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This is a case report of a huge hospital evacuation with 11 350 inpatients in the 2021 Zhengzhou flood in China, using a mixed methods analysis.
The qualitative part was a content analysis of semi-structured interviews of 6 key hospital staff involved in evacuation management. The evacuation experience was reviewed according to the 4 stages of disaster management: prevention, preparation, response, and recovery.
Because of unprecedented torrential rain, the flood exceeded expectations, and there was a lack of local preventive measures. In preparation, according to the alert, the evacuation was planned to reduce the workload on inpatients and to accept the surge of medical needs by the flood. In response, the prioritization of critically ill patients and large-scale collaboration of hospital staff, rescue teams, and accepting branch made it possible to successfully transfer all 11 350 inpatients. In recovery, restoring medical services and a series of activities to improve the hospital’s vulnerability were carried out.
A hospital evacuation is one of the strategies of the business continuity plan of a hospital. For the evacuation, leadership and collaboration were important. Challenges such as prolonged roadway flooding and the infrastructure issues were needed to be addressed throughout the evacuation process.
Robotics have important applications in the field of disaster medical rescue. The deployment of urban rescue robots at the earthquake site can help shorten response time, improve rescue efficiency and keep rescue personnel away from danger. This discussion introduces the performance of some robots in actual rescue scenarios, focuses on the current research status of robots that can provide medical assistance, and analyzes the merits and shortcomings of each system. Based on existing studies, the limitations and development directions of urban rescue robots are also discussed.
In December 2019, an outbreak of an unknown cause of pneumonia (later named coronavirus disease 2019 [COVID-19]) occurred in Wuhan, China. This was found to be attributed to a novel coronavirus of zoonotic origin, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously named 2019 novel coronavirus or 2019-nCoV). The SARS-CoV-2, a new type of highly pathogenic human coronavirus related to severe acute respiratory syndrome coronavirus (SARS-CoV), spread rapidly worldwide and caused 246,303,023 confirmed infections, including 4,994,160 deaths, by October 31, 2021. SARS-CoV-2 and SARS-CoV vary in their specific characteristics, regarding epidemics and pathogenesis. This article focuses on the comparison of the virology, epidemiology, and clinical features of SARS-CoV and SARS-CoV-2 to reveal their common and distinct properties, to provide an up-to-date resource for the development of advanced systems and strategies to monitor and control future epidemics of highly pathogenic human coronaviruses.
Since December 2019, a new coronavirus viral was initially detected in Wuhan, China. Population migration increases the risk of epidemic transmission. Here, the objective of study is to estimate the output risk quantitatively and evaluate the effectiveness of travel restrictions of Wuhan city.
We proposed a modified susceptible-exposed-infectious-recovered (SEIR) dynamics model to predict the number of coronavirus disease 2019 (COVID-19) symptomatic and asymptomatic infections in Wuhan. And, subsequently, we estimated the export risk of COVID-19 epidemic from Wuhan to other provinces in China. Finally, we estimated the effectiveness of travel restrictions of Wuhan city quantitatively by the export risk on the assumption that the measure was postponed.
The export risks of COVID-19 varied from Wuhan to other provinces of China. The peak of export risk was January 21-23, 2020. With the travel restrictions of Wuhan delayed by 3, 5, and 7 d, the export risk indexes will increase by 38.50%, 55.89%, and 65.63%, respectively.
The results indicate that the travel restrictions of Wuhan reduced the export risk and delayed the overall epidemic progression of the COVID-19 epidemic in China. The travel restrictions of Wuhan city may provide a reference for the control of the COVID-19 epidemic all over the world.
With the progress in science and technology, hazardous chemicals are becoming more essential in chemical products, industrial and agricultural production, and daily life. Hazardous chemicals have poisoning, corrosive, explosive, and combusting natures; once on fire, they can trigger a chain of catastrophic incidences, resulting in casualties, property loss, and environmental pollution and posing hazards to life and property. Using the “8–12” explosion of the Ruihai Logistics warehouse in Tianjin Port (Binhai New District, China), the present study analyzes the characteristics of trauma of the casualties in this accident and the emergency medical rescue strategies. The goals were to improve the ability of emergency rescue in such accidents and to save people’s lives and property to the maximum extent.
