ABSTRACT
Extracorporeal membrane oxygenation (ECMO) is a technique in which breathing and circulation are supported extracorporeally. Severe trauma may induce cardiopulmonary failure, for which ECMO can play an adjunctive role in the salvage treatment of circulatory and respiratory failure when conventional treatments are ineffective. Bypass with ECMO can rapidly improve the state such as circulatory failure and hypoxemia in critically ill patients in short term and can partially or fully replace their cardiopulmonary function in long term, winning valuable time for normal recovery of cardiopulmonary function. Because of the physical state of severe trauma patients and the ECMO equipment, there are still various complications clinically. Trauma patients show high risk of bleeding, vulnerability to wound infection and probability of combined organ injury and dysfunction, so more comprehensive measures for the prevention and treatment of complications during the use of ECMO therapy are required. The authors review the research progress in complications and corresponding prevention and treatment strategies during ECMO support for severe trauma, aiming to provide a reference to prevent and treat these complications.
ABSTRACT
Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.
ABSTRACT
Objective:To summarize critical cases of emergency helicopter transferring between hospitals and improve the quality and safety of critical care.Methods:The task records of Guangxi Aviation Medical Rescue Training Base from September 2017 to September 2020 were retrieved. The mission acceptance, implementation results, disease spectrum composition, pre-transfer preparation and medical intervention on board were summarized.Results:① General information: a total of 168 patients of helicopter transfer requests were registered, of which 36 patients were transferred, 35 patients were successful, 1 patient had cardiac arrest during the landing phase, and died several hours after continuous resuscitation. Of the 36 patients 30 were males and 6 were females, with median age of 50.5 (29.8, 66.0) years old, the average transfer time was (54.95±17.89) minutes, and the average transfer distance was (205.74±74.68) km. ② Disease spectrum included 11 cases of stroke (30.55%), 7 cases of trauma (19.45%), 5 cases of severe pneumonia (13.89%), 5 cases of heart and macro-vascular diseases (13.89%), 5 cases of abdominal emergency (13.89%), and 3 other conditions (8.33%).③ Severity: 31 patients (86.11%) were severe (≥15) according to acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score; 19 patients (52.78%) were high-risk emergency transport (≥6) according to Hamilton early warning score (HEWS); 6 patients (85.71% of trauma patients) were severe trauma (≥16) according to injury severity score (ISS). ④ Preparation before transfer: remote consultation was carried out to evaluate the latest state of the patient's condition, especially the respiratory and circulatory conditions. Relevant items were reviewed and emergency treatments were implemented when necessary. Targeted preparation was made for accidents that might occur during transfer, such as electrocardiogram (94.44%), blood gas analysis (94.44%), brain CT (36.11%) and other auxiliary examinations, endotracheal intubation or tracheotomy (72.22%), deep vein catheterization (91.67%), placement of gastric tube (86.11%) and urinary tube (88.89%), adjustment of sedative (38.89%), vasoactive drugs (58.33%) and drugs for dehydration and lowering intracranial pressure (33.33%), and fixation of fracture (11.11%), etc. ⑤ On-board medical intervention: cardiac monitoring, blood pressure, respiration and blood oxygen monitoring were carried out in all patients. The parameters of patients using ventilator were adjusted in time (66.67%). The dosage of patients using micropump was adjusted in time (91.67%). Other aspects included the use of sedative and analgesics (38.89%), sputum suction nursing (75.00%), all kinds of catheter nursing (endotracheal intubation/incision nursing of 72.22%, indwelling catheter nursing of 88.89%), and cardiopulmonary resuscitation for patient with cardiac arrest (2.78%).Conclusion:As the patients transferred by helicopter are mainly those of critically ill at this stage, the requirements for airborne medical equipment and rescue technology are high, and there is an urgent need to establish technical specifications and personnel training standards.
