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The advantages of 5G communication, including large bandwidth, low latency and wide connection, and rapid transmission, have proved to be vital in facilitating emergency medical rescue. On June 17th, 2019, an earthquake occurred in Channing, Yibin, Sichuan Province. Sichuan Provincial People’s Hospital initiated the Emergency Medical Rescue System for the rescue operation in the disastrous area. This was the first use of 5G emergency medical rescue worldwide. Remote consultations, injury assessments and helicopter transfers were carried out for the critical patients. Our rescue system have been effective and efficient in rapid responding, information transmission and the coordination of medical resources, which has led to the best possible medical decisions and treatments. However, there were challenges found in the application of this system: the stability of 5G signal, the optimization of the configuration of 5G ambulances, and the survival rate and self guarantee in the field. In conclusion, this practice of 5G emergency medical system provides a new paradigm and valuable experiences for the improvements in disaster rescue in China and worldwide.
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In accordance with the new model-core-curriculum for medical education, the current status of education about the science of radiation health was surveyed in all medical schools in Japan. Among the four learning points related to the “Biological effects of radiation and radiation hazards” , about half of the schools covered issues on “radiation and human body” and the “effect of medical radiation exposure” in one, or less than one, 60-minutes class, but did not touch on “radiation risk communication” and “radiological disaster medicine” . A significant deviation of human resources was also observed between schools. Learning tools such as presentation files and video content were preferred as education support materials. Therefore, development and distribution of the learning tools, especially in “radiation risk communication” and “radiological disaster medicine” , may be a first step to promoting high-quality education on the science of radiation health risk in each school’s curriculum.
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The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.
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Humanos , Medicina de Desastres , Vítimas de Desastres , Desastres , Emergências , Medicina de Emergência , Medicina Militar , Mortalidade , TriagemRESUMO
The advantages of 5G communication,including large bandwidth,low latency and wide connection,and rapid transmission,have proved to be vital in facilitating emergency medical rescue.On June 17th,2019,an earthquake occurred in Channing,Yibin,Sichuan Province.Sichuan Provincial People's Hospital initiated the Emergency Medical Rescue System for the rescue operation in the disastrous area.This was the first use of 5G emergency medical rescue worldwide.Remote consultations,injury assessments and helicopter transfers were carried out for the critical patients.Our rescue system have been effective and efficient in rapid responding,information transmission and the coordination of medical resources,which has led to the best possible medical decisions and treatments.However,there were challenges found in the application of this system:the stability of 5G signal,the optimization of the configuration of 5G ambulances,and the survival rate and self guarantee in the field.In conclusion,this practice of 5G emergency medical system provides a new paradigm and valuable experiences for the improvements in disaster rescue in China and worldwide.
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Fundamento: en la respuesta del sistema de salud ante un huracán, los municipios y sus establecimientos tienen un papel protagónico.Objetivo: describir la respuesta del sistema municipal de salud del municipio de Aguada de Pasajeros ante el paso del huracán Irma por el territorio. Métodos: estudio prospectivo, transversal, en sistema y servicios de salud, desarrollado en el municipio de Aguada de Pasajeros entre el 7 y 30 de septiembre de 2017. El universo lo constituyó la totalidad de trabajadores e instituciones del territorio, todos involucrados en la respuesta al huracán Irma. Se incluyeron la revisión documental (planes, indicaciones de los Consejos de Defensa y del Ministerio de Salud) y la observación participativa. También se revisaron indicadores de posible impacto y del cuadro de salud municipal. Resultados: se planificaron y ejecutaron un total de 88 acciones por el sistema municipal de salud; 50 durante la fase informativa, 29 en la de alarma y nueve en la de alerta. El plan de reducción de desastres fue cumplido en su totalidad, al que se le agregaron ocho nuevas tareas como parte de las lecciones aprendidas. No hubo fallecidos atribuidos al huracán, ni cambios en la morbilidad posterior al evento. Existió cobertura asistencial mantenida en sitios de difícil acceso y albergues. Todas las instituciones mantuvieron su vitalidad. Conclusiones: las acciones desarrolladas en el municipio permitieron mantener el cuadro de salud, la atención integral a las personas que demandaron asistencia médica durante el paso del fenómeno natural, así como la vitalidad de las instituciones.
