Milsten A
Department of Surgery, University of Maryland, Baltimore 21201, USA.
Prehosp Disaster Med. 2000 Jan-Mar;15(1):32-45.
Hospitals the world over have been involved in disasters, both internal and external. These two types of disasters are independent, but not mutually exclusive. Internal disasters are isolated to the hospital and occur more frequently than do external disasters. External disasters affect the community as well as the hospital. This paper first focuses on common problems encountered during acute-onset disasters, with regards to hospital operations and caring for victims. Specific injury patterns commonly seen during natural disasters are reviewed. Second, lessons learned from these common problems and their application to hospital disaster plans are reviewed.
An extensive review of the available literature was conducted using the computerized databases Medline and Healthstar from 1977 through March 1999. Articles were selected if they contained information pertaining to a hospital response to a disaster situation or data on specific disaster injury patterns. Selected articles were read, abstracted, analyzed, and compiled.
Hospitals continually have difficulties and failures in several major areas of operation during a disaster. Common problem areas identified include communication and power failures, water shortage and contamination, physical damage, hazardous material exposure, unorganized evacuations, and resource allocation shortages.
Lessons learned from past disaster-related operational failures are compiled and reviewed. The importance and types of disaster planning are reviewed.
世界各地的医院都会遭遇各种灾害，包括内部灾害和外部灾害。这两类灾害相互独立，但并非相互排斥。内部灾害仅限于医院内部，发生频率高于外部灾害。外部灾害会影响社区以及医院。本文首先关注急性灾害发生期间在医院运营和伤员救治方面遇到的常见问题。回顾了自然灾害中常见的特定损伤模式。其次，探讨从这些常见问题中吸取的经验教训及其在医院灾难预案中的应用。
利用计算机化数据库Medline和Healthstar对1977年至1999年3月期间的现有文献进行了广泛回顾。若文章包含有关医院应对灾害情况的信息或特定灾害损伤模式的数据，则予以选取。对选取的文章进行阅读、摘要、分析和汇编。
在灾害期间，医院在几个主要运营领域持续面临困难和出现失误。确定的常见问题领域包括通信和电力故障、缺水和污染、物理损坏、接触有害物质、疏散无序以及资源分配短缺。
总结并回顾了从过去与灾害相关的运营失误中吸取的经验教训。审查了灾难预案的重要性和类型。
