Objective We evaluated effectiveness and performance of medical rescue after Lushan earthquake during 2 weeks, and enriched Wenchuan lessons to provide useful references for emergency medical rescue (EMR) after similar earthquake worldwide. Methods We collected and analyzed official information, public documents, news release, and relevant information from websites, and then we systematically reviewed and descriptively analyzed all included literature of EMR after earthquake (domestic and foreign). Results Learned from Wenchuan earthquake, EMR for Lushan earthquake were characterized as: a) Assess the situations of quake damage and injuries were scientifically assessed; human resources, funds and materials were reasonably distributed; and the EMR relied mainly on regional rescue power of Sichuan province. b) Patients’ with critical injuries were treated using “Four concentration treatment principles”, which resulted in a new medical record of zero death, 14 days after the earthquake. c) The experience of EMR after Lushan earthquake verified, enriched and improved lessons from Wenchuan, Yushu and Yiliang earthquake, which provided first-hand references of evidence-based decision making for earthquake EMR worldwide.
The West China hospital of Sichuan university has underwent four times emergency medical rescue (EMR) of earthquakes, measuring 5.7 Ms to 8.0 Ms on the Richter scale, happened at Wenchuan, Yushu, Yiliang and Lushan in recent 5 years, which gradually improved and supplemented Wenchuan experience. After Lushan earthquake, a total of 392 patients were received during 2 weeks. Among 321 hospitalized patients, there were 39 (12.15%) patients with critical injury and 14 (4.36%) patients who needed intensive care. 184 operations were performed. Based on the experiences of resource centralization, multidisciplinary cooperation, and hierarchical management, zero death, a new medical record, has been achieved among 43 patients with critical injury after centralized admission and treatment. A total of 12 medical rescue teams involving 88 healthcare workers were sent to the epicenter to join and guide EMR. Besides, rehabilitation and psychological experts came to Lushan on the first day of earthquake, and started clinical intervention of mental and physical health for people needed on the second day.
A 7.0 Ms earthquake hit Lushan country at Ya’an city of Sichuan province at 8:02 am, on April 20th, 2013. Rehabilitation medicine department of the West China Hospital, a regional state-level hospital arrived at stricken area, and super early rehabilitation rescue was organized at the second day after Lushan earthquake. On the third day after Lushan earthquake, patients receiving super early rehabilitation intervention were moved forward to orthopedics, neurosurgery, thoracic surgery, pediatric surgery and ICU for super early rehabilitation intervention. Up to 6 pm, 14 days after the earthquake, 69 wounded in total were admitted in early rehabilitation. The experiences of Wenchuan earthquake has been applied, improved and sublimated more rapidly, more appropriately, more effectively in the Lushan earthquake rehabilitation rescue.
Objective To evaluate the performance of emergency medical rescue (EMR) within 1 month after Lushan earthquake, and to prove and enrich the experience from Wenchuan earthquake, so as to provide useful references for global earthquake EMR with regard to decreasing death and disability rates. Methods All the following date published within 1 month after 4.20 Lushan earthquake were collected and analyzed, including official information, public documents, news release, relevant information from websites and victims’ medical records in the West China Hospital, then the relevant domestic and foreign literature about EMR (including EMR of Wenchuan earthquake). And then comparative analysis was conducted to evaluate the performance of EMR in Lushan earthquake. Results a) Being 87 km apart from each other, the main seismic zones of Lushan and Wenchuan located in the south west and middle north of Longmenshan fault zone, respectively. Although only 1 earthquake magnitude differed between them, the disaster area, and the number of affected population, deaths, disappearances, injured, severe injured and migration population in Wenchuan earthquake were 40, 23, 353, 853, 27, 14 and 51 times higher than those in Lushan earthquake, respectively. b) Learned from Wenchuan experience, the manpower scheduling in Lushan earthquake was quicker: the assembled medical personnel peak of Lushan vs. Wenchuan was 87.62% vs. 56.06 % in golden 72 hours post-quake. c) Supplies scheduling was more rational: the utilization rate was higher under the guidance of accurate information of demand. d) Medical treatment was more rational and efficient: the critical injured were treated following “Four concentration treatment principles”; saving life and restoring function at the same time; treatment and physical-mental rehabilitation at the same time; treatment and evidence production and implementation at the same time. e) Medical institutions and service returned to normal in time: 96.7% (440/455) of government owned township medical institutions in 21 affected towns returned to normal and provided medical services at their original sites. Conclusion By learning form Wenchuan experience, the following performance is implemented in Lushan earthquake: medical rescue guided by the accurate information; supplies scheduling guided by the accurate demand; both critical injured treatment,and physical-mental rehabilitation guided by the accurate assessment of injuries. So the medical rescue within 1 month after Lushan earthquake is quicker, more rational and efficient. After 20 days post quake zero death of critical injured was achieved. The early physical-mental rehabilitation fastens the functional reconstruction of the injured and helps them return to the society. So it suggests that the Lushan EMR enriches and develops the reference value of EMR experience of Wenchuan earthquake.
