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Study on the Key Influence Factors of Environmental Mass Incidents by Delphi-PCA-Frequency Analysis Composite Method
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作者 Chuai Xiaoming HAN Jingwen +1 位作者 Zhou Ying Wang Jiajia 《Meteorological and Environmental Research》 CAS 2018年第3期54-59,共6页
In order to prevent and control environmental mass incidents,by comprehensively using literature research,case analysis and logical reasoning method,27 factors influencing environmental mass incidents were selected. A... In order to prevent and control environmental mass incidents,by comprehensively using literature research,case analysis and logical reasoning method,27 factors influencing environmental mass incidents were selected. Among them,15 key influencing factors were screened by Delphi-PCA-frequency analysis composite method. The key influencing factors were analyzed,and corresponding countermeasures were put forward. 展开更多
关键词 Environmental mass incidents Delphi-PCA-frequency analysis Key influence factors
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The Usage of Triage Systems in Mass Casualty Incident of Developed Countries
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作者 Junnan Wang Wenjing Lu +4 位作者 Jiating Hu Wang Xi Jibin Xu Zhinong Wang Yufeng Zhang 《Open Journal of Emergency Medicine》 2022年第2期124-137,共14页
Victims are usually overwhelmed by local medical system in an unexpected mass casualty incident (MCI). Triage systems originate from wartime necessity to achieve the greatest efficiency to the maximum number of victim... Victims are usually overwhelmed by local medical system in an unexpected mass casualty incident (MCI). Triage systems originate from wartime necessity to achieve the greatest efficiency to the maximum number of victims. In peacetime, the triage systems are applied to allocate constrained medical resources for the victims in MCI. There are several kinds of triage systems in different countries, such as Simple Triage and Rapid Treatment (START), Sort, Assess, Life-saving interventions, Treatment and/or Transport (SALT), Sacco Triage Method (STM), Careflight triage and Triage Sieve (TS). The START system is widely used in developed countries, especially in USA. The SALT is formulated by a work group of the Centers for Disease Control and Prevention (CDC) based on scientific data. STM is a triage algorithm designed for resource-constrained condition. Besides, the other triage systems show their power in managing the victims in MCI. However, the data of theses popular triage tools are mainly based on simulated tests, lacking of validity and reliability of triage systems. Therefore, the application, reliability, sensitivity and specificity of existing triage tools require to be validated in the real condition of MCI. Furthermore, due to the difference among triage tools used in different countries, international cooperation is demanded for a more highly organized mass-casualty medical response. 展开更多
关键词 mass Casualty incident Triage Systems Emergency Medical Resources Allocation
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Mass Casualty Incident Primary Triage Methods in China 被引量:4
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作者 Jin-Hong Chen Jun Yang +1 位作者 Yu Yang Jing-Chen Zheng 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第19期2664-2671,共8页
Objective:To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China.Data Sources:Chinese literature was searched by Chinese Academic J... Objective:To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China.Data Sources:Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014).The English literature was searched by PubMed (MEDLINE) (1950 to June 2014).We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/),National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/),and China Earthquake Information (http://www.csi.ac.cn/).Study Selection:We included studies associated with mass casualty events related to China,the PT applied in China,guidelines and standards,and application and development of the carding PT method in