Objective To analyze the spinal injury in Wenchuan earthquake and to investigate its cl inical features. Methods Data of 146 patients in Wenchuan earthquake with spinal injuries (79 males, 67 females; aged 11-88 years old, average 51 years old) were collected and analyzed epidemiologically. Two patients under 16 years of age, 15 patients withthe fractures of spinous process, transverse process or vertebra lamina, 1 patient with spinal fractures of type A2 according to AO classification but no corresponding type in Denis classification, and 9 patients with upper cervical injuries were excluded. The remaining 119 patients were divided into two groups according to their age: group A in which 78 patients were under 60 years of age, including 40 males and 38 females aged 18-58 years old (average 41 years old), and group B in which 41 patients were 60 years of age or above, including 24 males and 17 females aged 60-88 years old (average 71 years old). Analyses for the two groups were compared. Results The leading causes of spinal injuries were fall from high places (27.40%) and crush by heavy objects (67.81%). According to Denis classification, the major types of spinal injuries were burst fracture (54.62%) and compression fracture (33.61%). Serious nerve injury, defined as grade A, B and C in ASIA neurological function assessment, occurred in 31.51% of patients. The most common injured site was in thoracic or lumbar vertebrae (78.77%), and 52.74% of patients had combined injuries, among which the fractures of l imb (30.14%) and rib (19.86%) were the most common. Multilevel spinal fractures happened to 22.60% of patients. Comparative analysis revealed the rate of injury caused by fall from high places in group A (34.62%) was much higher than that in group B (12.20%). The commonest type of fracture in group A was burst fracture (58.97%), and it was compression fracture in group B (48.78%). The rate of serious nerve injury in group B (24.39%) was much lower than that in group A (44.87%). The rate of combined injury and multilevel vertebral body injury in group B was 70.73% and 39.02%, respectively, which was much higher than that in group A (combined injury 43.59%; multilevel vertebral body injury 21.79%). There were significant differences between two groups in all the indicators derived from cl inical data (P lt; 0.05). Conclusion In Wenchuan earthquake, the leading causes of spinal injuries are fall from high places and crush by heavy objects, the major types of fracture are compression fracture and burst fracture, and the occurrence rates of spinal injury, combined injury and multilevel vertebral body injury are high.
This article introduces the measures that the scientific research base of West China Hospital has taken in its emergent response to the unexpected huge Wenchuan earthquake disaster, including safe evacuation, safety examination and removal of hidden dangers, damage reporting and a series of subsequent measures.
Objective To examine the prevalence of post-traumatic stress disorder (PTSD), anxiety, and depression for medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake. Methods According to purpose sampling method, from June 12th to June 18th, we investigated the medical staffs in eight areas, and the total number was 500. The eight areas included Mianzhu, Deyang, Shifang, Chengdu, Mianyang, Pengzhou, Zitong, and Anxian. The survey tools were PTSD Checklist-Civilian Version (PCL-C), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). After collecting all questionnaires, we divided 500 medical staffs into 2 groups, according to the fact whether the rescue was carried out in the disaster area or not. Results A total of 500 questionnaires were given to the subjects, of which 481 effective ones were collected, and the effective rate was about 96.2%. In addition, the prevalence of PTSD for overall was 23.3%, anxiety was 21.6%, depression was 49.9%, and the anxiety plus depression was 19.54%. At the same time, we found out the averages of PCL-C (48.29±29.90 vs. 34.76±18.03), PCL-C frequency (16.27±15.14 vs. 9.99±10.25), PCL-C severity (32.03±15.26 vs. 24.85±8.60), SAS primitive (37.39±10.35 vs. 32.22±7.61), SAS standard (46.73±12.94 vs. 40.27±9.51), SDS primitive (42.00±8.32 vs. 37.99±9.63), and SDS standard (52.50±10.39 vs. 47.48±11.92) were different. The medical staffs in the disaster area were under more severe conditions, and there were significant differences between the 2 groups. The prevalence of PTSD (28.52% vs. 16.59), anxiety (28.89% vs. 12.32%), depression (58.15% vs. 39.34%), and anxiety plus depression (26.67% vs. 10.43%) between the 2 groups was significantly different, and the disaster area was under severe conditions. Additionally, the prevalences at three levels within SAS and SDS were much higher in the disaster area. There were also significant differences. Conclusion The prevalences of PTSD, SAS, and SDS within medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake are higher than in the non-disaster area. Therefore, we should work out mental intervention and rehabilitation project for medical staffs, especially those who took part in rescue in the disaster area. Finally, the medical staffs’ ability to copy with stress can be improved.