Foundation: in response of the health system before a hurricane, municipalities and establishments have a protagonist role. Objective: to describe the Aguada de Pasajeros municipal health system at the Irma hurricane's path across its territory. Methods: prospective cross study, in the health and service system, developed in the Aguada de Pasajeros Municipality between September the 7th and 30th, 2017. The universe was the territory total of workers and institutions, all involved in the response to Irma's hurricane. A documentary review was included (plans, instructions from the Defense Councils, and the Minister of Health) and participating observation. Indicators of possible impact and municipal health situation. Results: a total of 88 actions by the municipal health system; 50 during the informative phase and 9 in alert. The plan for disaster reduction was totaly achieved, to which 9 new tasks were added. There were no deaths due to the hurricane nor morbidity after the event. There was maintained assistance coverage in sites of difficult access and shelters. All the institutions maintained vitality. Conclusion: the actions developed in the municipality allowed maintaining the health situation, the comprehensive care to the people who demanded medical services during the path of the natural phenomena across the territory institutional vitality.
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Hydrological disasters are associated with infectious disease outbreaks and epidemics. Hydrological disasters will lead to water pollution, increased vulnerability to diseases, and increased density of vectors. These factors will facilitate the outbreaks of water-borne/food-borne diseases, vector-borne diseases, and air-borne/contagious diseases. Pre-event preparedness for disasters and post-event reconstruction of both disease surveillance system and water-supply system are key measures to prevent infectious disease outbreaks caused by hydrological disasters. This study reviews the domestic and overseas experiences of controlling infectious diseases after hydrologic disasters, outlines the spectrum of post-disaster infectious disease as well as their epidemiological characteristics, and provides practicable suggestions accordingly.
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We have conducted an active learning session for participants in various fields using a scenario in which university students encountered a great earthquake during a field trip. The program was unique because it not only gave participants an opportunity to simulate providing support, it also allowed them to simulate receiving support.
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As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.
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Humanos , Medicina de Desastres , História , Serviços Médicos de Emergência , História , Medicina de Emergência , História , Alemanha , História do Século XX , História do Século XXI , Sistema de RegistrosRESUMO
Objective To analyze the development trend of global and domestic major disaster medical rescue, pre-dict the development trend of key technologies in major disaster medical rescue, and put forward suggestions for the distribution of resources and technical training model in domestic major disaster medical rescue by investigating and comparing the researches in domestic major disaster medical rescue. Methods Data of disaster medical rescue were analyzed using the scientific knowledge mapping analysis tools ( TDA and VOSVIEWER) with the Web of Science Database-covered titles of papers on disaster medical rescue in 1995-2017 as the study objects. Results A total of 1333 titles of papers on disaster medical rescue were retrieved from the Web of Science Database, from which 89 high frequency co-occurrence key words in 7 major categories were selected. Conclusion The research on crush syndrome, posttraumatic stress syndrome, fracture, spinal cord injury, rehabilitation, casualty classification, and field hospital is advantageous over that on telemedicine, communication, pediatrics, personal identification and education in domestic major disaster medical rescue. Disaster rescue system should be established, research on disaster rescue concept, techniques and equipments should be deepened, and training model of emergency medical rescue should be expanded in our country.
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Presented in the paper are the necessity,general ideas and principles of building a teaching center for virtual simulation experiment on disaster medicine,covering the teaching modules, capability objectives and education resources deployment among other basics of such a center.The authors propose to build a comprehensive platform for teaching by experimentation,integrating basic clinical skills training to trainings targeted to disaster rescue in view of actual needs in experiments and teaching.This way resources can be shared between the experiment center website and virtual simulation teaching software,promoting a regular,standardized and scientific development of disaster medicine in China.
