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城市灾区野战医院的重症监护:1999年土耳其地震的经验教训。

Intensive care in a field hospital in an urban disaster area: lessons from the August 1999 earthquake in Turkey.

作者信息

Halpern Pinchas, Rosen Boaz, Carasso Shemy, Sorkine Patrick, Wolf Yoram, Benedek Paul, Martinovich Giora

机构信息

Emergency Department, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.

出版信息

Crit Care Med. 2003 May;31(5):1410-4. doi: 10.1097/01.CCM.0000059439.07851.BD.

Abstract

OBJECTIVE

To describe our experience with the implementation of intensive care in the setting of a field hospital, deployed to the site of a major urban disaster.

DESIGN

Description of our experience during mission to Turkey; conclusions regarding implementation of intensive care at disaster sites.

SETTING

Military Field Hospital at Adapazari in Turkey.

PATIENTS

Civilian patients admitted for care at the field hospital.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

On August 17, 1999 a major earthquake occurred in western Turkey, causing approximately 16,000 fatalities and leaving >44,000 injured. Approximately 66,000 buildings were severely damaged or destroyed. A medical unit of the Israeli Defense Forces Medical Corps, consisting of 23 physicians, 13 nurses, nine paramedics, 13 medics, laboratory and roentgen technicians, pharmacists, and associated support personnel, were sent to Adapazari in Turkey. The field hospital treated approximately 1,200 patients over a period of 2 wks, 70 surgical operations were performed, 20 babies were delivered, and a variety of medical, surgical, orthopedic, and pediatric/neonatal care was provided. The 12-bed intensive care unit operated by the unit, was staffed by three physicians and eight nursing/paramedic personnel. Patient mix was: a total of 63 patients, among them five with major trauma, 20 with acute cardiac disease, 15 patients with various acute medical conditions, and 11 surgical and postoperative patients. Three patients were intubated and mechanically ventilated (one cardiogenic pulmonary edema and two major trauma). The intensive care unit provided the following functions to the field hospital: care of the critically ill and injured, preparation for and implementation of transportation of such patients, pre- and postoperative care for major surgical procedures, expertise, and equipment for the care of very ill patients throughout the field hospital.

CONCLUSIONS

In suitable circumstances, an intensive care capability should be an integral part of medical expeditions to major disasters.

摘要

目的

描述我们在一家野战医院实施重症监护的经验,该医院被部署到一场重大城市灾难的现场。

设计

描述我们在土耳其执行任务期间的经验;关于在灾难现场实施重症监护的结论。

地点

土耳其阿达帕扎里的军事野战医院。

患者

在野战医院接受治疗的平民患者。

干预措施

无。

测量指标及主要结果

1999年8月17日,土耳其西部发生了一场大地震,造成约16000人死亡,超过44000人受伤。约66000栋建筑物严重受损或被毁。以色列国防军医疗队的一个医疗单位,由23名医生、13名护士、9名护理人员、13名医务兵、实验室和放射技术人员、药剂师及相关支持人员组成,被派往土耳其的阿达帕扎里。野战医院在两周内治疗了约1200名患者,实施了70台外科手术,接生了20名婴儿,并提供了各种医疗、外科、骨科和儿科/新生儿护理。该单位运营的拥有12张床位的重症监护病房,配备了三名医生和八名护理/护理人员。患者构成如下:共有63名患者,其中5名有严重创伤,20名有急性心脏病,15名有各种急性疾病,11名外科和术后患者。三名患者接受了气管插管并进行机械通气(一名心源性肺水肿患者和两名严重创伤患者)。重症监护病房为野战医院提供了以下功能:对危重伤员的护理、此类患者转运的准备和实施、重大外科手术的术前和术后护理、为整个野战医院的重病患者提供专业知识和设备。

结论

在合适的情况下,重症监护能力应成为重大灾难医疗救援行动的一个组成部分。

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