Sechriest V Franklin, Wing Vern, Walker G Jay, Aubuchon Maureen, Lhowe David W
Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Am J Disaster Med. 2012 Fall;7(4):281-94. doi: 10.5055/ajdm.2012.0101.
Since 2004, the US Navy has provided ship-borne medical assistance during three earthquake disasters. Because Navy ship deployment for disaster relief (DR) is a recent development, formal guidelines for equipping and staffing medical operations do not yet exist. The goal of this study was to inform operational planning and resource allocation for future earthquake DR missions by 1) reporting the type and volume of patient presentations, medical staff, and surgical services and 2) providing a comparative analysis of the current medical and surgical capabilities of a hospital ship and a casualty receiving and treatment ship (CRTS).
The following three earthquake DR operations were reviewed retrospectively: 1) USNS Mercy to Indonesia in 2004, 2) USNS Mercy to Indonesia in 2005, and 3) USNS Comfort/USS Bataan to Haiti in 2010. (The USS Bataan was a CRTS.) Mission records and surgical logs were analyzed. Descriptive and statistical analysis was performed. Comparative analysis of hospital ship and CRTS platforms was made based on firsthand observations.
For the three missions, 986 patient encounters were documented. Of 1,204 diagnoses, 80 percent were disaster-related injuries, more than half of which were extremity trauma. Aboard hospital ships, healthcare staff provided advanced (Echelon III) care for disaster-related injuries and various nondisaster-related conditions. Aboard the CRTS, staff provided basic (Echelon II) care for disaster-related injuries.
Our data indicate that musculoskeletal extremity injuries in sex- and age-diverse populations comprised the majority of clinical diagnoses. Current capabilities and surgical staffing of hospital ships and CRTS platforms influenced their respective DR operations, including the volume and types of surgical care delivered.
自2004年以来，美国海军已在三次地震灾害期间提供了舰载医疗援助。由于海军舰艇用于救灾是一项新发展，目前尚无医疗行动装备和人员配备的正式指南。本研究的目的是通过以下方式为未来地震救灾任务的行动规划和资源分配提供参考：1）报告患者就诊类型和数量、医务人员及外科服务情况；2）对医院船和伤员接收与治疗船（CRTS）当前的医疗和外科能力进行比较分析。
对以下三次地震救灾行动进行回顾性分析：1）2004年美国海军仁慈号前往印度尼西亚；2）2005年美国海军仁慈号前往印度尼西亚；3）2010年美国海军舒适号/美国海军巴丹号前往海地。（美国海军巴丹号是一艘伤员接收与治疗船。）分析了任务记录和手术日志。进行了描述性和统计分析。基于第一手观察资料对医院船和伤员接收与治疗船平台进行了比较分析。
在这三次任务中，记录了986次患者就诊情况。在1204例诊断中，80%为与灾害相关的损伤，其中一半以上为四肢创伤。在医院船上，医护人员为与灾害相关的损伤及各种非灾害相关病症提供高级（三级）护理。在伤员接收与治疗船上，工作人员为与灾害相关的损伤提供基本（二级）护理。
我们的数据表明，不同性别和年龄人群的肌肉骨骼四肢损伤占临床诊断的大多数。医院船和伤员接收与治疗船平台的当前能力和外科人员配备影响了各自的救灾行动，包括所提供手术护理的数量和类型。
