Leiba Adi, Ashkenasi Issac, Nakash Guy, Pelts Rami, Schwartz Dagan, Goldberg Avishay, Levi Yeheskel, Bar-Dayan Yaron
Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel.
Prehosp Disaster Med. 2006 Jan-Feb;21(1):s32-7.
The disaster caused by the tsunami of 26 December 2004 was one of the worst that medical systems have faced. The aim of this study was to learn about the medical response of the Thai hospitals to this disaster and to establish guidelines that will help hospitals prepare for future disasters. The Israeli Defense Forces (IDF) Home Front Command (HFC) Medical Department sent a research delegation to Thai hospitals to study: (1) pre-event hospital preparedness; (2) patient evacuation and triage; (3) personnel and equipment reinforcement; (4) modes used for alarm and recruitment of hospital personnel; (5) internal reorganization of hospitals; and (6) admission, discharge, and secondary transfer (forward management) of patients. Thai hospitals were prepared for and drilled for a general mass casualty incident (MCI) involving up to 50 casualties. However, a control system to measure the success of these drills was not identified, and Thai hospitals were not prepared to deal with the unique aspects of a tsunami or to receive thousands of victims. Modes of operation differed between provinces. In Phang Nga and Krabi, many patients were treated in the field. In Phuket, most patients were evacuated early to secondary (district) and tertiary (provincial) hospitals. Hospitals recalled staff rapidly and organized the emergency department for patient triage, treatment, and transfer if needed. Although preparedness was deficient, hospital systems performed well. Disaster management should focus on field-based first aid and triage, and rapid evacuation to secondary hospitals. Additionally, disaster management should reinforce and rely on the existing and well-trusted medical system.
2004年12月26日的海啸所引发的灾难是医疗系统所面临的最严重灾难之一。本研究的目的是了解泰国医院对这场灾难的医疗应对情况，并制定有助于医院为未来灾难做好准备的指导方针。以色列国防军（IDF）后方司令部（HFC）医疗部门派遣了一个研究代表团前往泰国医院进行研究：（1）事件前医院的准备情况；（2）患者疏散和分诊；（3）人员和设备增援；（4）警报和医院人员招募的方式；（5）医院内部重组；以及（6）患者的入院、出院和二次转运（后续管理）。泰国医院针对涉及多达50名伤亡人员的一般大规模伤亡事件（MCI）进行了准备和演练。然而，未确定衡量这些演练成效的控制系统，泰国医院也未做好应对海啸独特情况或接收数千名受害者的准备。不同省份的运作模式有所不同。在攀牙府和甲米府，许多患者在现场接受治疗。在普吉岛，大多数患者早早被疏散到二级（地区）和三级（省级）医院。医院迅速召回工作人员，并组织急诊科对患者进行分诊、治疗以及在必要时进行转运。尽管准备不足，但医院系统运行良好。灾难管理应侧重于现场急救和分诊，以及迅速疏散到二级医院。此外，灾难管理应加强并依赖现有的且值得信赖的医疗系统。
