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Covid-19 大流行:创伤准备和应对方面的持续教训。

The Covid-19 Pandemic: Lessons Learned for Sustained Trauma Preparedness and Responses.

机构信息

Department of Surgery, University of Washington School of Medicine, Seattle, Washington.

Department of Medicine, University of Washington School of Medicine, Seattle, Washington.

出版信息

Ann Surg. 2021 Jun 1;273(6):1051-1059. doi: 10.1097/SLA.0000000000004695.

Abstract

The emergence of coronavirus disease 2019 (COVID-19) that is caused by the SARS-CoV-2 virus has led to an overwhelming strain on healthcare delivery. This pandemic has created a sustained stress on the modern healthcare system, with unforeseen and potential drastic effects. Although the initial focus during this pandemic has been preparedness and response directed to the pandemic itself, traumatic injury has continued to remain a common problem that requires immediate evaluation and care to provide optimal outcomes. The State of Washington had the first reported case and death related to COVID-19 in the United States. Harborview Medical Center, which serves as the sole Level-1 adult and pediatric trauma center for the state, was rapidly affected by COVID-19, but still needed to maintain preparedness and responses to injured patients for the region. Although initially the focus was on the emerging pandemic on institutional factors, it became obvious that sustained efforts for regional trauma care required a more global focus. Because of these factors, Harborview Medical Center was quickly entrusted to serve as the coordinating center for the regions COVID-19 response, while also continuing to provide optimal care for injured patients during the pandemic. This response allowed the care of injured patients to be maintained within designated trauma centers during this pandemic. This present report summarizes the evolution of trauma care delivery during the first phase of this pandemic and provides informative recommendations for sustained responses to the care of injured patients during the pandemic based on lessons learned during the initial response.

摘要

由 SARS-CoV-2 病毒引起的 2019 年冠状病毒病(COVID-19)的出现导致医疗保健服务不堪重负。这场大流行对现代医疗保健系统造成了持续的压力,带来了前所未有的潜在剧烈影响。尽管在这场大流行期间,最初的重点是针对大流行本身的准备和应对,但创伤性损伤仍然是一个常见问题,需要立即进行评估和护理,以提供最佳结果。华盛顿州是美国第一个报告 COVID-19 病例和死亡的州。海港医疗中心是该州唯一的成人和儿科一级创伤中心,很快受到 COVID-19 的影响,但仍需要为该地区的受伤患者做好准备和应对。尽管最初的重点是机构因素引发的新兴大流行,但很明显,区域创伤护理的持续努力需要更全面的关注。由于这些因素,海港医疗中心很快被委以重任,成为该地区 COVID-19 应对的协调中心,同时在大流行期间继续为受伤患者提供最佳护理。这种应对措施使受伤患者的护理在大流行期间能够在指定的创伤中心内得到维持。本报告总结了大流行第一阶段创伤护理提供方式的演变,并根据初始应对期间的经验教训,就大流行期间受伤患者护理的持续应对提供了有价值的建议。

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