[Earthquake Rescue] 17 points to attend earthquake relief!

First, rescue should:

1 , think carefully and always be careful.

2. Inform the authorities about the extent of damage and the number of casualties in your area.

3. Reconnaissance before starting work is not a waste of time.

4 , on the damaged staircase or floor, try to walk against the wall.

5. If you want to clean the rubble by hand, wear gloves.

6. Be careful when removing rubble near the injured person.

7, the use of blankets, canvas or corrugated iron (corrugated iron) such as to protect the wounded to protect them from falling debris and dust damage.

8. Try not to get close to the wreckage and keep it as it is , so as to avoid the collapse once again and destroy the existing gap.

9. Be careful when removing rubble or obstructions ( especially in the gaps ) so as not to collapse again.

10. Be extra careful when using sharp tools in the rubble.

11. Before the ruins pass under or carry out rescue operations under it, first use some objects to support and reinforce it.

12. In the case of too many casualties and inadequate support, do not waste time and make good use of resources.

13. Due to the limited time and conditions, necessary inspections must be done before the wounded person is transferred, and first-aid measures should be taken only for those who are at risk.

14 , clean up the nose and mouth of the wounded, dust, sand, make it breathe smoothly.

15. Pay attention to the warmth of the wounded to ease the impact of the disaster.

16. Ensure that the stretcher is covered with blankets to maximize the warmth and comfort of the injured.

17. When carrying stretcher and wreckage and obstacles, it is necessary to adopt the correct method.

18. List a list of wounded people who have received emergency assistance.

Second, do not avoid the rescue:

1. Before the first aid is not implemented, the injured person can be easily moved (unless he or she is judged to be in critical condition and must be rescued immediately).

2 , smoking or matches, because the rescue site may have flammable gas leaks.

3. Crawling on the rubble, or touching or rocking a damaged building (unless it is a last resort).

4 , randomly pull out the wood in the rubble, which may cause another collapse.

5 , did not notify or leave teammates into the dangerous accident site.

6. Touch the damaged wire.

7. Randomly dispose of rubble - you may have to move it again.

III. Rescue the fractured patients on the earthquake scene

1. When a patient is found to have a fracture, he should first check whether the wounded person has a wound and if there is bleeding. If there is, he should find clean clothes or towels and bandages to wrap, and at the same time look for hard materials such as branches or boards to fix it. Subsequent use of wood to carry and receive professional treatment. Then different parts of the fracture should be used in different ways of dressing.

2. If there is obvious injury or bone exposure, there is obvious spurting phenomenon. It is necessary to use timely clean clothes or towels and bandages to bind the proximal limbs to stop bleeding, and then bandage the wounds, and then transport them in time.

3 , if the upper limb is injured, you can use a towel or a triangle to suspend it and fix it on your chest. If the lower limbs or the lower back are injured and the spine and organs are injured, do not move the injured person easily. If you move it casually, it will easily hurt the organs and destroy the nerves, causing secondary injuries. When necessary to move the injured, pay attention to move the injured as a whole.

The harm caused by improper first aid in fracture

1. When a fracture occurs in the cervical region, if the emergency treatment is improper, cervical spinal cord can be damaged and paraplegia can occur. In severe cases, respiratory depression can lead to life-threatening.

2 , when the thoracolumbar spine fracture, if improper first aid may damage the spinal cord and spinal nerves, paralysis occurs.

3 , when the limbs fracture, if improper first aid may occur limb deformity, shock and other symptoms.

Tip: When there is a fracture patient, be sure to use the right way to help, do not move the patient at will, so as not to cause other injuries.

Fourth, 17 points need to pay attention to participate in earthquake rescue

1 , to ensure the safety of rescue workers

After the disaster occurred, not only did the local material supply suffer serious losses, but there may also be secondary disasters. It is especially important to make relevant preparations.

He Xiong, deputy director of the Beijing Center for Disease Control and Prevention, who has participated in disaster emergency rescue for many times, pointed out that rescue preparation must grasp two basic principles: First, to ensure the safety of one's own life, and second, to minimize local organizations' rescue and post-disaster epidemic prevention. increase the burden.

“Lifeguard whistle, inflatable cushions, reflective vests...” After the Wenchuan earthquake in 2008 , the General Office of the Ministry of Health specifically issued the “Reference Catalogue for Equipment for the Health Emergency Troops (Trial)”, specifically enumerating the specialization of emergency rescue teams. List of individuals carrying equipment and medical rescue equipment. However, He Xiong believes that although there are documentary guidelines, health emergency rescue personnel should also make appropriate list additions and subtractions according to the characteristics of different rescue areas.

