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Objective:The regional emergency system needs to maintain normal operation in disasters and sudden public health events, ensuring the timely treatment of critically ill patients, and also bearing the responsibility of ensuring various large-scale sports events. This article explores the practice of the "three-dimensional closed-loop" emergency system in the guarantee of the Hangzhou Asian Games in Wenzhou.Methods:After analyzing and integrating existing medical resources, the First Hospital Affiliated to Wenzhou Medical University conducted a two-year medical emergency exercise in a simulated urban road and natural water environment, and improved and optimized the weak links in the medical security system.Results:The hospital established a "three-dimensional closed-loop" emergency system and completed the medical support tasks for the Asian Games. The "three-dimensional closed-loop" emergency rescue system adopted a three-dimensional management team that combined a decentralized organizational structure and a professional medical team, and also has a land-air-sea emergency rescue team. By combining manpower and information technology, the system could provide "4R" medical services: real-time perception of medical emergencies in venues, rapid assessment of the patient's condition, rapid transfer of patients and rapid deployment of medical forces within the hospital. In addition, closed-loop management of the hospital's diagnosis and treatment process improved patients' satisfaction during the treatment process.Conclusions:The the "three-dimensional closed-loop" emergency system provided a strong guarantee for the successful holding of the Hangzhou Asian Games in Wenzhou and also accumulates experience for future urban emergency rescue.
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Objective To meet the needs of public health emergency management in the new era, to improve the problems exposed in the public health emergency system after the outbreak of COVID-19, and to provide the government with a list of the gaps in the construction of the public health emergency system. Methods Several methods, including literature review, observation (discussion and questionnaire survey), and comparative and descriptive research, were used to conduct comprehensive analysis through the combination of induction and deduction. The evaluation questions were graded and were translated into some recognition indexes (averages). The golden section method was used for the recognition standard of evaluation problems, and U test method was used for statistical test. Results Five aspects of problem evaluation and suggestions were determined, including early warning, emergency plan, emergency management department, linkage between systems and epidemic situation judgment. The recognition indexes were 0.916, 0.905, 0.571, 1.000 and 1.190, respectively, all of which met the recognition standard, and there was no significant difference between them(P=0.357). The corresponding measures and suggestions were as follows: early warning trigger mechanism, modular emergency plan, government public health emergency agencies, collaborative emergency drill system of various industries, and expert epidemic situation judgment mechanism. Conclusion It is determined that the proposed measures to complement the weaknesses of public health emergency system in Suzhou are suitable for the locality and objectivity after the three steps of literature review, management staff discussion and professional questionnaire survey. The present study provides an objective basis for the health administrative department to propose the public health emergency system construction project to the government.
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<b>Objective:</b> Rescuing severe trauma patients who are injured far from a trauma center is challenging for rural emergency systems. We report a severe trauma case that occurred at a remote location, in which the patient’s life was saved by a dispatched doctor car and a physician from a local medical facility.<br><b>Patient:</b> A 31-year-old man experienced a left femur injury due to a fallen tree. The fire station requested a doctor car from our center, approximately 56 km away. Meanwhile, a paramedic team reported that the patient was in a state of shock. The doctor car docked over 1 h after the accident. Pressure hemostasis, rapid intravenous infusion, and tracheal intubation were performed en route. After arrival at our hospital, an emergency blood transfusion was administered; the injured blood vessel was sutured and the wound closed. On day 22, the patient was transferred to another hospital for rehabilitation.<br><b>Discussion:</b> Rapid response-type doctor car is often considered ineffective for distant severe trauma cases. However, this case demonstrates the benefits of a doctor car working with local medical facilities.<br><b>Conclusion:</b> The rapid response-type doctor car is effective even in remote severe trauma cases.
