Simpson D M
Center for Hazards Research and Policy Development, University of Louisville, 426 West Bloom Street, Louisville, KY 40208, USA.
Prehosp Disaster Med. 2000 Oct-Dec;15(4):199-206.
The following paper presents an argument for enhancing and encouraging the development of neighborhood-based disaster preparedness organizations, particularly as a potential medical triage and treatment resource following a disaster. First, the research context for the utility of non-institutional sources of post-diaster assistance is outlined, followed by the more specific instance of medical triage and treatment. An emerging model of community disaster preparedness training is described, noting the modules that address disaster medicine. Positive contributions and limitations are addressed looking to disaster and non-disaster experiences. While the potential for non-traditional resources to aid immediate post-disaster response is becoming both more common and more accepted, there are a number of recommendations that would improve the usefulness and value, including: 1) integration with existing emergency care infrastructure; 2) standardization of training; 3) use of coordinated drills between public safety organizations, hospitals, and voluntary sectors; and 4) dedication of more funding to assist in the creation and maintenance of programs. Because of the relative infancy of these community-based programs, and the infrequency of large-scale disasters, there is little, if any, pre-post research that can demonstrate a measured impact on response. More pre-disaster baseline data-gathering efforts are needed, combined with post-disaster evaluative research to understand the utility of these non-traditional resources in terms of overall response, and in particular the ability to assist in areas of disaster medicine practice. One also expects that under these kinds of [disaster] conditions, family members, fellow employees, and neighbors will spontaneously try to help each other. This was the case following the Mexico City earthquake where untrained, spontaneous volunteers saved 800 people. However, 100 people lost their lives while attempting to save others. This is a high price to pay and is preventable through training.
以下论文提出了一个观点，即加强并鼓励发展基于社区的备灾组织，特别是将其作为灾难发生后的潜在医疗分诊和治疗资源。首先，概述了非机构性灾后援助资源效用的研究背景，接着阐述了更具体的医疗分诊和治疗实例。描述了一种新兴的社区备灾培训模式，并指出了涉及灾难医学的模块。结合灾难和非灾难经历探讨了其积极贡献和局限性。虽然非传统资源在灾后应急中的潜在作用日益普遍且更被认可，但仍有一些建议可提高其效用和价值，包括：1）与现有急救基础设施整合；2）培训标准化；3）公共安全组织、医院和志愿部门之间进行协同演练；4）投入更多资金以协助项目的创建和维持。由于这些基于社区的项目尚处于起步阶段，且大规模灾难发生频率较低，几乎没有（即便有也极少）前后对比研究能够证明其对应急响应有可衡量的影响。需要在灾前进行更多基线数据收集工作，并结合灾后评估研究，以了解这些非传统资源在整体应急响应方面的效用，特别是在灾难医学实践领域提供协助的能力。人们还预计，在这类[灾难]情况下，家庭成员、同事和邻居会自发地互相帮助。墨西哥城地震后就是如此，未经培训的自发志愿者拯救了800人。然而，有100人在试图救人时丧生。这是一个高昂的代价，通过培训是可以避免的。
