Expert consensus on emergency first-aid transfer disposal and process management of sudden flood disaster(2021)

doi:10.3877/cma.j.issn.2095-9133.2021.04.001

Abstract

Abstract:

Floods often cause serious infrastructure damage in the disaster area, prone to secondary disasters, equipment damage of medical and health institutions and lack of material supply. It is difficult to carry out medical treatment work other than on-site first-aid in the disaster area. Especially when the medical institution itself is easy to be paralyzed, it is of great significance to transport patients at the disaster site and seriously damaged hospitals. The Special Committee on Health Emergency of China Research Hospital Association, the Special Committee on Disaster Medicine of China Association of Integrated Traditional Chinese and Western Medicine and the Professional Branch of Cardiopulmonary Resuscitation of Henan Hospital Association took the lead in organizing some experts to summarize the experience of emergency transportation and disposal under the condition of flood and waterlogging, and formulate the consensus of the experts, in order to provide reference for medical rescue and emergency transportation of major emergencies such as sudden floods in China in the future.

Key words: Flood disaster, Emergency transport, Expert consensus

Health Emergency Committee of Chinese Research Hospital Association, Disaster Medicine Committee of Chinese Society of Integrated Chinese and Western Medicine, Professional Committee of Cardiopulmonary Resuscitation of Chinese Research Hospital Association, Cardiopulmonary Resuscitation Branch of Henan Hospital Association, Emergency committee of Zhengzhou Medical Association, Zhengzhou Emergency Medical Rescue Center, Zhongyuan Institute of Cardiopulmonary Cerebral Resuscitation, Research Center of Cardiopulmonary Cerebral Resuscitation, Henan University of Traditional Chinese Medicine. Expert consensus on emergency first-aid transfer disposal and process management of sudden flood disaster(2021)[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(04): 193-198.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhwsyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9133.2021.04.001

https://zhwsyjdzzz.cma-cmc.com.cn/EN/Y2021/V07/I04/193

Figures/Tables 2

References 23

1	中国医学救援协会灾害救援分会．大规模伤害事件紧急医学应对专家共识[J]．中国急救复苏与灾害医学杂志，2016，25(4): 329-337.
2	Warren J, Fromm RE, Orr RA，et al.Guidelines for the inter- and intrahospital transport of critically ill patients[J]．Crit Care Med，2004，32(1): 256-262.
3	周国田，周楚妍．水系灾害医学应急救援体系的构建[J]．中华航海医学与高气压医学杂志，2017，24(2): 164-166.
4	中国创伤救治联盟，中华医学会急诊医学分会院前急救学组，北京医师协学院前急救分会．特重大突发事件医学救援策略专家共识[J]．中华灾害救援医学，2018，6(1): 1-4.
5	钱阳明．构建我国水系灾害医学救援体系研究[J]．中国急救复苏与灾害医学杂志，2008，3(8): 449-451.
6	中华卫生应急电子杂志编辑委员会．公共突发事件应急预案及部分急救流程[J/CD]．中华卫生应急电子杂志，2015，1(1): 52-63.
7	郭卿，樊毫军，沈宏，等．安徽抗洪抢险一线军地协同卫生应急救援的做法与体会[J]．武警医学，2017，28(4): 429-430.
8	中国心胸血管麻醉学会急救与复苏分会，中国心胸血管麻醉学会心肺复苏全国委员会，中国医院协会急救中心(站)管理分会，等．淹溺急救专家共识[J]．中华急诊医学杂志，2016，25(12): 1230-1236.
9	中国老年保健协会第一目击者现场救护专业委员会．现场救护第一目击者行动专家共识[J]．中华急诊医学杂志，2019，28(7): 810-823.
10	急诊危重症患者院内转运共识专家组．急诊危重症患者院内转运共识——标准化分级转运方案[J]．中华急诊医学杂志，2017，26(5): 512-516.
11	青义春．突发公共事件医院应急救援研究[D]．重庆：第三军医大学，2012.
12	Chipp E, Warner RM, Mcgill DJ，et al.Air ambulance transfer of adult patients to a UK regional burns centre：who needs to fly？[J]．Burns，2010，36(8): 1201-1207.
13	Winter MW.Intrahospital transfer of critically ill patients; a prospective audit within flinders medical centre[J]．Anaesth Intensive Care，2010，38(3): 545-549.
14	牛佳，徐建萍，王乐．国内外危重症病人院内转运指南比较[J]．护理研究，2016，30(11): 1392-1394.
15	蔡瑞霞，邓娟，巫丽文，等．集束化管理模式在急诊危重患者院内转运的应用及效果评价[J]．蛇志，2021，33(1): 71-73.
16	梁琦，许虹，彭凌．急危重症患者直升机急诊医疗安全转运的研究进展[J]. 护士进修杂志，2021，36(8): 707-711.
17	Knight PH, Maheshwari N, Hussain J，et al.Complications during intrahospital transport of critically ill patients：focus on risk identification and prevention[J]．Int J Crit Illn Inj Sci，2015，5(4): 256.
18	Jones HM, Zychowicz ME, Champagne M，et al.Intrahospital transport of the critically ill adult[J]．Dimens Crit Care Nurs，2016，35(3): 133-146.
19	Williams P, Karuppiah S, Greentree K，et al.A checklist for intrahospital transport of critically ill patients improves compliance with transportation safety guidelines[J]．Aust Crit Care，2020，33(1): 20-24.
20	Vieira J, Frakes M, Cohen J，et al.Extracorporeal membrane oxygenation in transport part 1：extracorporeal membrane oxygenation configurations and physiology[J]．Air Med J，2020，39(1): 56-63.
21	Zayas R．Critical care transport of patients with brain injuries[J]. AACN Adv Crit Care，2018，29(2): 175-182.
22	岳茂兴，梁华平，李奇林，等．批量复合伤伤员卫生应急救援处置原则与抢救程序专家共识(2018)[J/CD]．中华卫生应急电子杂志，2018，4(1): 1-9.
23	岳茂兴，王立祥，张秀梅．积极推进我国应急管理体系和应急救援与处置能力现代化[J/CD]．中华卫生应急电子杂志，2020，6(1): 1-9.

