Department of Paediatric Surgery, West China Hospital, Si-Chuan University, Si-Chuan 610041, China.
J Pediatr Surg. 2009 Dec;44(12):2273-7. doi: 10.1016/j.jpedsurg.2009.07.068.
The study aimed to review the effect of modifying triage strategies on the consultation and operation waiting times during the Wen-Chuan earthquake in China in 2008.
The triage during the post-earthquake period was categorized into 3 phases. The consultation and operation waiting times were analyzed.
Of the 119 admitted children, there were 58 boys and 61 girls. Most of the victims were school-aged. In phase 1 (24 hours after the quake), the triage waiting time was 78 minutes. The waiting time for pediatric subspecialty consultation was 3.5 hours. There was an additional 7.5-hour delay before operation. In phase 2 (24-72 hours after the quake), senior pediatric surgeons carried out the triage and consultation. The consultation waiting time was reduced to 31 minutes. Four rotating teams operated 24 hours a day. The waiting time for operation was reduced to 4.5 hours. In phase 3 (4-19 days after the earthquake), gas gangrene screening was implemented. The triage waiting times for closed and open injuries were 47 and 64 minutes, respectively. Operation waiting times of 4.4 and 4.8 hours were recorded for closed and open injuries, respectively. Compared to that of phase 1, the waiting times for both consultation and operation of phases 2 and 3 were significantly shortened (P < .05). Most of the (89%) of the injuries were orthopedic traumas with lower limb fracture being the most common injury. Intraabdominal and thoracic injuries were relatively uncommon.
(1) Triage by pediatric surgeons in the reception area greatly reduced the delay of treatment and (2) the predominance of orthopedic injuries resulting from the earthquake indicates the focus of medical resource allocation in natural disasters of this type in the future.
本研究旨在回顾 2008 年中国汶川地震期间修改分诊策略对就诊和手术等候时间的影响。
将地震后分诊分为 3 个阶段，分析就诊和手术等候时间。
119 名入院患儿中，男 58 例，女 61 例，多数为学龄儿童。在第 1 阶段（地震后 24 小时内），分诊等候时间为 78 分钟，儿科专科咨询等候时间为 3.5 小时，手术前还需额外等待 7.5 小时。在第 2 阶段（地震后 24-72 小时），由资深儿科外科医生进行分诊和咨询，咨询等候时间缩短至 31 分钟，4 个轮转小组每天 24 小时手术，手术等候时间缩短至 4.5 小时。在第 3 阶段（地震后 4-19 天），进行气性坏疽筛查，闭合性和开放性损伤的分诊等候时间分别为 47 分钟和 64 分钟，手术等候时间分别为 4.4 小时和 4.8 小时，与第 1 阶段相比，第 2 阶段和第 3 阶段的就诊和手术等候时间均明显缩短（P <.05）。大多数（89%）损伤为骨科创伤，以下肢骨折最常见，腹部和胸部损伤相对少见。
（1）在接待区由儿科外科医生进行分诊可大大减少治疗的延迟；（2）地震引起的骨科损伤为主，表明未来此类自然灾害中医疗资源分配的重点。
