Objective To compare the medical emergency rescue systems used during earthquakes in America, Japan, Russia and China; so as to provide reference material for the establishment and improvement of such a system in China. Methods We searched the official websites of China, America, Japan and Russia, WHO.int, CNKI, OVID, The Cochrane Library and other authoritative sources to collect information involving the medical emergency rescue systems used during earthquakes. The mechanism, legal management, preventive measures and performance of each country’s medical emergency rescue system were summarized and compared. Results Crisis management, integrated action and legal support were highly emphasized in America, Japan and Russia. America and Japan have performed well in implementing routine preventive measures. The organizational structure of the medical emergency rescue system in China was similar to that of the other countries, but its performance was not satisfactory due to insufficient financial support, poor management, inefficient operational mechanism and poor preventive measures. Conclusion There is an urgent need for China to reinforce its medical emergency rescue system. Different models should be taken into account because of the different regional situations in China.
ObjectiveTo investigate the status quo of emergency resources in all township hospitals in a county of Aba Autonomous Region. MethodWe set up a uniform electronic version questionnaire between April 15th and 18th, 2015. The leaders of township hospitals filled in their information and uploaded the data including emergency medical services, human resources, medical device and technology application situation. Then, the data were statistically analyzed. ResultsFor these township hospitals, the service population was 2 206.05±846.95, the service radius was (25.5±14.3) km. The number of registered doctors per 1 000 people of resident population was 1.52, the number of registered nurses per 1 000 people of resident population was 0.47, and the number of hospital beds per 1 000 people of resident population was 1.69. The staff in all township hospitals included 74 doctors and 23 nurses. The constitution of positional titles and academic qualifications of doctors and nurses in these township hospitals was not significantly different (P>0.05). All township hospitals had a total of six ambulances, one of which was ambulance for rescue and monitoring, and the others were ordinary ambulances. The devices equipped in the ambulances and hospitals were not sufficient, and most doctors and nurses could only perform surrounding vein puncture, and debridement and suture surgery. They could not recue critically ill patients alone. ConclusionsFor these township hospitals, the service radius is too long, the number of doctors and nurses is too small, and the ability of service is insufficient. In order to meet the demand of emergency resources in ethnic areas as far as possible, we should increase investment and promote medical devices, increase the number of doctors and nurses, improve the personnel structure, and strengthen professional training.
Objective To study traits and influencing factors of coping styles in the military groups of social emergency responders for special service and provide a theoretical basis for epidemiologic intervention. Methods A cross-sectional survey on coping styles and their influencing variables was carried out among 12 special service companies from Armed Police Forces and Fire Units of Public Security stationed in Chongqing by means of cluster sampling. Then, different coping styles were compared with general military personnel, the types and maturity degree of coping behaviors were evaluated, and major influencing variables were screened. Results Of 396 subjects, 86.36% had field experience in handling emergencies. The population’s average levels of coping styles are significantly higher than the military norm (P≤0.01), and the overall type of coping behaviors is mature. Although the relevance between the performance type and the number of 6 coping styles scores reaching the military masculine norm is significant (Plt;0.001), the Pearson contingency coefficient（c=0.23）represents a relatively limited maturity in coping styles. In view of direction and extent effects of various influencing factors, lack of survival skills, disaccord on self and experience, self-inferiority as well as self-stereotypes are negative factors. In addition to social support, self-flexibility responsibility may be positive factors. Use of social support, disaccord on self and experience, self-confidence and knowledge about danger-avoiding take universal impacts, and other factors take single impact on a certain coping style. Conclusion Coping styles in military groups of social emergency responders for special service are comparatively mature and stable, but there are significantly individual differences and a wide range of influencing factors. So, it is very necessary to advance maturity in coping styles through targeted interventions.
Objective To evaluate the effects of emergency coronary artery bypass grafting (ECABG) in the treatment of emergent patients, and to summarize our experience. Methods We retrospectively analyzed the clinical data of 160 patients who underwent coronary artery bypass grafting (CABG) in Nanjing General Hospital of Nanjing Command from January 2010 through December 2013. The patients were divided into an ECABG group (operation underwent on the day diagnosed, n=27, 22 males and 5 females, at age of 70.2±10.2 years) and a conventional group (CABG operation underwent on 5 days after diagnosed, n=133, 104 males and 29 females, at age of 66.3±8.9 years). Results Statistical differences were found between the ECABG group and the conventional group in EuroSCORE (5.8±3.2 versus 3.4±2.1, P=0.001), acute myocardial infarction (33.3% vs. 11.3%, P=0.007), rate of application of IABP (29.6% versus 12.0%, P=0.034), pericardium and mediastinal tube drainage (533.4±132.8 ml versus 414.8±124.3 ml, P=0.018). There was no statistical difference in continuous renal replacement therapy (P=0.677), postoperative sternal wound complication (P=1.000), the length of hospital stay (P=0.589), or 30-day-mortality (P=0.198) between the two groups. We followed up 24 patients(88.89%) for 3-36 months in the ECABG group. One patient occurred angina symptoms at the end of 1 year follow-up. The symptoms disappeared after treatment. The other patients had no symptoms of angina pectoris and myocardial ischemia. Conclusion ECABG as a lifesaving therapy is an effective procedure in the treatment of severe and acute patients. Sufficient preoperative assessment, good myocardial protection, full revascularization, and comprehensive treatment plays an important role in the success of ECABG.
