Zhenzhou Wang, Xiujuan Zhao, Fuzheng Guo, Fengxue Zhu, Tianbing Wang
{"title":"[在基层医院建立应急创伤小组]。","authors":"Zhenzhou Wang, Xiujuan Zhao, Fuzheng Guo, Fengxue Zhu, Tianbing Wang","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility of establishing a temporary trauma team led by trauma experts in primary hospitals for disaster medical rescue.</p><p><strong>Methods: </strong>In the coal mine flooding accident in Xiaoyi City, Shanxi Province on December 15, 2021, according to the local emergency plan and the characteristics of the accident, the trauma experts trained the medical staff from the local primary hospital on advanced trauma life support (ATLS) and damage control surgery (DCS) in the short time interval between the occurrence of the mine disaster and the admission of medical staff to the disaster scene. A temporary trauma team composed of trauma experts, ATLS team, and DCS team was formed to provide early diagnosis and treatment for survivors before and in the hospital.</p><p><strong>Results: </strong>The miners were found on the 36th hour of the disaster. All 22 miners were male, and 2 died underground. Another 20 people were rescued 39-43 hours after the disaster, with a median age of 48 years (34-57 years). All the survivors suffered from hypothermia, dehydration, maceration of feet and other injuries. There were 18 cases of acute inhalation tracheobronchitis, 14 cases of electrolyte acid-base disturbance, 6 cases of trunk contusion, 1 case of psoas major hematoma, and 1 case of lower extremity hematoma. Deep vein thrombosis was in 4 cases. The ATLS team focused on injury assessment, rewarming and rehydration within 50-60 minutes before admission, and completed auxiliary examinations within 2 hours after admission to clarify the diagnosis. The DCS team evaluated 6 patients with mechanical blunt trunk injury and excluded the indication of emergency surgery. The trauma experts conducted the whole process of supervision and quality control of disaster rescue. The positive rate of capillary refill test in the all survivors at the third hour of admission was significantly lower than that immediately after being rescued (75.0% <i>vs.</i> 15.0%, <i>P</i>=0.000 3), and they were discharged 4-7 days after admission.</p><p><strong>Conclusion: </strong>Under the leadership of trauma experts and relying on the medical staff of primary hospitals, it is feasible to establish and train a temporary trauma team with ATLS and DCS functions to participate in the medical rescue of disasters, which is in line with the current national conditions of China.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报(医学版)","volume":"57 2","pages":"323-327"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992455/pdf/","citationCount":"0","resultStr":"{\"title\":\"[A temporary trauma team established in primary hospital for disaster rescue].\",\"authors\":\"Zhenzhou Wang, Xiujuan Zhao, Fuzheng Guo, Fengxue Zhu, Tianbing Wang\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To explore the feasibility of establishing a temporary trauma team led by trauma experts in primary hospitals for disaster medical rescue.</p><p><strong>Methods: </strong>In the coal mine flooding accident in Xiaoyi City, Shanxi Province on December 15, 2021, according to the local emergency plan and the characteristics of the accident, the trauma experts trained the medical staff from the local primary hospital on advanced trauma life support (ATLS) and damage control surgery (DCS) in the short time interval between the occurrence of the mine disaster and the admission of medical staff to the disaster scene. A temporary trauma team composed of trauma experts, ATLS team, and DCS team was formed to provide early diagnosis and treatment for survivors before and in the hospital.</p><p><strong>Results: </strong>The miners were found on the 36th hour of the disaster. All 22 miners were male, and 2 died underground. Another 20 people were rescued 39-43 hours after the disaster, with a median age of 48 years (34-57 years). All the survivors suffered from hypothermia, dehydration, maceration of feet and other injuries. There were 18 cases of acute inhalation tracheobronchitis, 14 cases of electrolyte acid-base disturbance, 6 cases of trunk contusion, 1 case of psoas major hematoma, and 1 case of lower extremity hematoma. Deep vein thrombosis was in 4 cases. The ATLS team focused on injury assessment, rewarming and rehydration within 50-60 minutes before admission, and completed auxiliary examinations within 2 hours after admission to clarify the diagnosis. The DCS team evaluated 6 patients with mechanical blunt trunk injury and excluded the indication of emergency surgery. The trauma experts conducted the whole process of supervision and quality control of disaster rescue. The positive rate of capillary refill test in the all survivors at the third hour of admission was significantly lower than that immediately after being rescued (75.0% <i>vs.