转运分级	评估项目
转运分级	生命体征情况	意识状态(GCS评分)	呼吸支持情况	循环支持情况	临床主要问题	转运时间
Ⅰ级	在生命支持条件下，生命体征不平稳	昏迷，GCS评分<9分	人工气道，呼吸支持条件高，PEEP≥8 cmH₂O，FiO₂≥60%	泵入2种及以上血管活性药物	急性心肌梗死、严重心律失常、严重呼吸困难、反复抽搐、致命创伤、夹层、主动脉瘤等	>20 min
Ⅱ级	在生命支持条件下，生命体征相对稳定	轻度昏迷，GCS评分9~12分	人工气道，呼吸支持条件不高，PEEP<8 cmH₂O，FiO₂<60%	泵入1种血管活性药物	ECG怀疑心肌梗死、非COPD患者SaO₂ <90%、外科急腹症、剧烈头痛、严重骨折、持续高热等	10~20 min
Ⅲ级	无需生命支持条件下，生命体征尚平稳	GCS评分>12分	无人工气道，可自主咳痰	无需血管活性药物	慢性病症	<10 min

转运分级	评估项目
转运分级	生命体征情况	意识状态(GCS评分)	呼吸支持情况	循环支持情况	临床主要问题	转运时间
Ⅰ级	在生命支持条件下，生命体征不平稳	昏迷，GCS评分<9分	人工气道，呼吸支持条件高，PEEP≥8 cmH₂O，FiO₂≥60%	泵入2种及以上血管活性药物	急性心肌梗死、严重心律失常、严重呼吸困难、反复抽搐、致命创伤、夹层、主动脉瘤等	>20 min
Ⅱ级	在生命支持条件下，生命体征相对稳定	轻度昏迷，GCS评分9~12分	人工气道，呼吸支持条件不高，PEEP<8 cmH₂O，FiO₂<60%	泵入1种血管活性药物	ECG怀疑心肌梗死、非COPD患者SaO₂ <90%、外科急腹症、剧烈头痛、严重骨折、持续高热等	10~20 min
Ⅲ级	无需生命支持条件下，生命体征尚平稳	GCS评分>12分	无人工气道，可自主咳痰	无需血管活性药物	慢性病症	<10 min

名称	配置
药品	肾上腺素、阿托品、去甲肾上腺素、胺碘酮、多巴酚丁胺、多巴胺、呋塞米、5%碳酸氢钠、葡萄糖酸钙、20%甘露醇、50%葡萄糖、人工胶体、晶体液若干
耗材	气管插管包及喉镜、中心静脉穿刺包、口咽通气道、外固定夹板、导尿包、留置针及输液器、胃管、环甲膜切开导管、敷料及绷带等
设备	心电监护仪、除颤仪、氧气瓶、负压吸痰器、心电图机、血糖检测仪、听诊器、止血带、可移动呼吸机、简易呼吸气囊、配电盘、电极片若干

