What is disaster medicine that earthquake rescue is inseparable from?

At noon on December 2023, 12, after finishing a 28-day rescue work on the Jishishan earthquake in Linxia Hui Autonomous Prefecture, Gansu Province, Yan Hui, director of the Emergency Office of West China Hospital of Sichuan University, finally returned to Chengdu. After arriving in Chengdu, Yan Hui went straight to the hospital and put into a new job.

The Jishishan earthquake occurred at 2023:12 on December 18, 23, and at 59 a.m. on the 19th, Yan Hui received a call from the National Health Commission to go to Gansu for rescue. In addition to Yan Hui, West China Hospital also sent 5 experts to accompany him. Two hours later, the team assembled and left for the airport. About five hours later, the rescue team arrived at the Linxia Prefecture People's Hospital in Gansu Province.

In this earthquake assistance, the National Health Commission dispatched a number of expert groups from Peking Union Medical College Hospital, Beijing Children's Hospital, Beijing Jishuitan Hospital, Peking University Sixth Hospital and West China Hospital to form a national expert group, and Yan Hui served as the deputy leader of the expert group. These experts come from a variety of different professional disciplines, and the professional discipline represented by Yan Club is disaster medicine.

What is so special about disaster medicine

The word "disaster medicine" is translated from abroad, and some are also translated as emergency medicine, disaster medicine, etc. Yan Hui said that disaster medicine is an emerging discipline, which involves emergency management, rescue equipment research and development, ethics and law in addition to medical rescue technology.

From the perspective of discipline setting, disaster medicine is not yet a first-level discipline. West China Clinical Medical College of Sichuan University (West China Hospital) is the first medical school in China to set up this course. According to Yan Hui, a number of medical schools, including West China Clinical Medical College, are applying for this discipline to become a first-level discipline alongside clinical medicine.

The reason why I want to apply for the first-level discipline is that disaster medicine is very different from clinical medicine applied in everyday situations. For example, Yan Hui said that in the course of daily medical treatment, it is common to concentrate the best medical resources to treat a certain patient, but in the process of disaster relief, especially in the case of shortage of medical resources, it is necessary to use limited resources to save more people or people with more rescue value, rather than concentrating all medical resources to save a single person.

In the rescue process of shortage of medical resources, the basis for which wounded should be given priority treatment is the international general standard - the wounded are divided into four grades: red, green, yellow and black, "red" is the wounded who need to be treated first, indicating that the wounded are in danger of life, and if they are given emergency treatment, there is a possibility of survival, and their symptoms are: respiratory rate greater than 30 beats per minute, or less than 6 beats per minute, pulse, capillary refill time greater than 2 seconds.

In addition to ethics, the people treated are also different from the patients encountered in daily clinical medicine. For example, the injuries caused by earthquakes are mostly complex and complex injuries, and an injured person may have multiple system injuries such as head trauma, abdominal closure injury, and limb fractures at the same time, which require specialists in neurosurgery, general surgery, orthopedics, etc. When these injuries are concentrated in one person, how to formulate the best treatment plan requires multidisciplinary consultation, which is also involved in disaster medicine.

Yan Hui said that when they arrived at the Linxia Prefecture People's Hospital, where the earthquake victims were treated, the local medical staff had already implemented hierarchical management and classified treatment according to the correct theory, which also proved the role of disaster medicine in practice.

A world-class emergency medical team

The Emergency Office of West China Hospital of Sichuan University, where Yanhui is located, was established in 2018. In that year, the China International Emergency Medical Team (Sichuan), led by the hospital, accepted and passed the evaluation and certification of the World Health Organization expert team, becoming the 15th international emergency medical team certified by the World Health Organization, the first non-military international emergency medical team at the highest level in the world, and the first in China and the second in the world with the highest level of international emergency medical team.

Moreover, the World Health Organization expert team emphasized in its final certification report that the China International Emergency Medical Team (Sichuan) can be recommended to the world as a benchmark.

A total of 11 members of the national expert team assisted the Jishishan earthquake in Gansu Province, of which 5 were from West China Hospital. Yan Hui said that the rich rescue practice has objectively promoted the continuous improvement of West China Hospital's emergency rescue strength, and this world-class emergency medical team has also laid the foundation for the development of disaster medicine in West China Hospital.

Sichuan, where West China Hospital is located, and the surrounding Tibet, Qinghai, Gansu, Yunnan, Guizhou and other places are areas prone to geological disasters. Among these geological disasters, earthquakes are the most common. As the most comprehensive hospital in Southwest China, West China Hospital has undertaken a large number of rescue missions.