ABSTRACT
【Objective】 To investigate the availability and convenience of emergency blood transfusion in mainland China, and develop strategies for improvement. 【Methods】 The electronic questionnaire was self-made by the research team, and pushed to physicians and technicians related to emergency blood use and supply nationwide through the WeChat group of professional organizations such as the Chinese Medical Doctor Association′s Emergency Resuscitation and Disaster Medicine Professional Committee. The data was automatically aggregated by the internet survey platform named questionnaire star, and analyzed by statistics software SPSS 21.0. 【Results】 1) General information: A total of 3 151 questionnaires were collected, of which 85% (2 678 / 3 151), from 31 provinces, municipalities or autonomous regions in mainland China were valid, and 39%(1 044/2 678), 22%(577/2 678), 39%(1 057/2 678) were from the east, middle and west region, respectively; 78%(2 099/2 678) were from tertiary hospitals, and 22%(579/2 678) secondary hospitals and below; 60%(1 607/2 678), 16%(425/2 678), and 24%(646/2 678) were from Emergency Department(EM), Intensive Care Department (ICU) and other departments respectively. The respondents with senior position titles took up 34%(906/2 678) while those with intermediate and junior position titles took up 30% (798/2 678) and 36%(974/2 678) respectively. 2) Availability : 63%(1 680/2 678) of the respondents experienced untimely and insufficient blood supply at least once during June 2017 to May 2020, of which 75% (1 256/1 680) occurred in the past year. In the past half year, 51% (381/1 057) of respondents in the western region and 34% (713/2 099) in tertiary hospitals experienced more emergency blood shortages (P<0.05). The most prone to clinical blood supply shortage were red blood cells and whole blood, platelets and other plasma components, accounting for 43% (1151/2678), 42% (1125/2678) and 15% (402/2678), respectively. 48% (1 274/2 678) respondents believed that the insufficient blood supply for emergency use " has caused a significant adverse effect on the quality of rescue", and 40% (1 081/2 678) believed that it was " a potential medical safety threat" .3)Convenience: The waiting time for emergency blood transfusionwithin 0.5 h, 1 h and 2 h accounted for 28% (741/2 678), 71%(1 903/2 678) and 90% (2 547/2 678), respectively. The waiting time of emergency blood transfusion within 0.5 h accounted for 50% (286 / 577) in central region, which was significantly higher than that in eastern or western region (P < 0.05). 67% (889/2 678) of respondents experienced blood inventory depletion, of which 30%(792/2 678) had to wait for more than 8 hours for resuming blood supply. 80% (751/1 057) of the respondents in the western region experienced inventory depletion, significantly higher than that in the central region (P<0.05). 4)The influencing factors were mainly insufficient blood donation, growth of clinical demand in blood, blood waste due to expiration and clinical irrational use, accounted for 56% (1 485/2 678), 23% (619/2 678), 7% (183/2 678) and 6% (167/2 678) respectively. 60% (633/1 057) of the respondents in the western region considered insufficient blood donation as the influencing factors, statistically higher than that in the eastern and central regions (P<0.05).5)Suggestions for improvement included more voluntary blood donation, development of blood substitutes, standardization of clinical blood use and extension of blood storage shelf life, accounted for 49% (1 326/2 678), 24% (645/2 678), 19% (499/2 678), and 8% (208/2 678), respectively. 53% (561/1 057) of the respondents in the western region suggested strengthening voluntary blood donation (P<0.05), while 26% (268/1 044), 26% (152/577), 25% (553/2099) of respondents in the eastern, central region and tertiary hospitals respectively suggested strengthening the research and development of blood substitutes (P<0.05). 56% (504/906) of respondents with senior professional titles recommended strengthening voluntary blood donation, while 26% (453/1 772) and 0.9% (164/1 772) of those with intermediate and junior technical titles recommended research and development of blood substitutes and improvement of blood storage technology, respectively(P<0.05). 【Conclusion】 The whole blood reserve can not fully meet clinical emergency needs at present stage, especially in the western region and some tertiary hospitals,, showing the necessity to adopt comprehensive measures to further improve the availability and convenience of emergency blood transfusion, including strengthening voluntary blood donation, developing blood substitutes, prompting rational clinical blood use and improving blood storage technology.