From March 1979 to February 1987, 500 cases of firearm wounds of blood vessels were treated. Of them, 465 cases were recovered, 15 cases were disabled, 13 cases had amputation, and 7 cases died. The article presented the clinic materials. The following problems were discussed: (1) The characteristics of firearm wounds of blood vessels. (2) Emergency treatment of injuries of major blood vessels of limbs. (3) Indications of repair of blood vessels. (4) The methods of repair of defect in blood vessel. (5)Factors influencing the survival of extremities, and (6) Active prevention and treatment of complication.
Objective To summarize the experience of emergency coronary artery bypass grafting （CABG） after failed percutaneous coronary intervention. Methods From January 1998 to December 2002, 9 patients underwent emergency CABG after failed percutaneous coronary intervention. The indications of emergency CABG were coronary artery dissection （5 cases）or perforation （2 cases） and acute arterial occlusion （2 cases）. The time averaged 2 hours from onset of ischernia to revascularization. The CABG was performed under off-pump bypass in 3 cases and under CPB in 6 cases. The mean graft number was 3. Results There were no hospital death. The mean follow-up was 17 months. No death and angina occurred. The function of New York Heart Association class Ⅰ-Ⅱ were in 8 patients, class Ⅲ in 1 patient. Conclusion Emergency CABG is an effective management for failed percutaneous coronary intervention if the indication is right.
ObjectiveTo investigate the clinical effectiveness of early repair in infants with large ventricular septal defect complicated with pneumonia. MethodsWe retrospectively analyzed the clinical data of 30 infants who underwent emergency operation in our hospital between January 2014 and April 2015. There were 16 males and 14 females at age of 0.9-12.0 (4.6±2.9) months and with weight of 3.0-8.8 (5.6±1.4) kg. They were diagnosed as ventricular septal defect combined with pneumonia as a trial group. There were other 30 patients without pneumonia, 10 males and 20 females, aged of 0.7-19.0 (4.9±4.8) months, weighing 2.6-12 (5.8±2.1) kg, as a control group. All the patients were followed up for 6 months. ResultsOne patient died in the trial group. None died in the control group. There were statistical differences in length of hospital stay (15.73±6.44 d vs. 10.16±2.16 d, P=0.002) and mechanical ventilation time (28.00±15.72 h vs.12.17±9.10 h, P=0.000) between the trial group and the control group. There was no statistical difference in aortic cross-clamping time, cardiopulmonary bypass time, or CICU residence time (P > 0.05). All the patients were followed up for 6 months. Incidence of pneumonia reduced, growth status and exercise tolerance significantly improved. ConclusionEmergency operation for the infants who suffered from ventricular septal defect with severe pneumonia is efficient and effective. Early mechanical ventilation may be beneficial to the procedure.
This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.
ObjectiveTo evaluate the influence of personalized nursing intervention on the negative emotions after occupational exposure for nurses in the Emergency Department, in order to provide effective nursing intervention methods for relieving nurses' negative emotions after occupational exposure. MethodsTwenty nurses with occupational exposure between January and September 2013 were chosen to be the control group, and another 20 nurses with occupational exposure between October 2013 and October 2014 were designated as the personalized nursing group. The level of depression and anxiety was compared between the two groups by using the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) on the exposure day and 5 weeks after the exposure. ResultsBefore intervention, SDS score of the control group was 0.65±0.04 and of the personalized nursing group was 0.63±0.05, and there was no statistically significant difference between the two groups (t=0.59, P=0.44); SAS score of the control group was 51.98±6.77 and of the personalized nursing group was 50.73±10.03, and there was no statistically significant difference between the two groups (t=0.37, P=0.70). After the intervention, personalized nursing group had lower scores of SDS and SAS than the control group. SDS score was 0.64±0.11 in the control group and 0.50±0.09 in the personalized nursing group with a significant difference (t=5.11, P < 0.01); SAS score was 49.53±9.49 in the control group and 42.66±9.53 in the personalized nursing group, and the difference was statistically significant (t=4.10, P < 0.01). ConclusionThe personalized nursing intervention can effectively alleviate negative emotions after occupational exposure for nurses in the Emergency Department.
Objective To collect and analyze the data of emergency medicine supply for both Wenchuan and Lushan earthquakes victims in the West China Hospital, so as to provide evidence for scientifically and efficiently carrying out the logistical support for emergency rescue medicines supply, and improving the coping capacity for those similar public health emergencies. Methods Both medicine constituent ratios and DDDs were taken as evaluation indexes, and the data were input by Excel software. Then the following items were analyzed: the use and cost of emergency medicine for victims admitted in the hospital from one day to one month after earthquake, as well as, the acceptance, allocation and use of the donation medicines for both Wenchuan and Lusan earthquakes. Results During the first month after Lushan earthquake, the victims used 26 categories of medicines involving 455 drug specifications in the West China Hospital. The dosage and DDDs of therapeutic medicines were higher than those of ancillary medicines. The donation medicines for Lushan earthquake accepted by the hospital were in 8 categories involving 16 drug specifications, and they were all used to rescue the victims in the hospital. Based on the hospital emergency medicine supply system oriented by the information of victim’s medicine use, the drug specification and total drug cost of the donation medicines for Lushan earthquake decreased by 90.91% and 89.73%, respectively, indicating a more accurate and efficient system compared with those for Wenchuan earthquake. Conclusion The implementation of the hospital emergency medicine supply system oriented by the information of victim’s medicine use is helpful to improve the time efficiency and pertinence of earthquake medical rescue.