In this article, the development course and current research status of physiological information monitoring equipment are briefly reviewed and analyzed. The research progress of cardiopulmonary resuscitation (CPR) equipment at home and abroad, as well as the advantages and disadvantages of existing CPR equipment, are the main points of discussion. This article discusses the design feasibility and technical points of the portable integrated basic life support machine, based on existing equipment and technology, and summarizes possible interesting future research directions.
To investigate if toll-like receptor (TLR) 4/nuclear factor-kappa B (NF-κB) signaling pathways mediated crush injury induced acute kidney injury (AKI) in rats, and if TAK-242 (a specific inhibitor of TLR4) attenuates the injury through inhibiting the signaling pathways.
This study was divided into two parts: (1) Establish the crush injury model: 50 rats were randomly divided into control group and four crush injury groups (n = 10/group). Crush injury groups were given 3kg pressure for eight hours and were sacrificed at the time points of 0h, 6h, 12h, and 24h after relieving pressure. And (2) Select the most obvious injury group (12h group) for drug intervention group. Thirty rats were randomly divided into control group, 12h group, and 12h+TAK-242 group (n = 10/group). Two parts detection were as follows: pathological changes of kidney tissues were observed in Haematoxylin and Eosin (HE) staining. Serum creatinine, blood urea nitrogen (BUN), myoglobin (Mb), and blood potassium were examined by automatic biochemical analysis instrument. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). The TLR4 messenger ribonucleic acid (mRNA), TLR4, and P65 were detected by real-time polymerase chain reaction (PCR), western blot, immunohistochemistry staining.
Compared with the control group, kidney tissues were damaged in crush injury groups, and most obvious in the 12h group. The level of serum creatinine, BUN, Mb, blood potassium, IL-6, TNF-α, and TLR4mRNA were increased in the crush injury groups and significantly increased in the 12h group (P <.05). The TLR4 and P65 were significantly increased in the 12h group (P <.05). Compared with the 12h group, kidney tissue damage was significantly reduced in the TAK-242 group (P <.05). The level of serum creatinine, BUN, Mb, blood potassium, IL-6, TNF-α, TLR4mRNA, TLR4, and P65 in the TAK-242 group were significantly reduced (P <.05).
The present findings conclude that TLR4/NF-κB signaling pathways mediated crush injury induced AKI in rats, and TAK-242 attenuates the injury through inhibiting the signaling pathways.
Since December 2019, several new infectious diseases, mainly lung diseases caused by novel coronavirus infections, have been discovered in Wuhan, Hubei Province. With the spread of the epidemic, cases in other regions of China and abroad have been confirmed. This sudden outbreak of a new type of infectious disease has seriously threatened people’s health and safety, and China has adopted strong prevention and control measures in response. To provide a reference for international health emergency management workers, this article summarizes, from an academic perspective, the main prevention and control measures taken in China.
Disasters such as an earthquake, a flood, and an epidemic usually lead to large numbers of casualties accompanied by disruption of the functioning of local medical institutions. A rapid response of medical assistance and support is required. Mobile hospitals have been deployed by national and international organizations at disaster situations in the past decades, which play an important role in saving casualties and alleviating the shortage of medical resources. In this paper, we briefly introduce the types and characteristics of mobile hospitals used by medical teams in disaster rescue, including the aspects of structural form, organizational form, and mobile transportation. We also review the practices of mobile hospitals in disaster response and summarize the problems and needs of mobile hospitals in disaster rescue. Finally, we propose the development direction of mobile hospitals, especially on the development of intelligence, rapid deployment capabilities, and modularization, which provide suggestions for further research and development of mobile hospitals in the future.
More and more hospitals are using the Hospital Incident Command System (HICS) for organizational management under emergency conditions. HICS is an incident management system based on principles of the Incident Command System (ICS), which assists hospitals and healthcare organizations in improving their emergency management planning, response, and recovery capabilities for unplanned and planned events. This study aims to explore how Chinese hospitals manage their organizations with HICS in Mass Casualty Incidents (MCI).
To explore the feasibility of HICS in Chinese hospitals under MCI.
A combination of literature analysis and empirical research was used in this study. Through case studies and experience summarization, the necessity and feasibility of the incident command system (ICS) and the emergency medical response system (EMRS) was demonstrated in the early stage of MCI. Based on this, a new "1 SECTION-5 GROUPS-10 TEAMS " model was proposed, and its value of practical application was discussed in MCI.
