Graduate School of Engineering Science and Technology.
Bachelor Program in Interdisciplinary Studies, College of Future.
Medicine (Baltimore). 2021 Mar 19;100(11):e24482. doi: 10.1097/MD.0000000000024482.
The purpose of this research is to analyze and introduce a new emergency medical service (EMS) transportation scenario, Emergency Medical Regulation Center (EMRC), which is a temporary premise for treating moderate and minor casualties, in the 2015 Formosa Fun Color Dust Party explosion in Taiwan. In this mass casualty incident (MCI), although all emergency medical responses and care can be considered as a golden model in such an MCI, some EMS plans and strategies should be estimated impartially to understand the truth of the successful outcome.Factors like on-scene triage, apparent prehospital time (appPHT), inhospital time (IHT), and diversion rate were evaluated for the appropriateness of the EMS transportation plan in such cases. The patient diversion risk of inadequate EMS transportation to the first-arrival hospital is detected by the odds ratios (ORs). In this case, the effectiveness of the EMRC scenario is estimated by a decrease in appPHT.The average appPHTs (in minutes) of mild, moderate, and severe patients are 223.65, 198.37, and 274.55, while the IHT (in minutes) is 18384.25, 63021.14, and 83345.68, respectively. The ORs are: 0.4016 (95% Cl = 0.1032-1.5631), 0.1608 (95% Cl = 0.0743-0.3483), and 4.1343 (95% Cl = 2.3265-7.3468; P < .001), respectively. The appPHT has a 47.61% reduction by employing an EMRC model.Due to the relatively high appPHT, diversion rate, and OR value in severe patients, the EMS transportation plan is distinct from a prevalent response and develops adaptive weaknesses of MCIs in current disaster management. Application of the EMRC scenario reduces the appPHT and alleviates the surge pressure upon emergency departments in an MCI.
本研究旨在分析和介绍 2015 年台湾花莲“太鲁阁号”出轨事故中一种新的紧急医疗服务（EMS）转运方案，即紧急医疗调控中心（EMRC），这是一个临时的中度和轻度伤员治疗场所。在这起重大伤亡事故（MCI）中，尽管所有的紧急医疗响应和救治都可以被视为此类 MCI 中的黄金模式，但也应该公正地评估一些 EMS 计划和策略，以了解成功救治的真相。本研究评估了现场分类、明显的院前时间（appPHT）、院内时间（IHT）和转院率等因素，以评估此类情况下 EMS 转运计划的合理性。通过比值比（ORs）检测由于 EMS 转运不足导致患者转往首诊医院的风险。在这种情况下，通过 appPHT 的减少来评估 EMRC 方案的效果。轻度、中度和重度患者的平均 appPHT（分钟）分别为 223.65、198.37 和 274.55，而 IHT（分钟）分别为 18384.25、63021.14 和 83345.68。ORs 分别为：0.4016（95% Cl = 0.1032-1.5631）、0.1608（95% Cl = 0.0743-0.3483）和 4.1343（95% Cl = 2.3265-7.3468；P < .001）。采用 EMRC 模型后，appPHT 减少了 47.61%。由于重度患者的 appPHT、转院率和 OR 值较高，EMS 转运计划与当前灾害管理中流行的反应明显不同，并且在 MCI 中发展出了适应性弱点。应用 EMRC 方案可降低 appPHT，并缓解 MCI 中急诊科的压力。