"After receiving the mission, the person in charge of rescue should quickly establish contact with the front headquarters to understand the geographical environment, traffic conditions and climatic conditions in the disaster area." He Xiong told reporters that taking the Ludian earthquake in Yunnan as an example, Ludian is a mountainous region. It is also a rainy season and should be fully waterproof and ready for rock climbing. In addition, the earthquake may also lead to the rupture of the water supply network, and it is also possible to carry an individual water purifier.

In addition, to maximize the rescue force and ensure the quality of rescue workers' diet and rest is the top priority in the rescue.

At the same time, Zhou Rongbin, director of the emergency department of the General Hospital of the Beijing Military Region, pointed out that before the medical team set off, the team members must have strong psychological preparations for emergencies and emergency situations. Medical personnel are usually used to seeing sicknesses and deaths in hospitals. However, because the earthquake is an unexpected situation, the impact is huge and the scenes are constantly in dire condition. Under such circumstances, medical personnel must have excellent psychological qualities in order to minimize negative impacts. Involved in the rescue of the wounded. And set the plan, in the case of the first set of programs can not be implemented, there must be a second set of options.

2. Quickly identify critically ill people who need urgent treatment

Earthquakes are complex disasters. Because there are many injuries, many rescue victims are compound injuries, multiple injuries (including burns, electric shocks, and bruises) and severe injuries. The classification of injuries is very important. According to the severity of care, it is necessary to rapidly identify a large number of critically injured people who need urgent life-saving treatment. Usually 10% to 25% are critically injured and 80% are ordinary wounded. This is the most important and psychologically challenging task for medical rescue. And under the multi-sectoral coordination organization, such as the transportation department, the logistics department and the medical department, we can achieve the maximum number of injured people with the limited human resources and resources in the shortest time.

3 , on-site rescue principles

The first is that the first and the last are far; the nearest and the most rescued are saved;

The second is to help the patient after the first treatment;

Third, the exposed wound should be closed;

Fourth, secondary injury, man-made injury and secondary injury cannot be caused;

Fifth, we must prioritize things and save them first;

Sixth, it cannot bring psychological injury to the wounded;

Seventh, pay attention to their own safety and move the wounded to a safe place for treatment.

Eighth, besides paying attention to the direct injury factors, we must pay attention to the diagnosis and treatment of the primary disease to avoid misdiagnosis and mistreatment.

Nine is to protect the eyes of wounded people who stay in the dark for a long time.

4 , commonly used first aid technology

Zhou Rongbin pointed out that for on-site rescue, "tall" technology is not available, and the five basic technologies of hemostasis, dressing, fixation, transportation, and cardiopulmonary resuscitation are the most grounded and most practical. After moving to a second-line temporary medical station or mobile hospital, further treatment includes puncture, artificial airway establishment, blood purification, mechanical ventilation, and electric defibrillation.

5 , after the catastrophic epidemic

The center of the 7 days before the earthquake was mainly search and rescue. The medical rescue focused on on-site treatment. After 7 days, it focused on medical treatment. The medical rescue focused on diagnosis and treatment of diseases and epidemic prevention. Qin Enqiang, deputy director of the No. 302 Hospital of Infectious Diseases Research and Research Center of the Chinese People's Liberation Army (PLA) , suggested that to ensure the prevention of major epidemics after major disasters, we must actively carry out anti-epidemic work.

6 , rational allocation of medical personnel

The more medical personnel are the better, the rational deployment of professional medical personnel should be based on the needs of the affected areas to ensure the basic needs of medical treatment in disaster areas.

7 , medical treatment

Medical personnel should be grouped in a reasonable manner, and medical treatment visits should be conducted on time and regularly for the affected population resettlement sites and centralized settlement sites and military camps. In addition to chronic diseases, special attention should be paid to newly occurring discomforts, such as fever, cough, abdominal pain, and diarrhea, in order to identify early infectious diseases that may cause transmission and prevent the occurrence and spread of the disease, so that early detection, early reporting, and early detection can be achieved. Diagnosis, early treatment, early prevention.

8 , to live "sick from the mouth into" off

Closely monitor water hygiene, food hygiene, personal hygiene, and prevent gastrointestinal infections.

9 , prevent respiratory infectious diseases

Disaster victims and troop shelters should pay attention to ventilation. Once people develop symptoms such as fever, cough, sputum, and chest pain, they should seek medical attention.

10. Avoid Insect Infectious Diseases

Relief workers should pay attention to doing personal protection when working, try to wear long-sleeved medical materials, collar, cuffs, trouser legs should be tight, if necessary, can use drugs such as avoidants, and other clothing should be promptly changed and cleaned, remove possible insects.

11 , prevent secondary infection

Prevent the decline of immune function caused by cold or serious infection, timely treatment; At the same time pay attention to a reasonable diet and rest, improve the body resistance.

