） ; 3 ） parallel principle, ie, emergency resuscitation, evaluation and laboratory test performed simultaneously （P）. Clinical effects before and after applying ATP principle were retrospectively analyzed and compared. Results： During January 1, 2002 to December 31, 2003, 338 patients were treated without applying ATP principle, in which ISS was 25.9 ± 6.4, 152 cases died with the mortality being 39. 2%, and the time stayed in emergency department and the time to operation room after admission were （102.8±16.7） rain, （140.3 ±20.6） rain,respectively. During January 1, 2004 to December 31, 2005, 438 patients were treated based on ATP principle, in which ISS was 28.6 ± 7.8, 87 cases died with the mortality being 19.9%, and the time in emergency department and the time to operation room after admission were （69.5 ± 11.5） rain, （89.6 ±9 .3） min, respectively. ISS showed no significant difference between the two groups （ P 〉 0.05 ）, but the mortality, the time stayed in emergency department and the time to operation room after admission were greatly reduced and showed significant difference between the two groups （ P 〈 0.05 ）. Conclusions： Applying ATP principle to treat severe traumatic patients can shorten emergency treatment time in hospital and decrease mortality.

Epidemiological features of I 281 patients with head injuries arising from the 2008 Wenchuan earthquake

Objective： To analyze the epidemiological features of patients with head injuries in the 2008 Wenchuan earthquake. Methods： Medical records of patients with head injuries who were admitted to 14 hospitals in Deyang, Mianyang and Chengdu cities after the earthquake were retrospectively analyzed. The patients＇ age, gender, cause of injury, diagnosis, and outcome were analyzed retrospectively. Results： A total of 1 281 patients with 807 males and 474 females were included. According to Glasgow Coma Scale score at admission, 1 029 patients presented with mild injury, 161 moderate injury and 91 severe injury. The major cause of injuries （83%） was bruise by collapsed buildings.Open head injuries accounted for 60.8%. A total of 720 patients underwent surgical treatment. Good recovery was achieved in 1 056 patients, moderate disability in 106, se- vere disability in 71, coma in 29 and death in 19. Conclusions： In this series, male patients were more than female patients. The main cause of injury was hit by falling objects due to building collapse. Minor and open craniocerebral injuries were most common. The epidemiological features of head injuries in Wenchuan earthquake may be helpful to preparation for future rescue.