Emergency Response to the Mass Casualty Incident in the Formosa Fun Coast Dust Explosion Disaster - A Single Hospital Experience

緊急應變處理用於八仙塵爆大量燒傷病患發生事件－單一醫院處理經驗分享

鄭立言(Li-Yen Cheng) ； 陳柵君(Cha-Chun Chen) ； 林煌基(Hwang-Chi Lin) ； 鄭舉緒(Chu-Hsu Jeng) ； 林育賢(Yu-Hsien Lin) ； 林上熙(Shang-Hsi Lin) ； 陳瑋農(Wei-Nung Jim Chen) ； 侯勝茂(Sheng-Mou Hou) ； 吳鋼治(Gong-Jhe Wu) ； 陳國智(Kuo-Chih Chen) ； 莊麗敏(Li-Ming Chuang)

《臺灣整形外科醫學會雜誌》 26卷1期 (2017/03) Pp. 22-33

摘要

Background: The Formosa Fun Coast Dust Explosion Disaster, occurred on Jun 27, 2015, in New Taipei City, Taiwan. This event resulted in 499 victims tested the emergency response and burn management-protocol. We present our emergency response action to this incident. Aim and Objective: We aimed to integrate this disaster response to a mass burn casualty incident occurring in Taiwan into an existing disaster management plan to rapidly aid in the response to future mass casualty incident. Materials and Methods: Our hospital has a capacity of 817 beds, including three beds in the Burn Intensive Care Unit (BICU). The Department of Plastic Surgery includes 5 surgeons. The statistical data was obtained from our hospital and the Ministry of Health and Welfare in Taiwan. We present our protocol to treat this mass casualty incident and the rapid response, which included a temporary isolated burn ward. We also confirmed the result of patients' TBSA, infection rate and species, operation times, and ICU care quality to prove our efficient care method. Results: On the day of disaster, 261 available medical staffs, including doctors and nurses, were called to the emergency room for the management of 33 burn patients, including 24 major burn patients. The control center was ready within 30 minutes. In accordance with ATLS, we immediately established a special protocol for treating major-burn patients. The mean total burn surface area was 56.4% (range: 20 - 90 %). The ICU was prepared for management and infection control. A multiple care system, which included 6 groups, was developed for treating burn victims. All patients recovered within 3 months with no fatalities. Conclusion: Despite the BICU having limited space, excellent results were obtained for the management of these major burn victims. The temporary isolated burn ward and BICU could be model for hospitals lacking a large BICU. While not standard, this method could be used in similar disasters in the future.

關鍵字

massive casualty incident ； massive burn ； disaster management

並列摘要

背景：台灣八仙塵爆發生於2015/06/27，造成499名受難者，同時這場災難考驗著我們的緊急應變處理，單一醫院利用有限的資源及來完成這場突發其來的任務。目的及目標：此次塵爆事件是第一次發生在台灣，希望藉由我們此次經驗整合出有效處理大量傷患的計畫，幫助下次悲劇發生時能夠適時的提出方法解決。材料與方法：我們擁有817張病床的容量，包含3張燒燙傷加護病床以及五位專任整形外科主治醫師.根據台灣衛生福利部提供的資料，我們將提出緊急應變過程以及如何在短時間建立暫時性燒燙傷隔離病房。結 果：災難發生當晚我們緊急召回261位可以幫忙的醫療人員，包含醫師及護理人員來處理一開始的33位受難者。在30分鐘內建立緊急控制中心，建立一套緊急燒燙傷應變流程。病患燒傷範圍由20%到90%（平均56.4%），四天之內建立暫時性燒燙傷隔離病房，規則比照加護病房能夠有效控制感染，此外多專科團隊照顧也是促成這次事件成功的因素之一。結論：如何能在有限的資源建立暫時性燒燙傷隔離病房，儘管不如一般加護病房完善，但藉由這次事件來修正及建立方法，來應付未來發生的可能性。