12 , pay attention to psychological counseling

Arrange psychological counseling personnel to conduct psychological counseling to maintain the psychological stability of the victims.

13 , carry out education on disease prevention knowledge

Medical personnel need to conduct common-sense education on disaster victims and troops. How to identify the symptoms of diseases, including respiratory diseases, digestive tract diseases, and insect-borne diseases, etc. Once they happen, the main thing is to seek medical care instead of self-treatment, not only to protect themselves. Also protect others.

14 , crush syndrome: potential killer after being rescued

This is a widely disseminated news after the Wenchuan earthquake in 2008 . Chen Jian, who had been buried for more than 70 hours after being buried in the earthquake ruins, was rescued. However, after being rescued for half an hour, he left. It is the terrible "crush syndrome" that takes their lives.

The so-called crush syndrome is a clinical syndrome in which the extremities of muscles in the extremities or the trunk are compressed for a long period of time, with limb swelling, necrosis, hyperkalemia, myoglobinuria, and acute kidney injury. A large number of studies have shown that systemic symptoms occur after decompression of the limbs.

According to recent data, it is speculated that an earthquake can cause 3% to 20% of crush syndrome and cause about 20% mortality of acute renal failure. The treatment measures include rehydration, blood transfusion, diuresis, hemodialysis, and continuous renal replacement therapy ( CRRT ). Which has slowly continued CRRT solute clearance and inflammatory mediators and hemodynamic stability, etc., concern wounded in the crush syndrome.

2008 earthquake, the West China Hospital of Nephrology created one cases of patients admitted to hospital due to crush syndrome caused no record of success electrolytes and renal failure deaths, Professor Ji Ling shared this reason a team success. (West China Medical, 2008 , 23:1489 )

CRRT patients have a limited number of patients receiving acceptable treatment per unit of time, so it is important to choose CRRT patients. Professor Ji Ling recommendation, one of the following conditions can be OK CRRT treatment, if any, compared with more than two strong indications :( 1) with multiple organ failure arise; (2) hemodynamic instability, or normal blood purification Treatment can not control circulation volume; ( 3 ) severe infections, sepsis; ( 4 ) refractory high metabolic syndrome, difficult to correct the electrolyte and acid-base balance. When CRRT treatment is performed, the patient's replacement volume should be at least 35 ml · kg-1 · h-1 , and try to carry out continuous high-volume hemofiltration mode treatment.

In the earthquake, most patients have active bleeding or high bleeding tendency, so the use of anticoagulants is very important in the earthquake victims. Prof. Luan Ling and others recommend that the topical anti-coagulation of bursal acid should be preferred and the dose should be <26 mmol/h to prevent adverse reactions such as cataplasmic acidosis.

In addition, in the CRRT treatment, attention should also be paid to multidisciplinary collaboration, to determine the optimal dose of antibacterial agents with an infective physician, and to select an anticoagulant approach with an orthopedic surgeon, which is essential for the successful implementation of CRRT therapy.

15. Earthquakes can induce heart disease

As the saying goes, “The World Cup, war, and earthquake are the three major causes of heart disease.” Visible epicenters are very important for the treatment and care of heart attack patients.

Professor Ningbo Department of Intensive Care of the General Hospital of the Air Force introduced that patients with heart disease in the earthquake have a high chance of sudden heart disease and low success rate of treatment. It should be noted that patients who do not have heart-based diseases themselves are also susceptible to heart attacks. Causes of heart disease in this group of people have psychological factors, inflammatory reactions at the site of the injury, and heart disease in non-cardiac surgery.

When trapped in a confined space waiting for rescue, the psychological will panic extremely. At this time, heart diseases such as angina pectoris and myocardial ischemia can be easily induced. Therefore, maintaining a stable and optimistic state of mind in the epicenter is very important for obtaining rescue time.

After crushing the leg, it will cause ischemia, resulting in tissue necrosis and production of toxins. The longer the pressure is applied, the more toxins are accumulated and the heart is damaged. This phenomenon occurs during rescue, and it is possible to communicate when the patient is pressed, but once the weight is removed, the patient will immediately become unconscious. The reason is that the release of toxins into the blood leads to poisoning, causing heart suppression. At this time, the concentration of potassium ions in the body will also increase rapidly, inhibit myocardial contraction, resulting in decreased cardiac contractility of the patient until death. Therefore, in the face of such patients, we must amputate limbs to maintain the patient's life as soon as possible.

Cardiac adverse events such as myocardial ischemia, myocardial infarction, and arrhythmia can also be induced during non-cardiac surgery. Therefore, the surgeon can perform risk stratification on the type of surgery according to the guidelines before surgery to facilitate special protection for high-risk groups. After the operation, close observation of the patient's vital signs and timely treatment of abnormal conditions. Choose appropriate anesthesia during surgery to protect myocardium. During the operation, it is necessary to maintain hemodynamic stability, adequate oxygen supply, and avoid excessive infusion and hypothermia.

