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    災難醫學

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    在災難時如何拯救最多的生命?
    原作者: Andrea Tenner,肖鋒譯 文章來源: 中華急診醫學雜志編輯部 發布日期:2013-03-11

    Title: Saving lives in a disaster
    題目:在災難時如何拯救最多的生命
    Author 作者: Andrea Tenner

    Background Information 背景資料:
    Ever wonder what you would do if you were the first on scene after the earthquake in Haiti or in the Superdome as Hurricaine Katrina survivors started to arrive? How could you save the most lives? As is typical of emergency medicine, blood and gore tend to get the most attention, but if you want to save lives you have to think about what is the greatest life threat.  In a large-scale disaster, it turns out, lack of water and abundance of feces kill the most, the fastest and need to be addressed first.
    你想過沒有,如果你是在海地地震后第一個到達現場或看到第一批卡特里娜(Katrina)颶風生存者進入Superdome,你會做什么?你如何才能搶救最多的生命?與急診醫學典型例子一樣,血和血塊容易得到最多的注意力,但是你如果要搶救生命,你必須要考慮什么是最威脅生命的。在發生大規模災難時,實際上缺水和太多的糞便將在第一時間內奪去最多的生命,需要第一時間解決。
    The Sphere Proj:ect Handbook 全球計劃手冊:

    -one of the core documents of humanitarian response
    人類救援反應的關鍵文件之一
    -outlines what should be done to save the most lives in the first days, weeks, and months of a disaster.
    描述了在災害的第一天,第一周,和第一月內如何拯救最多的生命
    -available free online (see reference below)
    可在網上免費查到(見下面的參考文獻)

    Pertinent Conclusions: (need-to-know recommendations for the first few days)
    有關的結論(前幾天內需要知道做什么的建議):

    -Water: 15L/person/day (any quality--sanitize as per our previous pearl)
    水:每人每天15升(任何質量-按前面的必知進行解毒處理)
    -Latrines: max 20 people/latrine, <50m from dwellings, >30m from water sources
    廁所:最多每20個病人一個廁所,離住處50米內,離水源30米外
           -What kind? 什么樣的?
                 -First 2-3 days: demarcated defecation area
    在頭2-3天:劃定排糞區域
                 -days-2 months: trench latrines (shallow trenches to defecate in)
    幾天-2月:挖出廁所(排便的淺溝)
    Other hygiene 其它衛生方面:
    -Solid waste disposal: one 100L refuse container/10 households, emptied at least 2x/week
    固體廢物處理:每10家要有一個100升的廢物桶
    -Dead bodies: dispose of according to local custom. Generally not an immediate source of infection
    尸體:根據當地習俗處理,一般來說不是立即感染的原因
    -Shelter: >3.5 sq. meters/person of covered floor space
    庇護所:平均每人要有至少3.5平米覆蓋的地面面積

    Bottom Line 要點:
    People's need for water and defecation will not stop in a disaster and too little water and too much excrement are the greatest immediate life threats to disaster survivors. Plan to deal with these early to save the most lives.
    人對水和排便的需求并沒有因為災難的發生而停止,對災害生存者來說,太少的水和太多的排泄物是最大最快的危及生命的因素。
    References 參考文獻
    The Sphere Project. Sphere Handbook: Humanitarian Charter and Minimum Standards in Disaster Response, 2011, 2011, ISBN 92-9139-097-6, available at: http://www.sphereproject.org/handbook/

    文章來源:中華急診醫學雜志編輯部

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