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Received Aug 11; Accepted Nov 6. In this paper, we review the previous classic research paradigms of a mass casualty Mci reflection MCI systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management.
The following key words and medical subject headings were used: Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors.
The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods medical severity index MSIpotential injury creating event PICE classification, and disaster severity scale DSSwhich can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations.
However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses.
Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored—vulnerability, based on reflecting on the Mci reflection response to the Wenchuan earthquake and July 5 bus fire in Hangzhou.
This new paradigm breaks through the limitation of traditional research paradigms and will contribute to the development of a methodology for disaster research.
Mass casualty incident, Surge, Vulnerability, Earthquake, Fire incident 1. Meanwhile, in the studies of Aylwin et al.
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Official figures as of July 21, The number of those killed or missing is reported to be more than 23 in the Tohoku earthquake Nagamatsu et al. Due to such extensive casualties and massive destruction of social properties, a need for improving MCI response capability is in urgent demand Hamilton et al.
Recently, the science of surge medical surge response capability MSRC can be influenced by surge and surge capacity has been employed for the research of MCI response capability Kaji et al. The dynamic quantitative comparison between surge and surge capacity used in the science of surge provides a foundation for the exploration of MCI response capability.
The science of surge is especially beneficial in MCI where medical needs are clearly clarified. Yet, its limitations have been shown in dealing with MCI where the boundary of medical demands in the early stages of a calamity is unclear and the circumstance for responding is extremely serious, such as the Wenchuan earthquake.
By thoroughly investigating the current researches on MCI and emergency medical responses in the Wenchuan earthquake and applying the science of surge into the investigation, this paper is aimed at outlining and developing an improved research paradigm for MCI management.
Review of previous research paradigms MCI is an incident, which causes many casualties beyond the local medical capacity Einav et al. A major disaster leading to an MCI results in huge loss of properties and massive destruction of social structures in the local area.
Thus in addition to the suffering of a direct disaster attack, a local medical response system is subjected to a tremendous medical surge beyond its capacities. Compared with deaths and injuries caused by conventional emergencies, an MCI has two characteristics Rega et al. First, the large number of casualties in an MCI causes a gigantic medical need far in excess of available resources, including rescue equipment, logistic supply, and personnel.
Secondly, dangerous environmental conditions during the time of a disaster often restrain full medical responses. An MCI medical response cycle includes four phases: The current progresses on MCI management include the following: All of these developments could improve the outcomes for patients.
However, the progress of MCI response research has been slow. With limited time and resources in an MCI, a quantitative evaluation method to dynamically assess the MCI situation is needed and decision-making for MCI responses should be based on the results of such evaluations. The introduction of MSI made it possible to immediately assess the medical size of a disaster.
The three following parameters are needed to quantify a disaster. Patients treated at the scene by the simple triage and rapid treatment START program are divided into four classes: T1, life-threatening cases demanding immediate attention; T2, non-life-threatening cases requiring hospital treatment; T3, casualties not necessarily requiring hospitalization but rather less demanding single point care; and DOA, the dead and the dead-on-arrival.
An MSI can be applied to evaluate the disaster itself and estimate the medical requirements in the disaster preparedness phase. The proposed methodology is of practical importance for handling disasters. In an attempt to classify and assess disasters, a DSS was developed.
The assessment of the DSS is based on the following parameters: The classification scheme is based on these variables, which are directly related to either the origin or the effect of disasters.
By quantifying or weighing these variables and summing the individual scores, a DSS can be constructed, which normally runs from 1 to A limitation of the practical use of this scoring system is that it can only be applied retrospectively.Get In Touch.
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3. Reflection on the MCI response to the Wenchuan earthquake and Hangzhou bus fire, and the development of the science of surge. As the largest MCI since the founding of the People’s Republic of China, the Wenchuan earthquake is a comprehensive examination of a disaster response system in this country.
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Visit RateMDs for Dr. Gregory Jeffries reviews, contact info, practice history, affiliated hospitals & more. The reflections create more of a bow tie pattern as compared to Figure 3. Figure 5 (right) The reference sphere for a wall-hung object with reflections from the walls, ceiling and floor (the less defined reflections).