China.Results:From 3976 potentially relevant articles,22 met the inclusion criteria,20 Chinese,and 2 English.These articles included 13 case reports,3 retrospective analyses of MCI,two methods introductions,three national or sectoral criteria,and one simulated field testing and validation.There were a total of 19 kinds ofMCI PT methods that have been reported in China from 1950 to 2014.In addition,there were 15 kinds of PT methods reported in the literature from the instance of the application.Conclusions:The national and sectoral current triage criteria are developed mainly for earthquake relief.Classification is not clear.Vague criteria (especially between moderate and severe injuries) operability are not practical.There are no triage methods and research for children and special populations.There is no data and evidence supported triage method.We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real,practical,and efficient PT method. 展开更多
关键词 mass Casualty incident PREHOSPITAL Primary Triage STANDARDS Systematic Review
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Research approaches to mass casualty incidents response:development from routine perspectives to complexity science 被引量:4
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作者 Shen Weifeng Jiang Libing +3 位作者 Zhang Mao Ma Yuefeng Jiang Guanyu He Xiaojun 《Chinese Medical Journal》 SCIE CAS CSCD 2014年第13期2523-2530,共8页
Objective To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system,computational experiments and paralle... Objective To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system,computational experiments and parallel execution (ACP) method.Data sources We searched PubMed,Web of Knowledge,China Wanfang and China Biology Medicine (CBM) databases for relevant studies.Searches were performed without year or language restrictions and used the combinations of the following key words:“mass casualty incident”,“MCI”,“research method”,“complexity science”,“ACP”,“approach”,“science”,“model”,“system” and “response”.Study selection Articles were searched using the above keywords and only those involving the research methods of mass casualty incident (MCI) were enrolled.Results Research methods of MCI have increased markedly over the past few decades.For now,dominating research methods of MCI are theory-based approach,empirical approach,evidence-based science,mathematical modeling and computer simulation,simulation experiment,experimental methods,scenario approach and complexity science.Conclusions This article provides an overview of the development of research methodology for MCI.The progresses of routine research approaches and complexity science are briefly presented in this paper.Furthermore,the authors conclude that the reductionism underlying the exact science is not suitable for MCI complex systems.And the only feasible alternative is complexity science.Finally,this summary is followed by a review that ACP method combining artificial systems,computational experiments and parallel execution provides a new idea to address researches for complex MCI. 展开更多
关键词 mass casualty incident research approaches complexity science
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Development of the science of mass casualty incident management: reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire 被引量:1
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作者 Wei-feng SHEN Li-bing JIANG +3 位作者 Guan-yu JIANG Mao ZHANG Yue-feng MA Xiao-jun HE 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2014年第12期1072-1080,共9页
Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus tire, in ord... Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus tire, in order to outline and develop an improved research paradigm for MCI management. Methods: We searched PubMed, EMBASE China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The following key words and medical subject headings were used: 'mass casualty incident', 'MCI', 'research method', 'Wenchuan', 'earthquake', 'research paradigm', 'science of surge', 'surge', 'surge capacity', and 'vulnerability'. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. Results: The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored--vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. Conclusions: This new paradigm breaks through the limitation of traditional research paradigms and will contribute to the development of a methodology for disaster research. 展开更多