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Objective To summarize the treatment experience of extensive burn merging smoke inhalation acute lung injury(SIALI)in 32 early stage cases,and to provide a reference for the further improvement of success rate in early stage. Methods A total of 32 cases of extensive burn merging SIALI resulting from mine explosion that received clinical treatment and triage from November to December in 2014 were enrolled for the study. In addition,the experience of triage and prognosis(after injured in a month)to guide therapy was analyzed. Results Two of the 32 patients died from respiratory failure in shock period,after shock period(3 days after injured),19 bad sufferers were cured in the local hospital,and the oth?er 11 cases in stable condition were triaged to the nearby hospital. 1 month follow?up results showed that:patients who received therapy in local hospi?tal,one died from MODS in 3 weeks,one died from kidney failure in 4 weeks. The other 28 patients were alive. Conclusion For these patients who suffering from extensive burn merging SIALI received therapy in early stage,we should not only schedule positive anti?shock,tracheotomy,antibiot?ics,escharectomy and nutritional support or other treatments,but also face to the challenge of lacking medical resources from too more patients. Thus,we suggest to triage the wounded to nearby hospital after anti?shock treatment,so as to improve the success rate in early stage.
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El presente trabajo describe el programa de la asignatura Medicina de Desastres que se imparte a los estudiantes de Medicina de Villa Clara, procedentes de la Escuela Latinoamericana de Medicina desde el año 2003 como experiencia única en el mundo. Consta de 120 horas lectivas distribuidas en dos estancias que se desarrollan durante el cuarto y quinto años de la carrera, con un carácter teórico-práctico. Sus contenidos están orientados a la familiarización con la temática de los factores causantes de desastres, sus efectos sobre la salud y la dinámica de la sociedad y las comunidades, así como a la incorporación de conocimientos propios acerca del riesgo y la vulnerabilidad, además de los procedimientos vinculados a su disminución; donde priman el trabajo preparatorio a la población y la interrelación de sectores para el enfrentamiento a las adversidades.
The current work describes the program of the Medicine of Disasters subject that is imparted to the future physicians of the Latin American School of Medicine in Villa Clara since 2003, as an exclusive experience in the world. It consists of 120 teaching hours distributed in two rotations that are developed during the fourth and fifth years of the career, with a theoretical-practical character. Its contents are guided to the familiarization with the topic of the disasters-causing factors, their effects upon health and the dynamics of society and the communities, as well as to the incorporation of knowledge about risks and vulnerability, besides the associated procedures to diminish them; where the preparatory work with the population and the interrelation among sectors to face adversities are predominant.
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Medicina de DesastresRESUMO
Con el propósito de validar instrumentos de investigación orientados a evaluar la efectividad del currículo en relación con las funciones especiales del Médico General (Preparación para la Defensa y Medicina de Desastres), se realizó el diseño de sendos ejercicios teóricos y aplicación a una muestra de estudiantes de sexto curso, cubanos y extranjeros, de una facultad de Ciencias Médicas, quienes respondieron una encuesta acerca de estos. Profesores de la facultad actuaron como contraparte en la aplicación de dichos ejercicios te¾ricos y dieron su valoración en una entrevista. Se procesaron los resultados obtenidos por los estudiantes al responder los instrumentos, los relativos a las opiniones estudiantiles y las profesorales sobre estos y su aplicación. Los resultados indican que los instrumentos propuestos son adecuados para valorar el conocimiento acerca de las funciones especiales de los mÚdicos generales y recomendables para la evaluaci¾n de las funciones para las cuales fueron diseñados.
With the objective of validating research instruments for the evaluation of the curriculum effectiveness in terms of the special functions of the general physician (preparation for defense and disaster medicine), two theoretical exercises were designed and applied to a sample of 6th year students, both Cubans and foreigners, from a medical school, who answered a survey about this topic. The professors acted as a counterpart in implementing the said exercises and gave their final assessment in an interview. The results obtained by the students in answering the instruments, those related to the opinion of students and professors about their use and finally their application were all processed. The final results show that the suggested instruments are adequate to assess the knowledge about the special functions of the general physicians and can be recommended for the assessment of the functions for which they were designed.
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Currículo , Medicina de Família e Comunidade/educação , Estudantes de Medicina , Coleta de Dados/métodosRESUMO
First aid skills are very important in the process of disaster medical rescue methods. Some first aid skills is rarely applied in clinical work at ordinary times, resulting in relevant medical personnel grasp of these skills being not enough skilled. This training method combined with the sim-ulator, has the characteristics and advantages of being close to the real, operational and repeatable. The main training program consists of 6 basic skills such as ventilation, hemostasis, bandaging, fixing, handling, basic life support. By simulating the real disaster scenario and simulation cases, we have targeted a single first aid skills training and multiple comprehensive ability training of first aid skills to trainees. To evaluate the training effect we have examined the individual skills of our trainees, with excellent performance as the goal, and in the comprehensive skills ability assessment we have paid attention to the emergency team's team cooperation ability. By the application of comprehensive simu-lation training and evaluation, the trainees can master all kinds of first aid skills in a short period of time.
