A descriptive analysis of injury triage, surge of medical demand, and resource use in an university hospital after 8.12 Tianjin Port Explosion, China.

OBJECTIVE: The 8.12 Tianjin Port Explosion in 2015 caused heavy casualties. Pingjin Hospital, an affiliated college hospital in Tianjin, China participated in the rescue activities. This study aims to analyze the emergency medical response to this event and share experience with trauma physicians to optimize the use of medical resource and reduce mortality of critical patients. METHODS: As a trauma centre at the accident city, our hospital treated 298 patients. We retrospectively analyzed the data of emergency medical response, including injury triage, injury type, ICU patient flow, and medical resource use. RESULTS: There were totally 165 deaths, 8 missing, and 797 non-fatal injuries in this explosion. Our hospital treated 298 casualties in two surges of medical demand. The first one appeared at 1 h after explosion when 147 wounded were received and the second one at 4 h when 31 seriously injured patients were received, among whom 29 were transferred from Tianjin Emergency Center which was responsible for the scene injury triage. After reexamination and triage, only 11 cases were defined as critical ill patients. The over-triage rate reached as high as 62.07%. Seventeen patients underwent surgery and 17 patients were admitted to the intensive care unit. CONCLUSIONS: The present pre-hospital system is incomplete and may induce two surges of medical demand. The first one has a much larger number of casualties than predicted but the injury level is mild; while the second one has less wounded but almost all of them are critical patients. The over-triage rate is high. The hospital emergency response can be improved by an effective re-triage and implementation of a hospital-wide damage control.

The Influence of the Topography of the Ailao Mountains on Congregated Landings of Airborne Sogatella furcifera (Hemiptera: Delphacidae) Populations.

The Sogatella furcifera (Horváth) is an important migrating rice pest whose outbreak may be caused by large-scale congregated landings. Hitherto, the meteorological factors that influence congregated landings were thought to be rainfall and downdraft. However, for migratory insects on a plateau, low temperature may be another key factor leading to congregated landings. However, no reports have been published. Therefore, this paper evaluates the reason for a large-scale congregated landing in the mountainous area in Yuanjiang via light trap monitoring. The meteorological backgrounds during light catch peaks were analyzed using the numeric simulation method. The results were as follows: 1) from May 7th to May 9th, 2012, the congregated landing of S. furcifera was caused by precipitation; 2) the congregated landing of S. furcifera on May 10th, 2012, was a result of low temperatures in the mountainous region. The driving airflow of S. furcifera climbed along the mountain terrain, which led to a decrease in temperature with the rise of the mountain terrain. Low temperature created physiological changes in S. furcifera, forcing S. furcifera to a lower flight altitude and eventually to a congregated landing; and 3) in the statistical analysis on 39 peak periods from 2010 to 2016 in the early spring, 20 peaks were caused by precipitation, and 19 peaks were caused by a low temperature barrier. Therefore, this study provided evidence of a plateau-migrating S. furcifera population congregated landing caused by low temperature.