Objective To analyze the injury characteristics and the rescue process and effects for the victims admitted in the People’s Hospital of Deyang City within 72 hours after 4.20 Lushan earthquake, so as to discuss how to adopt the emergency program to implement medical rescue in disaster relief. Methods The data of 25 earthquake victims admitted in the hospital from April 20th, 2013 to April 23rd, 2013 were collected to analyze age, gender, the location of injury, the injury state of different age groups, and the prognosis of victims. Results Of the 25 victims with injuries on 32 locations of the body, there were 20 cases with single injury (80.00%) and 5 cases with multiple injuries (20.00%). Most injuries were seen in four limbs, body surface, and soft tissues; and the incidence of single injury was higher than that of multiple injuries. The number of admitted victims was largest on the first day after earthquake, accounted for 92.00%, which was obviously higher than that on the second and the third day. Victims aged from 19 to 45 years old was more than those of other ages. Conclusion Scientific emergency command system and disaster emergency program play an high-efficient command role in disaster rescue, shorten the time of emergency response, and improve the ability of disaster rescue. The comprehensive capacity of self-rescue and well-organized rescue for disaster area can be improved as long as the general public is educated about the disaster emergency program and cooperative emergency drill. Meanwhile, smooth traffic and unobstructed communication are guaranteed in the disaster area, and the cooperative efforts are made by all walks of society.
Objective To analyze the injury and dysfunction as well as the rehabilitation status and demand of the 188 Lushan earthquake victims admitted in the hospitals in and around Ya’an city and the West China Hospital of Sichuan University, so as to provide guidance for the rehabilitation work in the following step. Methods By means of the onsite investigation, 122 victims admitted in 7 hospitals and 2 health centers in and around Ya’an city within 1-9 days after Lushan earthquake, and the other 66 victims treated in the West China Hospital of Sichuan University were analyzed. Results The injury categorization of 122 victims in and around Ya’an city was as follows: upper limb fracture (12.30%), lower limb fracture (42.62%), spine fracture (16.39%) (25.00% treated by surgery and 75.00% treated by non-surgery treatment), pelvis fracture (1.64%), rib fracture (4.10%), traumatic brain injury (10.66%), soft tissue contusion (8.20%), and others (4.09%). At the corresponding period, the injury categorization of 66 victims treated in the department of rehabilitation medicine of the West China Hospital of Sichuan University was as follows: fracture (77.27%), traumatic brain injury (3.03%), spinal cord injury (4.55%), and others, including soft tissue injury (15.15%). At the ninth day after earthquake, among the 122 victims in and around Ya’an city, 8 victims (6.56%) were recovered with self-care ability of daily living, and the other 144 (93.44%) still needed the strengthened rehabilitation treatment. At the corresponding period, among the 66 victims in the West China Hospital, one victim (1.52%) was recovered with self-care ability of daily living, and the other 65 (98.48%) still needed the strengthened rehabilitation treatment. Conclusion Early rehabilitation treatment such as active exercise, elevating injured limbs, physical therapy, turning over at regular time, and psychological intervention can help the earthquake victims to return to home and society early.
Objective To explore the allocation of necessary living goods for the emergency medical rescue teams at Lushan earthquake sites. Methods The living goods requirements of 59 emergency medical rescue members at Lushan earthquake sites were investigated using a questionnaire and then analyzed, in order to provide references for the allocation of necessary living goods for emergency medical rescue teams in future. Results The top five necessary living goods for emergency medical rescue members at earthquake sites were food, drinking water, toilet, communication product, and bedclothe. The needs of bath of the members who stayed longer than 3 days were more than the members who stayed shorter than 3 days, with a significant difference (Plt;0.05). The number of living goods that female members need were more than that male members need (Plt;0.05). Conclusion For improving the work efficiency and quality of life, emergency medical rescue teams need to be equipped with not only the medical supplies, but also necessary living goods based on the length of stay and the ratio between male and female.
The injuries caused by earthquake were characterized as complicated injuries, multiple injuries, crush injury, commonly accompanied by the impairment of the organs, open wound with susceptibility to contamination, difficulties in the implementation of in-time treatment, and resource-limited settings. Considering the specialty of early treatment of earthquake victims and existing misconduct, we propose recommendations according to general principles of early rationale use of antibiotics, in order to treat the earthquake victims safely, effectively and feasibly, and to decrease wound infection rates after surgery.
This paper compares emergency medical rescue experience of West China Hospital of Sichuan University in the latest three earthquakes occurred in western Sichuan, and mainly introduces the experience in organization and coordination, rescue speed, treatment of the injured, and rescue characteristics in Jiuzhaigou earthquake, which can provide reference for future earthquake emergency medical rescue.
Earthquake emergency medical rescue evidence-based decision-making is a typical case of real-world evidence deriving from real-world data, conducting real-world research, and producing real-world evidence for solving real-world problems. This article focuses on the use of evidence-based science in the real-world through a problem-oriented, evidence-based decision making way, as well as transferring of results to practice and continuing outcome evaluation.