Objective To analyze drug use for 23 sick and wounded hospitalized in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital, during one month after Lushan earthquake, so as to provide references for the drug use for the sick and wounded women and children. Methods Medication information was retrospectively investigated in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. We extracted data including hospitalization duration, medication prescriptions, types and costs of essential medicines, types and costs of antibiotic medicines using the HIS system. Discharge diagnosis was standardized and classified according to ICD-10. Indicators of rational drug use included defined daily dose (DDD), defined daily dose statistic (DDDs), drug utilization index (DUI), children defined daily dose (cDDD), children drug utilization index (cDUI), proportion of essential medicines, proportion of antibiotic medicines, mismatch of medicine and diagnosis, repeated drug use, improper combination of drug, incorrect usage and dosage, and frequently drug change. Medication information was evaluated and discussed by the prescription working group. Discrepency was resolved by consulting with the panel. Results A total of 23 sick and wounded women and children were assessed during one month after Lushan Earthquake. There were 13 sick and wounded children in the department of pediatrics (mainly manifested as bronchial pneumonia) and 10 sick and wounded women in the department of gynaecology and obstetrics (mainly involved in cesarean delivery). Proportions of essential medicines were 13/13 in the department of pediatrics and 9/10 in the department of gynaecology and obstetrics. Proportions of antibiotic medicines were 10/13 in the department of pediatrics and 8/10 in the department of gynaecology and obstetrics. Irrational drug use was mainly caused by improper use of antibiotics. Conclusion The drug use for 23 hospitalized sick and wounded is rational in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. Evaluation methods of rational drug use in high-risk population are urgently needed. Using cDDD and cDUI is an active exploration for the evaluation of pediatric drug use, which needs more practice to test and improve.
Objective To summarize the experience of medical rescue conducted in Aba prefecture after the Wenchuan earthquake in order to provide information for similar tasks in seismo-active regions. Methods We participated and witnessed the whole process of medical rescue through 100 days after the quake. Data regarding the medical rescue work, work mode, performance and problems were collected and analyzed. Results Twelve counties out of the 13 counties in Aba prefecture were affected by the earthquake, including 2 most-hit counties and 5 most-hit areas. A total of 20 233 people died and 7 873 disappeared. Aba Prefectural Headquarters for Earthquake Resistance and Disaster Relief was set up and medical rescue teams were dispatched to the disaster area immediately after the quake: ① From May 12 to May 15 2008, 20 local medical teams comprising 138 healthcare professionals and 14 teams involving 428 professionals from other regions arrived at the most-hit areas. Through 7 days after the quake, medical treatment was provided for 6 285 patient-times. ② A total of 1 444 healthcare professionals participated in the medical rescue work. Through August 20, 355 579 outpatients and 7 028 inpatients were treated in the prefectural medical institutions and on-site medical centers. Of those, 6 726 were discharged, 604 were severely wounded, 20 died and 456 were transferred to other regions for further treatment. 2 703 operations were performed for the wounded and psychological treatment was provided for 4 630 person-times. Conclusion The medical rescue work in Aba prefecture after the Wenchuan earthquake was effective and efficient. Management of human resources and medical devices should be strengthened to enhance the ability of emergency response.
Objective To summarize the organization management and performance of volunteers taking part in the medical succor in People’s Hospital of Deyang City after 2 weeks of Wenchuan earthquake, in order to provide some reference for public health events in the future. Method Collecting some basic information, job flowing, workload, and management system of volunteers in the hospital from 12th to 26th, May, 2008, and so on, and then using Microsoft EXCEL to set up database for general analysis, in order to summarize management’s characteristics of volunteer organization and effects in hospital medical rescue. Result There are 6 838 persons that took part in the volunteer work, and this work can be divided into 3 phases according to the difference of the organization and management methods, they are 1 day later, 2-3 days later, 4-14 days later after earthquake. These volunteers assisted hospital finishing rescue, treatment and nursing for more than 1 870 wounded persons, transferring more than 441 wounded persons, and some works of logistic service, epidemic situation prevention and control, mentality intervention. Conclusion Different work tasks in different phases for volunteers after 2 weeks earthquake. Organizing and managing volunteers in different phases according to different work tasks to benefit the work performance.