ABSTRACT
Objective To develop a field psychological emergency rescue chest to improve mental health service during disaster relief.Methods The instruments and medicine involved in for mental health were determined based on service orientation,function design and expert survey,and the psychological emergency rescue chest was developed based on optimization of the external and internal structures of field Ⅳ-type chest.Results The chest developed was composed of office instruments,psychological devices,logistics instruments and first-aid medicine for mental health.conclusion The chest gains advantages in design,structure,size,transport,utilization,equipped devices and function integration,and thus is worthy promoting for field mental health service during disaster relief.
ABSTRACT
Objective To investigate the protective effect and the possible mechanism of intravenous infusion with perfluorocarbon pretreatment and posttreatment on acute lung injury in rats on LPS-induced acute lung injury in rats.Methods A total of 24 Wistar rats were randomly divided into 4 groups:control group(NS group),LPS group,Pre group and Post group.Normal saline was given to NS group as a control.Rats were treated with LPS by intratracheal instillation in LPS group,rats received PFC through femoral vein.prior to LPS instillation in Pre group and rats received PFC through femoral vein after LPS instillation in Post group.NS group were sacrificed at 6 h after being injected with NS,LPS group,Pre group and Post group were sacrificed at 6h after being given LPS.Pathological changes of king,PaO2,lung wet to dry weight ratio (W/D),expression of myeloperoxidase (MPO) and intercellular adhesion molecule-1 (ICAM-1) of lung were assessed.Results Intravenous.infusion with perfluorocarbons increased PaO2,decreased W/D,MPO and ICAM-1 significantly (P＜0.05),and this effect is more remarkable in Pre group.Conclusion Intravenous infusion of PFC significantly protects lung from acute lung injury,especially by pretreatment forms,probably by down-regulate the expression of ICAM-1.
ABSTRACT
Objecive To explore the medicine packaging improvement based on PAP shelter hospital requirements to fulfill emergency medicine support,Methods The medicine support during rescue was discussed from the aspects of considerations in medicine plan,requirement for emergency medicine,special medicine purchasing and medicine support,and some countermeasures were put forward for improving medicine packaging.Results Its suggested that the optimization of medicine packaging be performed with considerations on medicine property,package capacity,convenience,transport and environmental suitability.Conclusion Emergency medicine support is of importance for disaster medical rescue,and medicine packaging improvement based on PAP shelter hospital requirements contributes to enhancing the efficiency during disaster rescue.
ABSTRACT
Objective To investigate the protective effect of rosiglitazone on the rats with high altitude pulmonary edema.Methods Thirty-six SD rats were randomly (random number) divided into 6 groups (n =6 each):control group (Control),hypobaric hypoxia model group (HH),rosiglitazone groups (RSG) which were administered with 3 different doses [RSG-L:5 mg/ (kg · d),RSG-M:10 mg/ (kg·d),RSG-H:20 mg/ (kg· d)],dexamethasone group [Dex,4 mg/ (kg· d)].Rats were injected intraperitoneally with different doses of rosiglitazone (RSG),dexamethasone (Dex) or vehicle (Control and HH) for 3 days before placed in simulated altitude of 6 000 m hypobaric hypoxia animal chamber where the temperature and pressure were constant.After 72 h in the chamber,each rat was anesthetized.The water content of lung was determined with wet/dry weight ratio.Bronchoalveolar lavage fluid was measured by bradford method.The contents of GSH was measured by micro-ezymed labeled method.The contents of MDA was measured by TBA method.The enzymatic activities of SOD was measured by WST-1 method.The changes of the TNF-α,IL-6 and IL-10 