</i> 15.0%, <i>P</i>=0.000 3), and they were discharged 4-7 days after admission.</p><p><strong>Conclusion: </strong>Under the leadership of trauma experts and relying on the medical staff of primary hospitals, it is feasible to establish and train a temporary trauma team with ATLS and DCS functions to participate in the medical rescue of disasters, which is in line with the current national conditions of China.</p>\",\"PeriodicalId\":8790,\"journal\":{\"name\":\"北京大学学报(医学版)\",\"volume\":\"57 2\",\"pages\":\"323-327\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992455/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"北京大学学报(医学版)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"北京大学学报(医学版)","FirstCategoryId":"3","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨在基层医院建立由创伤专家领导的临时创伤小组进行灾害医学救援的可行性。方法:在2021年12月15日山西省孝邑市煤矿透水事故中,根据当地应急预案和事故特点,创伤专家在矿难发生至医护人员进入灾害现场的短时间间隔内,对当地基层医院医护人员进行创伤高级生命支持(ATLS)和损伤控制手术(DCS)培训。由创伤专家、ATLS小组和DCS小组组成的临时创伤小组,为幸存者在入院前和住院期间提供早期诊断和治疗。结果:矿工在灾难发生后的第36小时被发现。22名矿工均为男性,其中2人死于井下。另有20人在灾难发生后39-43小时获救,平均年龄为48岁(34-57岁)。所有幸存者都遭受了体温过低、脱水、足部浸湿和其他伤害。急性吸入性气管支气管炎18例,电解质酸碱紊乱14例,躯干挫伤6例,腰肌大血肿1例,下肢血肿1例。深静脉血栓4例。ATLS团队在入院前50-60分钟内重点进行损伤评估、复温补液,并在入院后2小时内完成辅助检查以明确诊断。DCS小组评估了6例机械钝性躯干损伤患者,排除了紧急手术指征。创伤专家对救灾全过程进行了监督和质量控制。所有幸存者入院第3 h时毛细血管再灌注试验阳性率显著低于获救后即刻阳性率(75.0% vs. 15.0%, P=0.000 3),入院后4 ~ 7 d出院。结论:在创伤专家的领导下,依托基层医院医务人员,建立和培训一支具有ATLS和DCS功能的临时创伤队伍参与灾害医学救援是可行的,符合中国当前国情。
[A temporary trauma team established in primary hospital for disaster rescue].
Objective: To explore the feasibility of establishing a temporary trauma team led by trauma experts in primary hospitals for disaster medical rescue.
Methods: In the coal mine flooding accident in Xiaoyi City, Shanxi Province on December 15, 2021, according to the local emergency plan and the characteristics of the accident, the trauma experts trained the medical staff from the local primary hospital on advanced trauma life support (ATLS) and damage control surgery (DCS) in the short time interval between the occurrence of the mine disaster and the admission of medical staff to the disaster scene. A temporary trauma team composed of trauma experts, ATLS team, and DCS team was formed to provide early diagnosis and treatment for survivors before and in the hospital.
Results: The miners were found on the 36th hour of the disaster. All 22 miners were male, and 2 died underground. Another 20 people were rescued 39-43 hours after the disaster, with a median age of 48 years (34-57 years). All the survivors suffered from hypothermia, dehydration, maceration of feet and other injuries. There were 18 cases of acute inhalation tracheobronchitis, 14 cases of electrolyte acid-base disturbance, 6 cases of trunk contusion, 1 case of psoas major hematoma, and 1 case of lower extremity hematoma. Deep vein thrombosis was in 4 cases. The ATLS team focused on injury assessment, rewarming and rehydration within 50-60 minutes before admission, and completed auxiliary examinations within 2 hours after admission to clarify the diagnosis. The DCS team evaluated 6 patients with mechanical blunt trunk injury and excluded the indication of emergency surgery. The trauma experts conducted the whole process of supervision and quality control of disaster rescue. The positive rate of capillary refill test in the all survivors at the third hour of admission was significantly lower than that immediately after being rescued (75.0% vs. 15.0%, P=0.000 3), and they were discharged 4-7 days after admission.
Conclusion: Under the leadership of trauma experts and relying on the medical staff of primary hospitals, it is feasible to establish and train a temporary trauma team with ATLS and DCS functions to participate in the medical rescue of disasters, which is in line with the current national conditions of China.
期刊介绍:
Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases.
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