A Study On Mass Casualty Incident Disposal Process And Treatment Strategy In Military Hospital

By Mass Casualty Incident（MCI）is meant an incident occurred in an area with rescue capabilities required to save casualties exceeding the local rescue capabilities.MCI mainly include natural disasters such as earthquakes and landslides,human error accidents such as production accidents and horrific car accidents,terrorist attacks and local armed conflict.Some examples are the Wenchuan Earthquake,the Lushan Earthquake,the bus blaze accident on 5^th June in Chengdu,the terrorist attack in Kunming Railway Station and the violent blaze and explosion accident on 12^th August in dangerous cargo warehouse in Tianjin Harbor.Currently,China has become one of the most serious countries where MCI occurs in the world.In recent years,China has experienced various MCI rescue activities and made a series of rules and laws on disaster rescue,and Chinese military has become a n indispensible participant in MCI rescue operations.Emergency medical rescue is a vital component of MCI rescue,which is the research hotspot and difficulty in the field of military medicine,medical services and first-aid medicine.Major developed countries have established MCI health relief system by cooperation between military and civilians or mobile support provided by military.Therefore,in order to minimize casualties and improve the treatment efficiency,military hospitals urgently need a mass c asualty incident disposal process tested by rescue practice and an effective treatment strategy.The research topic,MCI Disposal Process and Treatment Strategy in Military Hospital,originates from key scientific research project of the army’s logistics and general projects of the 11th Five-Year Plan and the 12th Five-Year Plan of Chengdu Military Region.The study is focus on military hospitals’MCI rescue operations for natural disaster such as earthquakes and debris flow,and human error accidents such as horrific car accidents and fire disasters and terrorist attacks,its basic thinking and scheme being based on such document research as the overall framework of foreign disaster relief operations of the U.S.army,MCI disposal process and plan of foreign military and air relief system of international peacekeeping force,investigation of pandeMCI in earthquake medical rescue in the Wenchuan Earthquake,Yushu Earthquake and Lushan Earthquake.An integrated treatment process and treatment strategy for MCI pre-hospital and in-patient rescue.The mainly innovation points of this research are as follows:First,based on aeromedical evacuations provided by medical service and air resc ue practical drills,and consulting air rescue system of U.S.and other advanced countries’military,“Regional Air Medical Rescue System”should be established by zone control method with“two lines and three zones”（inner warning line and outer warning line,golden zone,silver zone and copper zone）in site,achieving the goal of reasonable dispose in rescue scene and quick transportation of wounded personal.Second,hospital treatment centered with case analysis,twice inspection diagnosis,surgery consultation and on-site treatment by multi-units should be established:（1）According to case analysis on the wounded peak in the Wenchuan Earthquake,the significance,complexity and dyna MCI of case analysis in MCI have been proved.（2）The method of treating and curing the wounded after classification and complementary classification for the wounded in hospital（twice inspection diagnosis）is put forward creatively,not only ensuring smooth acceptance and treatment for the wounded but also reducing rate of missed diagnosis.（3）The surgery consultation mode commanded by clinical department’s leader is established to effectively solve the problem of too many MCI wounded and a large number of surgeries.（4）The treatment mode of“on-site treatment and back up by the entire military”is put forward under the circumstance of non-triage of burn wounded.Third,it is raised that the team training methods"based on ability"for mobile medical unit as well as blood,medical devices and information and communication se curity system should be established:（1）Physical and psychological adaptability,field rescue ability,medical command and coordination ability and information technology ability should be highlighted in the training of mobile medical team.（2）Virtual blood banks should be adopted as the supplement of emergency inventory blood.Preplan of medical devices under various conditions should be formulated by multi-channel guarantee modes,setting up a We Chat-based information platform for medical rescue in earthquakes.（3）A standard operating procedure system of equipment operation and maintenance in the mobile medical team should be established.Forth,summed up the implementation of MCI in the external medical treatment process,the military hospital should focus on the problems and key points.The Sino US military humanitarian relief joint tabletop exercise and Nepal executive relief mission as an example,the task start,team delivery,task execution,team from the four stages of focus were described.Fifth,taking the case of medical rescue after the strong earthquake in Nepal as a case study,this paper verified the treatment process and the treatment strategy of the military hospital in the MCI medical treatment.Through this study,hope is a front MCI Institute proposed by internal integration process and the management strategy,further standardize and establish MCI disposal site control,triage and evacuation of stereo pre hospital treatment process;to establish the situation judged,two classification examination,"hospital in hospital operation mode,battle of multi unit combined treatment on the spot as the core of hospital treatment process.The two is to hope that the research results of MCI disposal process and treatment strategy for construction of foundation to further improve the mobile medical team training level and ability construction;enhance the blood,medical devices,and information and communication security level.To improve the MCI Earthquake medical rescue efficiency and effect of the treatment of a large number of victims,and for the future in rescuing the wounded has been provided through the actual test,effective experience,improve the ability and level of our army medical service.