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2018年台湾花莲地震——我们在一家三级医院急诊科学到的灾害教训

2018 Taiwan Hualien Earthquake-Disaster Lessons We Learned in the Emergency Department of a Tertiary Hospital.

作者信息

Nieh Jen-Hao, Hsu Tzu-Heng, Cheng Hsing-Chia, Chong Kok Chin, Lai Pei Fang

机构信息

Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Department of Emergency Medicine Hualien Taiwan.

Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Department of Nursing Hualien Taiwan.

出版信息

J Acute Med. 2020 Dec 1;10(4):149-155. doi: 10.6705/j.jacme.202012_10(4).0003.

Abstract

BACKGROUND

On February 6, 2018, a magnitude-6.2 earthquake on the Richter scale struck Hualien, and that disaster killed 17 people and injured more than 300 people. Our hospital, the only tertiary hospital in eastern Taiwan, responded to a mass casualty incident (MCI) in two hours. Such a devastating earthquake infl uenced the health of the general population and the mental health of hospital staff. Thus, we aimed to analyze the medical problems in earthquake victims, the MCI response's operation, and the prevalence of post-traumatic stress disorder (PTSD) among healthcare providers.

METHODS

We reviewed the medical records to investigate the information on the medical requirement of victims. Questionnaires were collected from emergency department staff regarding the operation of the MCI and the effect of regular MCI drills. For a survey of PTSD among healthcare providers, we used the Chinese version of the Davidson Trauma Scale for the psychiatric assessment.

RESULTS

Among the 113 victims who entered the emergency room, almost 90% had a minor injury. The results of the operation of the MCI revealed that 71.5% of them knew the response process of the MCI and performed well. The hospital staff's mental health assessment showed 17.5% met the diagnostic criteria for PTSD one month after the disaster, and 3.2% met the criteria seven months after the earthquake. Personal psychiatric histories were the only risk factor for PTSD.

CONCLUSIONS

Most earthquake victims presented to the emergency room with trauma injuries. Thus, we need to prepare more resources to manage surgical problems. To be well prepared for mass casualty events, the annual exercises play a signifi cant role. Besides, we can't ignore the mental health condition of healthcare providers after the disaster. We record this tragic earthquake's valuable experience and lessons and share them with others.

摘要

背景

2018年2月6日,花莲发生里氏6.2级地震,造成17人死亡,300多人受伤。我院作为台湾东部唯一的三级医院,在两小时内响应了大规模伤亡事件(MCI)。如此毁灭性的地震影响了普通民众的健康以及医院工作人员的心理健康。因此,我们旨在分析地震受害者的医疗问题、MCI响应行动以及医护人员中创伤后应激障碍(PTSD)的患病率。

方法

我们查阅病历以调查受害者的医疗需求信息。从急诊科工作人员处收集有关MCI行动及常规MCI演练效果的问卷。对于医护人员中PTSD的调查,我们使用中文版的戴维森创伤量表进行精神评估。

结果

在进入急诊室的113名受害者中,近90%为轻伤。MCI行动结果显示,其中71.5%的人了解MCI响应流程且表现良好。医院工作人员的心理健康评估显示,灾难发生一个月后,17.5%的人符合PTSD诊断标准,地震发生七个月后,3.2%的人符合标准。个人精神病史是PTSD的唯一风险因素。

结论

大多数地震受害者到急诊室就诊时伴有创伤损伤。因此,我们需要准备更多资源来处理外科问题。为应对大规模伤亡事件做好充分准备,年度演练起着重要作用。此外,我们不能忽视灾难后医护人员的心理健康状况。我们记录了这次惨痛地震的宝贵经验教训并与他人分享。

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