醫院因應重大災難對各式臨時收治場所的規劃評估

Hospitals Preparation of Various Temporary Shelters in Response to a Major Disaster

陳永福(Ying-Hock Teng) ； 周希諴(Hsi-Hsien Chou) ； 周志中(Chu-Chung Chou) ； 楊大羽(Dar-Yu Yang) ； 林錦源(Jin-Yuan Lin) ； 周明智(Ming-Chih Chou)

《中山醫學雜誌》 17卷1期 (2006/06) Pp. 33-43

https://doi.org/10.30096/CSMJ.200606.0004

摘要

本研究之目的在瞭解臺灣各緊急醫療網責任醫院，面臨重大災難時如何規劃臨時收治場所。經專家會議及彙集國內外相關資料後，設計出一份評量式問卷，並在2001年3-8月由二位研究員實地訪查各醫院，了解場地設置情況並討論相關困難。實際受訪醫院為82家，含16家醫學中心及66家區域醫院，其對臨時收治場所的規劃如下：多數設置點為停車場(76.8%)，63.4%的場地為醫院財產，僅口頭約定或共識者則有58.5%；多數(76.8%)面積在1000平方公尺以上；大多數(95.1%)容量在50人以上；多數(96.3%)將備用發電機放在地下室，但42.7%未具移動式發電機；具有帳篷規劃者僅12.2%，少數(8.5%)與軍方訂有合作協定，而大部分認為戶外活動使用的大型遮雨篷是合適的替代物；近半數(48.8%)具獨立規劃書，其他醫院則與相關防災計劃共用或無。
本研究發現：一個良好的臨時收治場所應具備水電供應、供氧、通訊、交通以及膳食設備等規劃，並定時模擬演練，以及與提供者訂定供應協議，以備不時之需。因為各醫院面臨大型災難時的反應能力有所差距，且僅有少數具實際院外架設臨時收治場所的經驗，故有必要由中央及地方政府研擬一套標準作業流程，以供大家參考並執行；建議各級醫院應該事先規劃臨時收治場所並加以演習，並冀望衛生署將之明訂為醫院評鑑的項目，以加強醫院的設置意願與重視程度。

關鍵字

緊急醫療網 ； 重大災難 ； 臨時收治場所

並列摘要

This study evaluates the design of each of Taiwan's Emergency Medical Services (EMS) hospitals for suitability as temporary shelter during an attack of major disaster. After attending some expert conferences and collecting related data, we proposed designing a questionnaire to evaluate hospital preparedness and-identify the problems at each location. The questionnaire was completed by two researchers who visited all 82 hospitals between March and August, 2000. We surveyed 16 medical centers and 66 regional hospitals. The following formed part of their preparations for setting up a temporary shelter: the majority (76.8%) designates a parking lot as the site for this shelter, 63.4% owned a site, but 58.5% only had oral permission in the form of a common consensus. The majority (76.8%) had sites exceeding 1000m^2. Of those hospitals, 95.1% had sites with a capacity for more than 50 persons, 96.3% had installed electric power equipment in the basement, 42.7% did not have a portable generator. Only 12.2% has prepared tents, and 8.5% had cooperative agreements with local military bases. Most hospitals preferred the canopies that were popular for use during outdoor activities. Therefore, almost half (48.8%) of all the hospitals we evaluated had specific plans for a temporary shelter, while others either included them in related disaster protection plans or had no plan whatsoever.
In conclusion, these hospitals need to thoroughly plans for a sudden disaster, which should include water and power supplies medical oxygen, communication equipment, transportation, food, etc. The preparation should also include scheduled emergency drills and support agreements with all providers for contingent use. Because individual hospitals have different abilities to respond and few have real experience setting up a temporary out-of-hospital shelter, it is necessary for local and central government to create a standard operational procedure for them. We suggest that every hospital have preparation plans and drills for a temporary shelter, and that the Health Department include these as requirements for hospital accreditation.

並列關鍵字

Emergency Medical System ； Major Disaster ； Temporary Shelter