Mass Burn Injury Triage Experience in Formosa Fun Coast Dust Explosion Disaster of National Taiwan University Hospital

八仙塵爆大量燒傷病患檢傷處置分析－臺大醫院經驗

莊樹揚(Shu-Yang Chuang) ； 黃慧夫(Hui-Fu Huang) ； 劉昌杰(Tom-J Liu) ； 柯安達(An-Ta Ko) ； 張哲瑋(Che-Wei Chuang) ； 吳俞鋒(Yu-Feng Wu) ； 楊永健(Eng-Kean Yeong) ； 戴浩志(Hao-Chih Tai)

《臺灣整形外科醫學會雜誌》 26卷1期 (2017/03) Pp. 14-21

摘要

Background: In mass burn injury, correct triage and resuscitation in severe burn patients are the keys to decreasing mortality and morbidity. Lack of experience and literature guide which is better to practice in a mass burn disaster. Aim and Objectives: To investigate the experience of mass burn injury triage management experience in a single hospital and the patient outcome. Material and Methods: This study included 33 patients sent to National Taiwan University Hospital in dust exploration disaster on June 27, 2015. 17 patients were sent to emergency room directly from the scene, and other 16 patients were transferred from other hospitals. The triage strategy in the emergency room was discussed. Results: The patients to National Taiwan University Hospital directly were reviewed by a burn specialist and divided into four groups including burn intensive care unit, burn ward, recovery room then general ward, and discharge. The average length of stay in the emergency room was 85 minutes. Eleven intubated patients and three with inotropic agents in transferred patients. No mortality in all these 33 patients. Conclusions: Triage by a burn specialist and temporally burn patients buffer in recovery room help us clean up the emergency room and distribute the patients as soon as possible. The treatment outcome is excellent without any mortality.

關鍵字

mass burn injury ； triage ； emergency room ； length of stay

並列摘要

背景：當大規模燒傷發生時，正確的檢傷分類以及給予嚴重燒傷病患所需要之處置是降低死亡率以及嚴重後遺症的關鍵。然而，當大量燒傷災難發生時，臨床實際執行方面仍缺乏文獻報告以及經驗的指引。目的與目標：進行對於一個大規模燒傷事件回溯性研究及經驗分析，以及文獻回顧。材料與方法：檢閱2015年6月27日發生於新北市八仙塵爆之病患，有33人於台大醫院接受治療。其中有17位病患直接送到台大醫院急診室，其餘16位為轉院病人。此研究分析17位病患於急診室檢傷分類經驗以及分析。結果：所有直接送入急診室之病人由一位燒燙傷之醫師負責評估檢傷，並將病人因嚴重程度分為入住燒燙傷加護病房、燒燙傷病房、恢復室觀察後轉入一般外科病房以及直接出院。平均病患於急診的時間為85分鐘。在16位轉院病患當中，有11位插管以及3位使用升壓劑。所有33位病人當中沒有死亡病例。結論：在這次八仙塵爆的經驗當中，由一位燒燙傷醫師而非急診醫師或護理師檢傷以及利用恢復室當作緩衝空間幫助快速的清空急診室以及更正確的評估燒傷病人。