in serum were determined by ELISA.Light microscope was used to observe the pathological changes of lung tissue.Results Compared with Control group,the wet/dry weight ratio of lung (5.08 ± 0.24) and total protein content of BALF (351.06 ± 44.55) μg/mL increased significantly (P ＜ 0.01) in HH group.There were red blood cells in the alveolar and interstitium,pink fluid exudation in the alveolar,the alveolar septum enhancement,and a large number of inflammatory cell infiltration;the SOD activity (10.65 ± 0.94) U/mgprot and the content of GSH (1.63 ±0.20) μmol/gprot in lung tissue were significantly decreased (P ＜ 0.01),the contents of MDA (2.1 5 ± 0.18) nmol/mgprot increased significantly (P ＜ 0.01),TNF-o (56.92 ± 2.87) pg/mL and IL-6 (217.80 ±48.01) pg/mL levels in serum were significantly increased (P ＜0.01),and IL-10 (76.85 ± 16.72) pg/mL level decreased (P ＜ 0.05).Compared with the HH group,the wet/dry ratio of lung and total protein content of BALF in different doses of rosiglitazone group significantly decreased (P ＜ 0.01),the pathological changes of the lung tissue was significantly improved,SOD activity and the content of GSH in lung tissue was significantly increased (P ＜ 0.01),the content of MDA decreased (P ＜ 0.01),The levels of TNF-α and IL-6 in serum were significantly decreased (P ＜ 0.01),while the IL-10 level was significantly increased (P ＜ 0.01).Conclusion Rosiglitazone could protect the high altitude pulmonary edema by alleviating the oxidative stress and inflammatory response.
ABSTRACT
Objective To obtain the recombinant corticotropin releasing hormone (CRH) protein with soluble, high purity protein through optimizing prokaryotic expression condition and purifying glutathione thiol transferase (GST)-CRH protein. Methods To detect the expression of soluble CRH protein through grope of the host strain GST-CRH temperature of induction expression, the host strain concentration (OD600), IPTG concentration and induction time, the purification of GST-CRH was performed by GST-CRH agarose gel. Western Blot assay was used for the expression identification of the target protein. Results The optimal conditions for the induction of CRH protein were determined: temperature of 30 ℃, IPTG induced concentration 0.1 mmol/L, bacteria density (OD600) 0.8, the induction time of 8 hours, purified GST-CRH>95% fusion protein was obtained. Conclusion The optimal expression conditions of GST-CRH are obtained, and the soluble protein of high purity GST-CRH is also obtained.
ABSTRACT
Introduced in the paper is the development and building of motor medical equipment in China,namely vehicle-mounted field hospitals,cabin hospitals,hospital ships,and rescue helicopters among others.It is pointed out that such development falls far from complete in the country,as evidenced in the poor development for airborne,and an integrated medical rescue system covering land, sea and air needs to be further enhanced in the future.
ABSTRACT
Objective To investigate the mechanism of oxidative damage caused by lipopolysaccharide (LPS)induced sepsis in rat brain.Methods The rats were randomly divided into control group and model group (low LPS group and high LPS group).Twenty-four hours after the modeling,the rats were sacrificed before their brain tissue was taken out and prepared for the test.The changes in malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px),total antioxidant capacity (T-AOC),hydrogen peroxide (H2 O2 )and succinate dehydrogenase (SDH)were detected.The expression level of JNK and Nrf2 protein in brain tissue was detected by qRT-PCR and Western blotting. Results Compared with the control group,the MDA,SOD,GSH-px,T-AOC,H2O2 and SDH level increased significantly in the model group,and the difference in expressions of JNK and Nrf2 was statistically significant (P <0.05). Conclusion The LPS induced septic oxidative brain damage model in rats is successfully established,and the process may be regulated through the Nrf2 and JNK signal pathways.