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El presente trabajo presenta una revisión bibliográfica que enumera los problemas más comunes encontrados en los servicios de urgencias y las metodologías de investigación de operaciones más aplicadas para su estudio y solución. Se muestran las ventajas y desventajas de los métodosy los resultados obtenidos. Se encontró que los principales problemas abordados por los investigadores son: la ineficiencia en el flujo de pacientes, evaluar la capacidad del serviciovs. la demanda, y los largos tiempos de espera de los pacientes para ser atendidos. Se utiliza, principalmente, la simulación de eventos discretos y la programación matemática. Ningunade las referencias evaluadas plantea un cambio de esquema al sistema actual ni explora la reducción de la demanda...
This paper presents a literature revieAw that lists the most common problems encountered in emergency departments and operations research methodologies most applied for study and solution. The advantages and disadvantages of the methods and results are shown. We found that the main issues addressed by researchers are: inefficiency in the flow of patients, assess service capacity vs. demand and long waiting times of patients for treatment. It is mainly useddiscrete event simulation and mathematical programming. None of the references evaluated considering changing the current system outline and explore demand reduction...
Este trabalho apresenta revisão bibliográfica respeito dos problemas mais comumente encontradosnos serviços de urgências e das metodologias de pesquisa de operações mais aplicadas para seu estudo e solução. São mencionadas as vantagens e desvantagens dos métodos e resultados obtidos. Encontrou-se que as principais questões abordadas pelos pesquisadores foram: ineficiência no fluxo de pacientes, avaliar capacidade de serviço versus demanda real e longosperíodos de espera dos pacientes antes de serem atendidos, utilizando principalmente a simulação de eventos discretos e a programação matemática. Nas referências bibliográficas estudadas não foram encontradas propostas de mudanças aos sistemas de saúde vigentes nem mesmo estudosa respeito da redução da demanda...
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Emergências , Medicina de EmergênciaRESUMO
Objective To explore the theory and measures of armymen's clinical flow through information technology based on an exclusive armymen clinical area.Methods On the basis of No.1 Military Medical Project,such system was developed as automatic medical service classification & guide system,clinic backstage & auto-medicine provision system and comprehensive clinical service system in order to optimize medical service for armymen.Results By integrating the armymen's clinical information system,Navy General Hospital optimized comprehensively the clinical flow of registration,waiting,diagnosis,pricing,medicine pick-up,etc.Therefore,the efficiency of medical service for the army was greatly improved.Conlusion The full application of information technology will make an improvement in clinical flow and provide better service to army patients.
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HIS constitutes part of the technical support and infrastructure indispensable for the running of a modemized hospital. At present, more than 50% of hospitals at or above prefecture and city levels in China have set up HIS. However, because of the lack of reliability of facilities and man-made factors, HIS is apt to break down, which greatly hinders the normai activities of the hospital. The authors argue that wriat affects outpatient service the most in case of a network failure is the charging subsystem for outpatient service and thus offer an emergency charging plan for outpatient service as well as a method for putting it into effect. The workstation in charge of charging regularly downloads relative data on charging for outpatient service from the netvvork, and in case of a netvvork failure, the stan-dalone computer takes over, and when the network retums to normal, the computer then uploads the data it collected during the failure period to the database server, thus ensuring the integrity of the data.
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Based on the lessons and experience from the country's fight against SARS, the paper analyzes the problems and shortcomings in its public health emergency reaction. It also describes the pubhc health systems set up in America, Britain and Japan in response to emergent events. With regard to the building up of a public health emergency system that conforms to the situation in China, the following proposals are put forward: (1)establishing effective command networks, such as setting up a national crisis management commission and formulating corresponding laws and regulations and crash programs; (2)establishing unimpeded information networks, such as setting up a national disease monitoring and reporting system and urban symptom monitoring systems; and (3)establishing tight prevention and treatment networks, with the network of prevention being composed of the headquarters, disease prevention and control institutions, medical institutions, health supervision institutions, experts commissions, and cooperation centers for tackling key problems in science and technology.