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The extended service in domestic and foreign medical libraries was summarized according to the trans-formation of medical library and the need of public health information followed by a description of some typical cases of extended service provided by MedlinePlus website , Disaster Medical Information Management Research Center , and patient libraries in order to provide the reference for domestic medical libraries to cary out their extended service .
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Disastrous blast injury is a rare type injury, but an increasing incidence happened worldwide due to various reasons, often causing mass casualties incidents (MCIs). However, most clinicians have no treatment experience in managing blast injury. The present paper introduces the classification and severity prediction, as well as systematically describes medical rescue strategies for blast injuries, including on-site triage and in-hospital trauma emergency treatments such as trauma emergency care, and emergency care for lung and gastrointestinal tract blast injuries.
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Objective] To explore disaster response capability and the vulnerability as well as the current level and training needs of disaster medicine knowledge in urban populations . [ Methods] Five communities in Yangpu District of Shanghai were randomly enrolled in this study .The study populations were then stratified by age groups .A total of 1700 residents were recruited , 1643 of which completed a structured questionnaire designed by the investigators . [ Results] Eight-nine percent of the residents be-lieved the importance of understanding disaster medicine -related knowledge .The correct answer rates of “pro-tective measures of nuclear leakage issues” and “self-rescue measures in a high building fire” reached over 80%;however , the overall correct answer rate of “cardiorespiratory resuscitation operation” was less than 40%.The main channels of community residents accessing disaster medicine knowledge were mainly news -papers, magazines, and internet (52.1%);whereas only 5.3%of them obtained the knowledge from school education .Community residents most liked to obtain “first aid skills”and“basic theory of disaster medicine”through formal lectures (72.4%). [Conclusion] School education lacks disaster-related knowledge , pos-sibly resulting in the fact that community residents have a limited ability to save both oneself and others in disaster .There are significant differences between residents with different education levels .Community resi-dents have limited knowledge of disaster occurrence and development , and lack capabilities of self-rescue and mutual aid .Colleges should increase the contents of disaster medicine education in their curriculum .Disaster education should be enforced in school education .Continued education and simulation of disaster-related knowledge should be regularly offered to community residents to greatly reduce their vulnerability to disasters .
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Disaster medicine and emergency medicine are common in many parts, particularly in the acute stage of disaster, so the role of emergency medicine in disaster is very important. For adequate disaster preparation and response, interest and investment to emergency medical care for emergency and safety issues that deal with most important thing, life conservation, must be made in the future. Specifically, support to the emergency medical centers as disaster base hospitals is necessary for emergency medicine to perform adequate roles in disaster, and it is also necessary to assign the role to the hospital in the area that holds the local risk factors. Because of the poor preparedness for nuclear, chemical or biological disaster in Korea, the important things are the preparation and establishment of infrastructure based on equipment and facilities, related to special type disasters. So the government should support the emergency medical system for the adequate response to disasters as well as individual emergency care.
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Medicina de Desastres , Desastres , Emergências , Serviços Médicos de Emergência , Medicina de Emergência , Investimentos em Saúde , Coreia (Geográfico) , Fatores de RiscoRESUMO
For adequate disaster preparation and response, the capacity of various sectors should be integrated harmoniously into a single system. Investment must be made in disaster medical care for emergencies and safety issues that address the most important priority - conservation of life. Specifically, support for disaster base hospital is necessary for a hospital to perform an adequate role in disaster, and it is also necessary to assign the role of disaster base hospital to hospitals in areas that contain local risk factor. Because of the problems for nuclear, chemical or biological disaster preparedness in Korea, important things to consider are the preparation and establishment of an infrastructure based on equipment and facilities, including personal protective equipment, decontamination equipment and facilities. Governments should support the operation of disaster medical assistance teams in order to improve the disaster medical system.