16. The golden time for salvaging ischemic limbs is 8 hours

Professor Zhang Yingze of the Third Hospital of Hebei Medical University pointed out that earthquake disasters in China are frequent and the incidence of fractures in earthquakes is high. Therefore, post-earth orthopaedic emergency is particularly important.

A large number of wounded people will be produced at the same time in a short time when the earthquake is examined . Most of them are multiple injuries. Most of them are fractures of the spine, hand-foot damage, and crush injuries. Doctors are required to face a large number of casualties when they are busy and not chaotic, follow the principle of first aid, “the priority of critically ill, save lives first” when the first treatment to maintain the wounded airway open, maintain the stability of the respiratory and circulatory system; followed by a comprehensive physical examination of the wounded, Reduce misdiagnosis and missed diagnosis.

The best time to save lives is 72 hours after the earthquake. The golden time for salvaging ischemic limbs is 8 h after injury . For wounded patients with vascular injuries, we must fight for the timely and effective treatment of the wounded in the shortest possible time. The shorter the time of treatment, the higher the success rate of treatment.

Open fracture treatment must first be debrided as soon as possible. For open fracture wounds as far as possible using external fixation. The external fixator is easy to install and can effectively correct blood vessel buckling, facilitate venous return, and reduce limb edema.

In crush syndrome and acute renal failure, a large amount of fluid was resuscitated at the earthquake site and urine was basified with 5% sodium bicarbonate, while hyperkalemia was corrected. If the affected limb has symptoms such as progressive muscle swelling, sensory and motor impairment, oliguria, and myoglobinuria, the hemodialysis treatment should be performed at the time of incision and relaxation. If there is no hemodialysis condition, consider amputation if necessary to ensure the lives of the wounded.

Osteofacial compartment syndrome For long-bone fracture patients, we must be diligent in observing changes in the condition of the wounded. When there are symptoms such as high limb tension, blood circulation, and sensory disturbances such as compartment syndrome, decompression should be performed decisively. At the same time, attention should be paid to the identification of compartment syndrome and vascular injury. If it is diagnosed as a vascular injury, it is conditional to detect blood vessels.

The relationship between the time period of the earthquake and the location and severity of the injury The earthquake occurs at night, people will immediately sit up and the incidence of spinal injury will be higher, especially the cervical spine and lumbar spine. When the earthquake occurred during the day, people would run out of the house for the first time, so the fractures of the limbs were more common. This experience helps traumatologists to prepare corresponding emergency equipment and supplies in advance.

In the disaster-stricken area, the transportation of the wounded is not normal. The sanitary conditions are poor, and the operating room in the earthquake-treating area is difficult to be strictly disinfected. Therefore, the wounded person has a high surgical infection rate in the field. Therefore, the trauma orthopedic surgeon must not be greedy and must be transshipped. Get to a hospital with better medical conditions.

As an orthopaedic traumatist, when faced with an earthquake disaster, calm and calm should be done. When it is broken, the patient must be brave and careful, and he should not hesitate to look forward to a decisive and effective emergency treatment.

Finally, Professor Zhang called on the Chinese Medical Doctor Association to set up an earthquake disaster emergency reserve team to train its members systematically. Usually more drills to enhance the team's targeted, practical and operability to form a standardized model of medical assistance. In emergency rescue, it is necessary to unify the command, unify the deployment, and play its biggest role in completing the first-line treatment tasks after the earthquake.

17. Early psychological intervention can relieve post-traumatic stress disorder

After the earthquake, people's psychology will generally have various stress responses such as tension, fear, etc., even sleep disorders, too sensitive to external stimuli, muscle tension, trembling, night sweats, nausea, frequent urination, frequent urination, palpitation, chest tightness, etc. Psychological response.

Early psychological interventions for post-traumatic stress disorder are very important for relieving the disease. If good social support can be obtained, especially family support, the incidence rate can be greatly reduced. At present, intervention programs are mainly based on psychotherapy, including early psychological crisis interventions, cognitive behavioral counseling, and psychological counseling.

Recently, Professor Zhu Zhuohong of the Institute of Psychology of the Chinese Academy of Sciences and others have found that calligraphy exercises may help children recover from their psychological problems. Through calligraphy practice treatment of 1129 children who survived the Wenchuan earthquake , one month later, the psychological recovery of children in the treatment group was faster. ( Neuropsychiatr Dis Treat. 2014;10:977 ) Whether this method is equally effective in adults requires more research.

In addition to self-adjustment and the treatment of psychiatrists, psychological assistance to the victims has the responsibility of the entire society.

The information in this article comes from the Internet and was reorganized and edited by China Rescue Equipment Network.