Multiple resources must be mobilized In MCI, and it is necessary to establish an ICS and an EMRS as soon as possible in the early stages of MCI. The earlier ICS is set up, the more initiative can be taken. The "1 SECTION-5 GROUPS-10 TEAMS" model proposed in this study has a good effect on the practice of drills and rescues, indicating that this model has a certain promotion effect in the hospital's response to MCI.
The "1 SECTION-5 GROUPS-10 TEAMS" model has high feasibility and can be further verified in the subsequent rescue practice.
In recent years, the development of disaster medicine has made rapid progress in China after the Wenchuan earthquake in 2008. China formed a more systematic and specialized health emergency force. In addition, the Ministry of Emergency Management was established In 2018, which demonstrated that the Chinese government is paying more attention to the disaster rescue work. In this report, the practice, experience, and prospect of disaster medicine in China was reviewed.
To explore the current status and prospects of disaster medicine development in China.
The literature research method was used to analyze literature at home and abroad. It was used to retrospectively analyze the rescue experience of Chinese medical rescue teams, sort out the current situation of disaster medical disciplines and rescue teams, and propose disaster medical development recommendations suitable for China’s national conditions.
After years of construction, China has formed a more systematic and specialized health emergency force, but the personnel, equipment, plans, and training of the professional rescue team need to be improved. The discipline system of disaster medicine in China is still lagging behind, and it is still unable to meet the needs of the rescue situation at home and abroad.
Disaster medicine is the area of medical specialization serving the dual areas of providing health care to disaster survivors and providing medically related disaster preparation, disaster planning, disaster response, and disaster recovery leadership throughout the disaster life cycle. It requires multidisciplinary intervention, integration, and application. A forward-looking perspective must be strengthened on the discipline and team building of disaster medicine.
In recent years, with the increasingly frequent variety of large-scale disasters that have happened in China, the Chinese People’s Armed Police Forces (PAP) has undertaken increasingly frequent and diversified tasks, which has led to greater requirements for the construction of emergency medical rescue equipment. Therefore, as determined by the characteristics of the PAP’s tasks and based on the construction of special boxes and frame tent equipment, a new PAP mobile rescue hospital system was successfully developed, and all PAP provincial-level medical rescue teams have been equipped with this system. In the present article, we describe this mobile rescue hospital system, which is mainly composed of professional emergency vehicles, frame-type tents, and advanced medical equipment. The system has the following characteristics: significant integration, a fast response, flexibility, and practicability. The mobile rescue system is generally used as the army’s own health service support system and to provide certain emergency medical rescue services to disaster-stricken people. The successful construction and further application of this system have significance in terms of accelerating the response of rescue teams and the emergency treatment ability of the PAP’s provincial-level emergency medical rescue teams. (Disaster Med Public Health Preparedness. 2018;12:455–459)
To explore the 3-tiered treatment model for medical treatment after an earthquake.
Based on the practices of the national emergency medical rescue services in the Lushan earthquake zone, the 3-tiered treatment classification approach was retrospectively reviewed.
Medical rescue teams assembled and reported quickly to the disaster areas after the earthquake. The number of injured people had reached 25,176 as of April 30; of these, 18,611 people were treated as outpatients, 6565 were hospitalized, and 977 were seriously or severely injured.
The 3-tiered treatment model was the main approach used by rescue services after the Lushan earthquake. Primary and secondary treatments were of the highest importance and formed the basis of the Lushan model of earthquake rescue and treatment. (Disaster Med Public Health Preparedness. 2018; 12: 301–304)
Field first-aid data from the Wenchuan Earthquake in China was analyzed retrospectively in order to probe into ways to develop field first-aid operations and provide a reference for future emergency rescue. Related documents about the Wenchuan Earthquake were collected and reviewed. The state of injury and leading causes of death during the disaster were identified. The presnece of emergency medical resources on-site after the earthquake was relatively insufficient. Deaths mainly were due to cardiopulmonary arrest, severe craniocerebral injury, incurable hemorrhagic shock, and crush syndrome that caused multiple organ system dysfunction syndrome. Only by strengthening the on-site emergency medical resources, speeding-up triage, and equipping responders with professional, portable medical equipment, can field first-aid operations be delivered more efficiently.
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