A descriptive analysis of injury triage, surge of medical demand, and resource use in an university hospital after 8.12 Tianjin Port Explosion, China / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSIONS</b>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.</p>

Post-disaster medical rescue strategy in tropical regions / 世界急诊医学杂志（英文）

BACKGROUND: Earthquakes, floods, droughts, storms, mudslides, landslides, and forest wild fires are serious threats to human lives and properties. The present study aimed to study the environmental characteristics and pathogenic traits, recapitulate experiences, and augment applications of medical reliefs in tropical regions. METHODS: Analysis was made on work and projects of emergency medical rescue, based on information and data collected from 3 emergency medical rescue missions of China International Search and Rescue Team to overseas earthquakes and tsunamis aftermaths in tropical disaster regions Indonesia-Aceh, Indonesia-Yogyakarta, and Haiti-Port au Prince. RESULTS: Shock, infection and heat stroke were frequently encountered in addition to outbreaks of infectious diseases, skin diseases, and diarrhea during post-disaster emergency medical rescue in tropical regions. CONCLUSIONS: High temperature, high humidity, and proliferation of microorganisms and parasites are the characteristics of tropical climate that impose strict requirements on the preparation of rescue work including selective team members suitable for a particular rescue mission and the provisioning of medical equipment and life support materials. The overseas rescue mission itself needs a scientific, efficient, simple workflow for providing efficient emergency medical assistance. Since shock and infection are major tasks in post-disaster treatment of severely injured victims in tropical regions, the prevention and diagnosis of hyperthermia, insect-borne infectious diseases, tropic skin diseases, infectious diarrhea, and pest harms of disaster victims and rescue team staff should be emphasized during the rescue operations.