Objective To summarize the experience of providing medical supplies for the medical rescue after the Wenchuan earthquake so as to provide information for similar tasks in the future. Methods We collected and analyzed relevant data from the Medical Supply Group of the Headquarters for Earthquake Resistance and Disaster Relief. Results ① The Medical Supply Group of the Headquarters for Earthquake Resistance and Disaster Relief was set up immediately after the quake. Professional software for the medical supply information management was developed to ensure the completeness and timeliness of relevant data. ② Within the first 3 days after the quake, 12 460 medical device parts were delivered to the disaster area, which effectively ensured the availability of medical supplies for the “golden 72 hours”. ③ A great amount of donated material from other provinces and overseas also arrived. These donations reached a peak 2 weeks after the quake. A total of 428 411 drug products, 196 504 medical device parts and 5 999.4 tons of disinfection material were successfully delivered to most of the quake-stricken areas within 24 hours after its delivery to Sichuan province. ④ Three months after the quake, the remaining 193 831 drug products, 96 423 medical device parts and 2 000 tons of disinfection material were disposed appropriately. A regional medical supply warehouse was established to reserve 129 895 drug products, 74 018.4 medical device part and 231.28 tons of disinfection material. On the 115th day after the quake, a portion of these reserves were allocated to the quake-hit areas in Panzhihua, Liangshan, and Yunnan province. ⑤ Nearly 20 tons of drug products, 10 tons of medical devices and 724.54 tons of disinfection materials were properly destroyed due to expiration or disqualification. ⑥ Based on the data collected during the disaster relief work, a series of articles were published. Conclusion The medical supply work for the medical rescue after the Wenchuan earthquake was efficient, well-organized, transparent, and open.
Objective To retrospectively analyze and classify 23 open fractures that resulted in severe infection, in order to provide evidence that can be used in future disaster scenarios. Methods Based on medical records of 23 cases of open fracture and subsequent bacterial infection, we analyzed the clinical diagnosis, treatment, laboratory tests, bacterial smear of wound secretion, and the bacterial culture of the wound secretion. We then analyzed which antimicrobial agents were used and how they were applied, and the subsequent effect on controlling the serious infection.? Results All cases were related to seismic injury and belonged to class VI open fracture. Eight cases were male and 15 were female. All cases had similar symptoms such as chills, fever, large scale muscle necrosis, and severe infection. A direct smear of the wound showed that the number of cases with one bacterial infection was 6 (26.09%), the number that had double bacterial infections was 12 (52.18%), and the number with multiple bacterial infections was 5 (21.74%).There were 18 strains of 11 types of bacteria recovered from wound samples. Conclusion Early treatment with the joint application of multiple antibacterial agents, early debridement, and adequate drainage all helped to control the infection and avoid nosocomial infection. Employing these strategies in the future will control infection in disaster situations.
Objective To evaluate the psychological trauma incurred by the people in wenxian after the Wenchuan earthquake so as to provide relevant information for psychological and medical interventions. Methods Thepsychological state of the people after the earthquake was investigated using a mental health self-assessment questionnaire, self-rating anxiety scale, and self-rating depression scale. Results We found: 56.0% of the respondents were not happy, 39.6% often cried bitterly, 56.7% felt pain, 40.7% lost interest, 69.2% felt uneasy, nervous, or worried, and 27.0% would like to end their lives; the SDS scores (56.48±110.43) and SAS scores (39.88±11.38) of the people were significantly higher than those of the national norms (Plt;0.001). The following symptons appeared: 59.3% had headache, 50.5% poor appetite, poor sleeping 56.0%, 58.2% were easily frightened, tremors 29.7%, 50.5% dyspepsia, 42.9% thoughts fuzzy, 60.4% stomach discomfort, fatigue 85.7%. Conclusion The earthquake disaster brought about serious psychological harm to people. It is necessary to strengthen post-earthquake psychological relief and strengthen interventions in order to reduce the psychological suffering of victims.
This article introduces the information release and news reports related to the medical rescue in West China Hospital after Wenchuan earthquake, in terms of organization and management of internal and external propaganda, as well as how to organize and optimize volunteers’ involvement in news report. A total of more than 500 medias and over 2000 journalists have been received, 439 items of information have been released, 6675 photos covering 159 topics and 30-hour video records covering 100 topics have been collected. In addition, 5-hour video records and over 1000 photos have been provided to more than 20 medical teams or individual from other provinces.