ABSTRACT
To perform modal analysis of CT shelter by applying computer simulation technology so as to pro-vide theoretical guidance for CT shelter structure optimization. Based on CAD model, the finite element model of a CT shelter was established with ANSYS simulation platform. Through modal analysis, different-order modal frequency and modal shape of the shelter were computed and the kinetic characteristics were evaluated. Low order modal frequency was kept away from the natural frequency range of chassis system resonance to avoid the overall structure reso-nance; the 3rd and the 4th modal frequency and engine idle speed frequency were very close so that local resonance might occur; road roughness excitation frequency covered the first 6 order modal frequencies and the further vibration-re-ducing measures of CT equipment were suggested. Based on the theories of finite element method and current software platform, modal analysis of shelter structure can be simulated and the results can provide valuable data for the improvement of kinetic characteristics and structure design.
ABSTRACT
The daily management of medical equipment in the shelter hospital of CAPF was explored, and some measures were put forward including completing administration, determining responsibilities, improving supervising system, creating management tools, strengthening application for military and civilian uses, enhancing professional awareness and etc. The problems were solved in the discrepancies between construction and management, application and maintenance as well as training and daily service, so that the equipment was improved in efficiency, service life, metrology and stability. References may be provided for the shelter hospital or other medical units of CAPF for daily management of medical devices.
ABSTRACT
To study the equipment modular allocation in the emergency medical unit after Beijing emergency public affairs. Using an improved Delphi method, 25 experts from various fields in Beijing were involved into two rounds consultations. The questionnaire of the first round consultation was formed based on analysis of emergency rescue equipment. Based on the result of the first round consultation, the questionnaire of the second round consultation was set up. The two rounds of questionnaires had the responding rates of experts 100% respectively, and the au-thoritative coefficients of the experts were 0.81 and 0.88. An emergency medical rescue equipment solution with three de-grees modular configuration in Beijing was made based on the consultations and experts' advices. The solu-tion develops the emergency medical service ability of mobile medical units and vehicle-mounted mobile hospital. LUO Ying and GAO Hong-wei are the first authors who contributecl equally to the article.
ABSTRACT
Objective To analyze emergency medical treatment measures and the problems encountered during disaster relief in Chinese intemational rescue team (CIRT) , and to provide reference to improve the level of medical assistance. Method The data were based on the materials of the emergency medical rescue work in Haiti earthquake disaster by CIRT. The data were retrospectively analyzed. Results From January 13 , 2010 to January 27, 2010, CIRT provided medical service for more than 2500 wounded and sick persons, including 700 traumatic debridement, 150 operations, 12 the critical wounded. CIRT duged out 15 bodies. Conclusion Fast and prepara-tive job is the foundation to complete rescue mission with high-quality . The unique workflow ensure to complete the emergency medical rescue missions. Profession and multi-function is the basic quality for intemational rescue team members. Medical equipment regularization is needed.
ABSTRACT
Objective As members of CNEDERT, we were trusted to take the mission of medical rescue in April of this year in Yushu area of Qinghai province. As soon as we heard of the news of earthquake with shock of 7.1 on Richter scale happened on 14th April 2010, our team of 32 members from the General Hospital of Armed Police Force rapidly rushed to get there at 19 o'clock on 14th April. It is a cold plateau with 4000 meters in average above sea level. Of course, they would face many difficult problems and some of them could not be figured out in advance. It was really a new and big challenge. First of all, we had to bear the very low barometric pressure,threatening lives of team members. In order to fulfill the mission of medical rescue, and to prevent the acute mountain sickness (AMS) ,we monitored the physiological changes of every member. Method A total of 32 members aged from 27 - 42 years old with average age of (33.26 + 