名称	配置
药品	肾上腺素、阿托品、去甲肾上腺素、胺碘酮、多巴酚丁胺、多巴胺、呋塞米、5%碳酸氢钠、葡萄糖酸钙、20%甘露醇、50%葡萄糖、人工胶体、晶体液若干
耗材	气管插管包及喉镜、中心静脉穿刺包、口咽通气道、外固定夹板、导尿包、留置针及输液器、胃管、环甲膜切开导管、敷料及绷带等
设备	心电监护仪、除颤仪、氧气瓶、负压吸痰器、心电图机、血糖检测仪、听诊器、止血带、可移动呼吸机、简易呼吸气囊、配电盘、电极片若干

[1]	Pediatric Burn Study Group, Burn Surgery Branch of Chinese Medical Association. Expert consensus on fluid resuscitation of early pediatric burn shock (version 2023) [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(05): 371-376.
[2]	Burns and Trauma Branch of Chinese Geriatrics Society, Burns and Trauma Wound Repair Materials Branch of Chinese Biomaterials Society. Expert consensus on the treatment of diabetic foot amputation (toe) in China (2022 version) [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(01): 1-9.
[3]	Burns and Trauma Wound Repair Materials Branch of Chinese Biomaterials Society, Burns and Trauma Branch of Chinese Geriatrics Society., Yuesheng Huang, Haihua Huang, Qizhi Luo, Yi Zhang. Expert consensus on basic configuration standards of wound repair departments in tertiary and secondary hospitals (2021 version) [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(03): 195-197.
[4]	The Burn Professional Committee of the China Medical Education Association. National expert consensus on early clinical diagnosis and treatment of frostbite [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(01): 1-6.
[5]	Expert Committee on Specimen Collection and Detection of Respiratory Infectious Diseases. Expert consensus on specimen collection and detection of respiratory infectious diseases [J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2022, 16(04): 217-228.
[6]	Guangdong Urological Association. Expert consensus on elderly urinary incontinence nursing [J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(05): 389-393.
[7]	Professional Committee of Peritoneal Metastasis, Colorectal Cancer Committee of Chinese Medical Doctor Association. Chinese expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastases (2022 edition) [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2022, 11(04): 265-271.
[8]	Professional Committee of Natural Orifice Specimen Extraction Surgery, Colorectal Cancer Committee of Chinese Medical Doctor Association, Professional Committee of Robotic Surgery, Colorectal Cancer Committee of Chinese Medical Doctor Association. Expert consensus on robotic natural orifice specimen extraction surgery for colorectal neoplasm [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2022, 11(03): 177-191.
[9]	Ling Liu, Xuyan Li, Yonghao Xu, Huiying Zhao, Qiaoxia Luo, Xiaofeng Ou, Lei Song, Yuan Cheng, Juan Zhou, Yiping Zeng, Aihua Liu, Bianbaqiongda, Shuo Zhang, Jie Lyu, Xi Wang, Yanyun Lu, Baixu Chen, zhen Da, Yun Yu, Jia Shao, Critical Care Respiratory Group, Chinese Society of Critical Care Medicine, Chinese Medical Association, Tibet Medical Association for High Altitude Medicine and Cardiology, Chinese Association of Critical Care Physicians. Expert consensus on the diagnosis and treatment of critically ill patients with COVID-19 at high altitudes in China [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(04): 340-346.
[10]	Writing Group for Clinical Expert Consensus on Venolymphatic Insufficiency Related Disease. Clinical expert consensus on venolymphatic insufficiency related diseases [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 630-638.
[11]	Chinese Geriatrics Society Anesthesia Branch. Expert consensus on prevention and treatment of postoperative pulmonary complications in elderly patients [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(01): 7-22.
[12]	Nursing Collaboration Group, Chinese Society of Digestive Endoscopology, Beijing 100710, China. Consensus opinion on the environment and layout of the digestive endoscopy center [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(04): 240-247.
[13]	Chinese Society of Digestive Endoscopology, Beijing 100710, China. Chinese expert consensus on cold snare polypectomy for colorectal polyps (2023, Hangzhou) [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(02): 73-82.
[14]	Chinese Society for Metabolic and Bariatric Surgery, Chinese Obesity and Metabolic Surgery Collaborative. Chinese expert consensus on case management of preoperative clinical pathways of bariatric and metabolic surgery (2023 edition) [J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2023, 09(02): 73-82.
[15]	Chinese Society of Diabetes and Bariatric Surgery, Chinese Research Hospital Association. Expert consensus on the prevention and treatment of postoperative nausea and vomiting after laparoscopic sleeve gastrectomy (2022 edition) [J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(04): 217-224.

Please choose a citation manager

Content to export