敏督利風災後南投縣山地鄉的醫療照護：臺北市災難醫療救護隊的經驗

Health Care in a Mountainous Area Following Typhoon Mindulle: The Experience of the Taipei City Disaster Medical Assistance Team

陳思穎(Szu-Ying Chen) ； 李芳年(Fang-Niarn Lee) ； 張裕泰(Yu-Tai Chang) ； 璩大成(Da-Chen Chu)

《北市醫學雜誌》 2卷8期 (2005/08) Pp. 766-773

https://doi.org/10.6200/TCMJ.2005.2.8.11

摘要

颱風是台灣最常見的天然災難之一，每年往往造成龐大的生命財產損失。中度颱風敏督利(Typhoon Mindulle)於2004年7月1日晚間登陸台灣，挾帶強大的西南氣流重創中台灣，尤其以台中縣及南投縣災情最為嚴重。經評估後，台北市政府衛生局於7月5日派遣一支由台北市立醫院42位醫護人員組成的災難醫療救護隊(Disaster medical assistance team, DMAT)前往南投縣執行醫療救護工作。進一步劃分為14個醫療小組後，經由直昇機運送至南投縣仁愛及信義鄉14個山地部落。從7月6日至7月8日，市醫DMAT共服務1,017人次病患，針對其中873份完整病歷資料進行分析，病患平均年齡為49.5歲，其中54.5%為女性。疾病型態除4位重症病患後送外，大部分以輕症居多，其中以呼吸道感染(34%)、骨關節炎(14%)、皮膚疾病(11%)、及肌肉軟組織發炎(11%)所佔比例最高。此次任務對甫成立的市醫DMAT是一次難得的經驗，但檢討整個任務過程，下列幾點可作為未來災難應變的參考：(1)中央及地方救災體系應緊密結合，相互溝通，避免政治化。(2)DMAT的派遣需要完善的協調及評估機制。(3)DAMT有關指揮、通訊、計畫、執行、及後勤等指揮架構均有須要再加強之處。(4)加強人員教育訓練及各種緊急災害的應變計畫。

關鍵字

敏督利颱風 ； 天然災難 ； 災難醫療救護隊

並列摘要

Typhoons are common natural disasters and cause injuries and deaths in Taiwan every year. Typhoon Mindulle hit Taiwan at midnight, July 1, 2004 and caused devastating damage in central Taiwan, especially in Nantou and Taichung Counties. After evaluation by the Taipei City Government's Department of Health, the Taipei City Disaster Medical Assistance Team (DMAT), composed of 42 medical staff, was dispatched to Nantou County on July 5. A total of 14 DMAT field clinics were further divided and dispatched to habitations throughout Jen-Ai and Shin-Yi Counties via helicopter. From July 6 to 8, 2004, DMAT field clinics provided medical assistance to 1,017 patients. Excluding the missing data, 873 patients’ information was included in the data analysis. The patients' average age was 49.5 years. and 54.5% were female. There were four patients who were transferred to higher level medical care facilities due to their critical condition. The four main categories of diseases were airway infection (34%), arthritis (14%), dermatological diseases (11%) and myofasciitis (11%). It was an impressive experience for the Taipei City DMAT. However, after self-examination of the task, we could concluded that: (1) all units involved in the response systems need better horizontal and vertical integration but these are not political issues; (2) more detailed pre-dispatching evaluation and coordinating mechanisms are necessary to improve future disaster responses; (3) the incident command system of DMAT from commander to planning, operation, finance and logistics sections must be further reinforced; (4) comprehensive personnel training and emergency planning are necessary.

並列關鍵字

Typhoon Mindulle ； natural disaster ； DMAT