12.54) years, 6 male and 6 female, gathered at Peking, 50 meters above sea level, 6 hours ahead of getting to Yushu and received physical examination with measurements of SaO2, HR, Hb and breath holding test. The team worked in Yushu area for 13 days and returned back to Peking on 27th April at 13 o'clock. The measurements of SaO2, HR and He were kept on from 14th April to 4th May, 21 days in total. The occurrence of AMS was surveyed by questionnaire from 18 to 48 hours after arrival,and the AMSA was diagnosed and scored according to the Lake Louise consensus on the definition and quantification of altitude illness. When the score was equal or above 3, it was considered to be AMS. Our work activities included searching the victims under the collapsed building, carrying out treatment and operation as soon as possible in the mobile hospital, doing medical round visiting, public health and disease prevention, work of joint rescue of multiple professions and psychological counseling. Results Of them 26 (81.25%) members suffered from AMS of various severities and few of them had pulmonary edema and hematuria, and those with SaO2 below 60% were sent down to the plain of low level above sea. The average level of SaO2 at Peking was ( 98.21 + 2.63) %, and it suddenly dropped to (66.31 ± 4.24)% on the first day of entering Yushu area, and from the 2nd day on, it gradually increased to (84.80 ± 4.20)% on the 13th day of stay in Yushu. On the 14th day, we returned back to Peking, the average SaO2 gradually went up from ( 85.57 + 2.73) % to (85.70 + 3.11 ) % on the 15th day,(87.93±2.63)% on the 17th day, (92.21 ±3.62)% on the 18th day, and (98.2333 ± 1.78)% On the 21st day (5th May ). At plain the average HR was (78 ± 11 ) beats/min, and it went up abruptly to ( 121 ± 18) beats/min on the first day of arrival to Yushu, and from the 2nd day on, it slowly lowered down to (99± 12) beats/min at the end day of stay in Yushu area. When we got back to Peking, the average HR gradually normalized from (91± 18) beats/min to (77 + 16) beats on the 5th May. The average Hb in Peking was ( 118 ± 32) g/L, and it gradually increased to ( 137 ± 18) g/L on the 5th day and to ( 161 ± 27) g/L on the 11th day after arrival, and it gradually dropped to (127:± 13) g/L on the 17th day and to (120± 13) g/L on the 21st day. Various measures were taken to treat and prevent the AMS with Chinese herbal medicines such as hongjingtian (Rholiola sacra [Prain ex Hamet] Fu), droplet-sized pill of danshen (salva miltiorrhiza Bge), slice of xiyangshen (Panax quinquefolium L)for lozenge which had some effect of minimizing the symptoms of AMS, and with easily digestible diet catered for in less amount of food in each meal and more meals every day, and diet was composed of mainly carbohydrate and vitamins. Large amount of fluid was required at least 4000 - 6000 mL daily guided by the number of urination at least once or twice a day. For the severe case with shortness of breath and sense of oppression over chest, the oxygen inhalation and intravenous glucose saline with small dose of hydrocortisone were given. Conclusions There were great changes in SaO2, HR and Hb of individuals rushed into high altitude area from plain of low level above sea in a short length of time. But those individuals had the capability of adaptation to ameliorate bit by bit those changes day by day until 13 days of stay, the end of stay at high altitude. On that day, the levels of SaO2, HR and He were still far away from normal. And those changes took 6 days to resume the original levels after the members retumed to the plain. Of them, 81.25% (26/32) members suffered from AMS of various severities. Various measures taken to treat and prevent the AMS are very important. In addition, working at high altitude area, the medical equipment and facilities should be miniaturized for easy portability on the rugged and narrow footpath in order to preserve the energy of medical members.
ABSTRACT
In April 10, 2010, an earthquake measuring magnitude 7.1 shocked Yushu County,Qinghai province. For medical rescue, the National Earthquake Disaster Emergency Rescue Team was sent to Yushu right away. Rescue work in Yushu was faced with such difficulties as short preparative time, heavy workload, high exposure to various acute high altitude diseases (AHAD), and a number of other diseases frequently found on the cold plateau. To ensure the rescue work a success, the team took a series of measures including efficient preparative procedure, scientific and logical procedure in the emergency medical aid operations, reliable and effective handling of AHADs, along with sufficient self protection for team members.