关键词 mass casualty incident SURGE VULNERABILITY Earthquake Fire incident
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高血压合并肾上腺占位病变的临床特点分析 被引量:1
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作者 陈未艾 张俊清 《医学综述》 2017年第13期2676-2680,共5页
目的探讨高血压合并肾上腺占位病变患者的临床特点。方法收集2016年1—7月北京大学第一医院以血压控制不佳入院的166例高血压患者的临床资料,根据患者临床表现、血浆肾素活性(PRA)、醛固酮化验结果、醛固酮/肾素比值(ARR)及影像学检查,... 目的探讨高血压合并肾上腺占位病变患者的临床特点。方法收集2016年1—7月北京大学第一医院以血压控制不佳入院的166例高血压患者的临床资料,根据患者临床表现、血浆肾素活性(PRA)、醛固酮化验结果、醛固酮/肾素比值(ARR)及影像学检查,将患者分为高血压合并无功能偶发肾上腺瘤(NIDAM)组(77例)、原发性醛固酮增多症(PA)组(48例)和单纯原发性高血压(EH)组(41例),对3组患者性别、年龄、体质指数、腰围、是否合并糖尿病、血脂(三酰甘油及低密度脂蛋白胆固醇)及血钾水平、肾上腺占位病变大小、卧位PA、醛固酮水平及ARR值及立位PA、醛固酮水平及ARR值进行对比分析。结果 3组患者性别、年龄、体质指数、腰围、是否合并糖尿病、血脂(三酰甘油及低密度脂蛋白胆固醇)及血钾水平比较,差异无统计学意义(P>0.05),但PA组尿酸水平较EH组低[(303.4±57.0)μmol/L比(347.0±88.4)μmol/L,P=0.013]。3组患者PRA比较,PA组患者卧/立位PRA均低于NIDAM组和EH组(P<0.001),NIDAM组立位PRA低于EH组[3.37(1.59,5.12)μg/(L·h)比4.18(2.13,8.28)μg/(L·h),P=0.032],NIDAM组卧位PRA亦低于EH组(P<0.001)。3组ARR比较,PA组患者卧/立位ARR高于NIDAM组和EH组(P<0.001),NIDAM组立位ARR高于EH组(P=0.019),NIDAM组卧位ARR高于EH组(P<0.001)。3组醛固酮水平比较,差异均无统计学意义(P>0.05)。NIDAM组和PA组肾上腺占位病变分布比较,差异无统计学意义(P>0.05);PA组病变直径为0.8(0.3,1.2)cm,小于NIDAM组病变直径的1.3(0.7,2.0)cm(Z=-3.080,P=0.002)。结论醛固酮水平正常不能排除PA,PRA降低和ARR升高可作为PA的诊断和筛查标准,较醛固酮具有更高的敏感性和特异性,并且不应根据患者腺瘤直径大小判断有无内分泌功能。对于NIDAM患者,肾素水平低于正常,应定期随访进行内分泌功能检查,以免漏诊。 展开更多
关键词 原发性醛固酮增多症 无功能偶发肾上腺瘤 高血压 醛固酮/肾素比值 肾上腺占位
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偶发肾上腺占位的影像学诊断策略 被引量:3
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作者 高井海 高凌云 车舒平 《医学综述》 2018年第4期799-803,共5页
在影像临床工作中偶发肾上腺占位极为常见。这些病变尽管大多为良性,仍需排除潜在的恶性可能。因此,临床的首要工作是排除恶性肿瘤的侵袭性特征,并确定最常见的良性病变肾上腺腺瘤。CT、增强CT、磁共振成像(MRI)多种成像模式已广泛应用... 在影像临床工作中偶发肾上腺占位极为常见。这些病变尽管大多为良性,仍需排除潜在的恶性可能。因此,临床的首要工作是排除恶性肿瘤的侵袭性特征,并确定最常见的良性病变肾上腺腺瘤。CT、增强CT、磁共振成像(MRI)多种成像模式已广泛应用于临床。如果CT平扫肾上腺占位低衰减(<10 Hu),增强CT绝对廓清比≥60%和(或)相对廓清比≥40%及MRI反相位序列信号降低,则提示为腺瘤。能谱CT及正电子发射计算机断层显像的迅猛发展为肾上腺占位精确诊断提供了新的方法及思路。 展开更多
关键词 肾上腺偶发占位 肾上腺腺瘤 肾上腺髓样脂肪瘤 肾上腺转移瘤 能谱CT
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The role of plastic surgeons in extremity reconstruction following mass casualty incidents 被引量:1
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作者 Dustin T.Crystal Ahmed M.S.Ibrahim Samuel J.Lin 《Plastic and Aesthetic Research》 2019年第1期1-10,共10页
Aim: Mass casualty incidents (MCIs) are a devastating source of morbidity and mortality, testing the infrastructure of acute care management and challenging the ability to reconstruct limbs. Herein, we look to further... Aim: Mass casualty incidents (MCIs) are a devastating source of morbidity and mortality, testing the infrastructure of acute care management and challenging the ability to reconstruct limbs. Herein, we look to further a discussion on upper and lower limb reconstruction following MCIs.Methods: Review of the literature, including our institute's experience with the 2013 Boston Marathon Bombings, the 2015-2016 Terror Attacks in Ankara, and the 2010 earthquake in Haiti, pertaining to extremity reconstruction following MCIs.Results: The three aforementioned case profiles highlight extremity wounds associated with MCIs and the subsequent reconstructive role of plastic surgeons. Surgical intervention or temporization of extremity wounds is a critical responsibility of plastic surgeons in this setting. Limb salvage is possible and often the preferred option following disasters.Conclusion: Intentional or naturally occurring MCIs are a grim reality. Successful response to these events requires prompt mobilization of emergency medical staff and hospital activation. Plastic surgeons play a paramount role in multidisciplinary management of trauma with a particularly important involvement in limb reconstruction. 展开更多
关键词 Upper extremity reconstruction lower extremity reconstruction mass casualty incidents MICROSURGERY
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全力防范偶发事件转化为大规模群体性事件——抓好源头治理和初期处置 被引量:1