This time, it was able to respond quickly to the Jishishan earthquake in Gansu Province, and behind it was the mature operation of the China International Emergency Medical Team (Sichuan). This rescue team classifies the rescue team members into a modular category, involving the damage spectrum of different disasters such as earthquakes, car accidents, explosions, and mudslides, with about 10~20 people in each module. The personnel in the module are divided into an expert group that goes to the hospital to guide the rescue and a team that goes to the front line for rescue.

Yan Hui introduced that before setting off for rescue in Gansu, both the expert group and the team were prepared. After actually arriving in Gansu, it mainly played the role of an expert group, and the responsibility of on-site medical rescue was undertaken by the local medical rescue force.

In addition to personnel, supplies were also well prepared. This time, the members of the expert group such as Yan Hui carried a red backpack when they set off. This backpack contains everyone's work supplies and carrying equipment. These backpacks are stored in the hospital's emergency warehouse on a daily basis for easy access at any time. Yan Hui introduced that these backpacks have a perennial reserve of 30, and the reason why they are determined to be 30 is because after summarizing the emergency tasks of West China Hospital for more than 10 years, it was found that the first batch of rescue team members generally did not exceed 30 people, even if the second and third batches of team members were needed, the corresponding preparation time was more sufficient. In addition to backpacks, the stockpiled supplies also include medicines, consumables, and some rescue equipment urgently needed at the scene.

In addition to the reserve of personnel and materials, there is also a set of mature working mechanisms and processes to deal with emergency rescue. Taking the Gansu earthquake rescue as an example, the experts involved in the rescue usually have outpatient services, surgery, scientific research, teaching and other work. After the rescue experts rushed to the front line, the hospital also had a corresponding set of working mechanisms to maintain the normal working order in the rear.

The development of disaster medicine is promising

After the earthquake in Gansu, the casualties have attracted much attention. In order to minimize casualties, the National Committee for Disaster Prevention, Mitigation and Relief, the Ministry of Emergency Management, the National Health Commission, and the Red Cross Society of China sent working teams to the disaster area as soon as possible.

As a medical expert involved in the rescue, Yan Hui guided the treatment work in Linxia Prefecture People's Hospital in the early stage. Later, as the seriously injured were transferred to five hospitals in Lanzhou, Yan Hui and other experts were also transferred to Lanzhou. After the rescue work in Gansu was over, they went to Qinghai to participate in the treatment of the wounded.

What is the status of China's development of disaster medicine in the world? Yan Hui personally believes that compared with other countries in the world, China's disaster medicine is not lagging behind, and it can basically achieve simultaneous development with the world.

"Although the development of disaster medicine in China started late, the starting point is relatively high, and with the support of policies in recent years, the future development trend will be better. Yan will say.

The "Healthy China 2030" Planning Outline clearly states that by 2030, a nationwide and relatively complete emergency medical rescue system will be established, and the health emergency response capacity and emergency medical rescue capacity of emergencies should reach the level of developed countries. Yan Hui introduced that at present, Sichuan University has included disaster medicine in the priority development of cutting-edge disciplines.

In December 2022, the "12th Five-Year Plan for Emergency Medical Rescue in Emergencies" issued by the National Health Commission requires that the construction of primary medical emergency teams be promoted and the emergency response capacity of primary medical care be improved, requiring each of the country's 2843,20 county-level administrative districts to establish a <>-person primary medical emergency team. The team is composed of various basic units such as emergency medical rescue, poisoning disposal, psychological rescue, etc., which can be modularized according to the type and level of emergencies, and has the ability to rely on ambulances for short- and medium-distance rapid response, as well as the ability to deal with short-distance vehicles without relying on motor vehicles.

As one of the experts involved in the compilation of the 14th Five-Year Plan for Emergency Medical Rescue, Yan Hui said that the reason why grassroots emergency capacity building is an important goal is because when a disaster occurs, it must be the local medical force that can reach the front line as soon as possible.

As the "national team" of emergency medical rescue, the emergency medical team of West China Hospital will do a good job in relevant training and drills on the basis of the discipline support of disaster medicine, in addition to continuously improving its own capabilities, it is also necessary to undertake the training of medical teams at all levels in different provinces, cities and counties, and train more ordinary medical personnel into qualified emergency medical rescue personnel.

China Youth Daily, China Youth Network reporter Liu Changrong Source: China Youth Daily