- 期刊
強震地區醫院非結構物防震系統之評估
Evaluation of Seismic Capacity of Hospital Nonstructural Elements in a Seismic Region
摘要
背景 : 災難型地震(Catastrophic earthquake)發生時常造成大量的傷患，如何在最短的時間內發揮地震災區醫院的功能，是降低災區死亡率的重要因素。災區醫院是否能發揮其功能端視醫院結構體元素(建築設施)及非結構體元素(醫院設備及醫療設施)的完整防震能力。所謂醫院「功能性設施(operational and functional components)」即是提供醫院非結構體元素正常運作及維護醫療救護能力的重要設施。本文嘗試分析「921地震」中災區醫院其「功能性設施」受損的情形，並評估其是否影嚮該區緊急醫療救護系統。 方法 : 自民國八十九年二月至七月間，本研究小組針對南投地區兩百床以上的責任醫院，實地訪視其急診室、加護病房、開刀房、洗腎室、放射科等救護單位並勘驗各機房、電腦室等工程單位，紀錄其非結構體元素受創的情形。 結果 : 我們共收錄四家災區醫院(南投縣甲、乙、丙、丁等)，分析其供水、供電、空調、通訊及電梯等主要「功能性設施」受損程度，發現當所謂「功能性設施」損害時會直接影嚮各醫院的緊急救護單位並癱瘓該區緊急醫療救護系統。 結論 : 醫院非結構體中「功能性設施」是這幾年來逐漸受到重視的防震系統觀念，本研究亦闡明此「功能性設施」的重要性及其損害時對緊急醫療救護系統造成的衝擊。如何提昇強震地區醫院的防震系統及有效評估醫院非結構體元素之「功能性設施」是我們將來努力的方向。
並列摘要
Background: Catastrophic earthquakes cause mass casualties. The timely and appropriate activation of emergency medical services and coordination of affected hospital play important roles in reducing mortality. Operational and functional components (OFC) are critical nonstructural elements that provide support after earthquakes to preserve medical capacity. The aim of this study was to understand the nonstructural vulnerabilities of affected hospitals' OFCs in the Chi-Chi earthquake and to evaluate the impact of nonstructural damage on emergency medical service systems (EMSS). Methods: From Feb. to July 2000, we investigated all affected hospitals with at least 200 beds available for medical care department in Nantou. The surveyed acute medical wnits included the Emergency Depautment (ED), Intensive Care Unit (ICU), Operation Room (OR), hemodialysis department and rddiological department. The seismic performance of OFCs wuch as electrical systems, water supply systems, air-conditioning systems, communication systems and elevators was assessed. All retrospective data were obtained by discussion with hospital stall who served in acute medical units and technicians who majored in repairs. Results: We enrolled four affected hospitals in Nantou county and analyzed the severity of their damage after Chi-Chi earthquake. It was found that damage to hospital's OFCs significantly reduced patient care in affected hospitals and also overwhelmed the local EMSS. Conclusion: The operational and functional components of nonstructural elements in the seismic building code have become more important in recent years. We elucidated damage to nonstructural elements, especially the hospital's OFCs, which caused direct impacts on emergency medical service systems. Further studies are needed to investigate the seismic capacity of hospitals in seismic areas and to find an effective evaluation method of a hospital's major OFCs.