ABSTRACT
Objective To compare the effects of oxygen therapy and local pressurization in alleviating plateau hypoxia at high altitude.Methods Forty-five healthy male soldiers were investigated at an altitude of 3992 meters.The subjects were randomly divided into three groups, ie.an oxygen inhalation group, a single-soldier oxygen increasing respirator (SOIR) group and a BiPAP group.The oxygen inhalation group was treated with oxygen inhalation via nasal catheter at 2 L/min.SOIR was used to assist breath in the SOIR group.The BiPAP group were treated with bi-level positive airway pressure ventilation, with IPAP of 10 cm H20 and EPAP of 4 cm H2O.PaO2、PaCO2、SpO2 and heart rate were measured before and 30 minutes after the treatment.Results There were continuous increase of PaO2 from (53.30±4.88) mm Hg to (58.58±5.05) mm Hg and (54.43±3.01) mm Hg to (91.36±10.99) mm Hg after BiPAP ventilation and oxygen inhalation, respectively (both P < 0.01).However, the PaO2、of the SOIR group was decreased from (56.00±5.75) mm Hg to (50.82±5.40) mm Hg (P < 0.05).In the other hand, the PaCO2、 was increased from (30.41±1.51) mm Hg to (32.5±2.98) mm Hg in the oxygen inhalation group (P< 0.05), declined from (28.74±2.91) mm Hg to (25.82±4.35) mm Hg in the BiPAP group (P < 0.05), and didn't change significantly from (28.65±2.78)mm Hg to (29.75±3.89) nun Hg in the SOIR group (P > 0.05).Conclusions Both BiPAP ventilation and oxygen inhalation can alleviate plateau hypoxia by improving PaO2 at 3992 meter altitude while SOIR has no significant effect.
ABSTRACT
Objective To approach the validity of the fast aid and medical organization of earthquake.Method China International Search and Rescue Team (CISAR) fast arrived Wenehuan earthquake area.The problems of medical organization and emergency treatment on spot were rethospectively analyzed.Twenty-two members from different departments,including department of emergency medicine,department of cardiology and orthopaedics,etc,took 280 species of medicine,consumable material,equipment and device,totally more than 1000 kinds.When finding survivors,the members of medical team gave both medical rescue and psychological inter venfion to them.Results After members of CISAR searched 9 hours,they found and treated 49 survivals,including 21 males and 28 females in collapse field of Wonchuan ease.Survivals were 7～61 years old,30 cases<18 yearn old,8 cases 18～39 years old,8 cases 40～59 years old,3 cases>60 yearn old.And 39 cases were found and treated within 72 hours,10 eases over 72 hours.Eight cases had head injuries,12 eases chest injuries,15 cases abdominal injuries,3 eases spinal injury,5 cases pelvic injury,48 eases limb injury,and all eases had medium or severe dehydrate.Forty-nine survivals were rescued with fluid infusion,oxygen inhahtion,bandaging,fixation and transported to hospitals,and none d the 49 cases died.conclusions The effective medical organization and first aid on spot can avoid the rescue chaos on emergency treatment,and reduce the rate of disability and case fatality in disaster.
ABSTRACT
Objective To investigate the injury of members nation earthquake emergency relief team(NERT) in Wenchuan earthquake, and to explore right measures to protect themselves in emergency relief.Method The injury of 187 members of rescue team,who took emergency relief of"5·12" Wenchuan earthquake from 12 May to 29 May 2008, was registered according to International classification of Diseases (ICD). Results Medical staff have treated the members for 268 times, dennatogic and subcutaneous tissue disease accounted for 35.4%, masele,skeleton and connective tissue disease accounted for 26.9% ,disease of respiratory system ac-counted for 13.4% .More members responsible for search injured fixed medical aid post,the treatment times were 224,accounting for 91.0% times (91.0%). Conclusions Sufficient medical preparation,fixed medical aid post,psychological quide are very important for members of relief team.