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作者 郭经文 《吉林公安高等专科学校学报》 2009年第2期5-9,共5页
近年来,因偶发因素引发的群体性事件逐渐增多,社会危害极其严重,已成为影响社会和谐、稳定的突出问题,如不能有效加以防范和控制,极易引发社会骚动,甚至造成局部社会动荡。偶发事件引发社会骚动存在一定的必然因素,它反映的是我国社会... 近年来,因偶发因素引发的群体性事件逐渐增多,社会危害极其严重,已成为影响社会和谐、稳定的突出问题,如不能有效加以防范和控制,极易引发社会骚动,甚至造成局部社会动荡。偶发事件引发社会骚动存在一定的必然因素,它反映的是我国社会转型、经济转轨时期的深层次社会矛盾,所暴露出来的是政府职能部门及其党员干部在工作理念、工作机制、工作方式中存在的一些不足和弊端。 展开更多
关键词 偶发事件 群体性事件 偶发因素 政府职能 源头治理 初期处置
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Mass-Casualty Distribution for Emergency Healthcare:A Simulation Analysis 被引量:1
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作者 Mohsin Nasir Jat Raza Ali Rafique 《International Journal of Disaster Risk Science》 SCIE CSCD 2020年第3期364-377,共14页
This study focuses on the casualty-load distribution problem that arises when a mass casualty incident(MCI)necessitates the engagement of multiple medical facilities.Employing discrete event simulations,the study anal... This study focuses on the casualty-load distribution problem that arises when a mass casualty incident(MCI)necessitates the engagement of multiple medical facilities.Employing discrete event simulations,the study analyzed different MCI response regimes in Lahore,Pakistan,that vary in terms of the level of casualty-load distribution and the required coordination between the incident site and the responding hospitals.Past terrorist attacks in this major metropolitan area were considered to set up experiments for comparing delays in treatment under the modeled regimes.The analysis highlights that the number of casualties that are allowed to queue up at the nearest hospital before diverting the casualty traffic to an alternate hospital can be an important factor in reducing the overall treatment delays.Prematurely diverting the casualty traffic from the incident site to an alternate hospital can increase the travel time,while a delay in diversion can overload the nearest hospital,which can lead to overall longer waiting times in the queue.The casualty distribution mechanisms based only on the responding hospitals’available capacity and current load can perform inefficiently because they overlook the trade-off between the times casualties spend in traveling and in queues. 展开更多
关键词 Casualty distribution Emergency response mass casualty incidents Pakistan Urban terrorism
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Civilian casualties of Iraqi ballistic missile attack to Tehran, capital of Iran
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作者 Ali Khaji 《Chinese Journal of Traumatology》 CAS 2012年第3期162-165,共4页
Objective: To determine the pattern of causalities of Iraqi ballistic missile attacks on Tehran, the capital of Iran, during Iraq-Iran war. Methods: Data were extracted from the Army Staff Headquarters based on dai... Objective: To determine the pattern of causalities of Iraqi ballistic missile attacks on Tehran, the capital of Iran, during Iraq-Iran war. Methods: Data were extracted from the Army Staff Headquarters based on daily reports of Iranian army units during the war. Results: During 52 days, Tehran was stroked by 118 A1-Hussein missiles (a modified version of Scud missile). Eighty-six missiles landed in populated areas. During Iraqi missile attacks, 422 civilians died and 1 579 injured (4.9 deaths and 18.3 injuries per missile). During 52 days, 8.1 of the civilians died and 30.4 injured daily. Of the cases that died, 101 persons (24%) were excluded due to the lack of information. Among the remainders, 179 (55.8%) were maleand 142 (44.2%) were female. The mean age of the victims was 25.3 years+19.9 years. Our results show that the high accuracy of modified Scud missiles landed in crowded areas is the major cause of high mortality in Tehran. The presence of suitable warning system and shelters could reduce civilian casualties. Conclusion: The awareness and readiness of civilian defense forces, rescue services and all medical facilities for dealing with mass casualties caused by ballistic missile at- tacks are necessary. 展开更多
关键词 Mortality WAR mass casualty incidents Wounds and injuries
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