Lessons learnt from the Wenchuan earthquake: performance evaluation of treatment of critical injuries in hardest‐hit areas

Abstract

The medical relief model of "supervising body helping subordinate unit, severely stricken areas assisting hardest-hit areas, least-hit areas supporting both hardest-hit and severely stricken areas, and self help and mutual assistance applied between hardest-hit areas" was roughly established for injured from severely stricken areas after the Wenchuan Earthquake. The "four-centralization" treatment principle, which referred to concentrating patients, experts, resources and treatment for those injured in critical condition effectively reduced the mortality from 15.06% to 2.9%. Timely, scientific, and standard on-site triage and postmedical transfer guided by accurate injury information determine rescue effect for the injured, while there is large space to fulfill as for treatment for critical diseases among the hardest-hit areas under extreme conditions after the Wenchuan earthquake.

Epidemiological Analysis of Trauma Patients following the Lushan Earthquake

“…Seven hospitalized patients who had suffered severe brain injuries died. Unlike the Wenchuan earthquake [15], most of the areas affected by the Lushan earthquake were remote rural and no tall buildings collapsed. Injured patients were rescued immediately.…”

Integrating epidemiological and engineering approaches in the assessment of human casualties in earthquakes

“…These criteria used to screen all abstracts included. Eight studies met these criteria and were included in this section (Noji et al 1993;Pretto et al 1994;Tanaka et al 1998;Fawcett and Oliveira 2000;Liang et al 2001;Bissell et al 2004;Jiang et al 2012;Wen et al 2012 studies were included in this section for the purpose of establishing a theoretical framework for the association between medical preparedness and response and the number of casualties in earthquake events (Schultz et al 1996;Peek-Asa et al 1998;Ashkenazi et al 2005;Ramirez and Peek-Asa 2005;Macintyre et al 2006;Bayard 2010;Bartal et al 2011;Haojun et al 2011;Archer et al 2011). Although these studies did not quantitatively measure the association between medical preparedness and response and earthquake casualties, they contributed through establishing the need for evidence-based and theoretically driven modeling.…”

“…Local hospitals, which are expected to provide care for the victims, may be overwhelmed by the large number of casualties arriving in a short period. In addition, providing medical aid in a disaster-affected area also entails working under extreme conditions, such as reduced workforce, limited medical supplies and resources compared to the increased demands for medical care (Archer et al 2011;Jiang et al 2012), and requires particular knowledge and preparedness for this scenario. Nonetheless, hospitals are considered the principal providers of immediate medical care after catastrophic events, and the general assumption is that a wellprepared hospital and medical staff could reduce mortality after a serious earthquake (Schultz et al 1996;Pretto et al 1994).…”

“…The findings revealed that 'low prepared' regions had five times more fatalities per 100 injuries compared to 'medium prepared' regions and that 'high prepared' regions had 30 times fewer fatalities compared to 'medium prepared' regions (Bissell et al 2004). Other studies found that the mortality rate for severely injured victims was 15-25 % and was usually higher in frontline hospitals and that these rates may decline to 9-3 % or even lower, if proper medical care is not delayed (Pretto et al 1994;Tanaka et al 1998;Fawcett and Oliveira 2000;Jiang et al 2012;Wen et al 2012). Some studies reported findings that relate to this subject indirectly.…”

Very serious and non‐ignorable problem: Crisis in emergency medical response in catastrophic event

“…In order to improve the survival rate of critically injured patients, the measure of ‘four concentrations’ was implemented for critically injured patients 14 days after the earthquake. The mortality rate of critically injured patients in the designated hospitals was lower than 2.9% 5 months after the earthquake . Based on the emergency medical rescue after the Wenchuan earthquake, the construction of an effective and cooperative coordination system has been proposed in China, with diversified medical relief forces and emergency linkage mechanisms of four levels, including nation, province, city and county .…”