空難緊急醫療團隊之組成與協調機制的探討－以中正國際機場為例

The Study on Team Composition and Coordinating Mechanisms of Emergency Medical Support in Aircraft Crushed Disaster:

施秀(Shih Hsiu)

指導教授 ： 李弘暉 博士

元智大學/管理學院/管理研究所/碩士(2003年)

摘要

民國89年10月31日強烈颱風象神侵襲的深夜23:17分，新加坡航空公司編號SQ006的波音747客機，墜毀在桃園中正國際機場的跑道上，造成79人當場死亡，72人送醫急救的重大空難意外。雖然空難發生前四個月，機場剛修訂了空難緊急醫療作業程序的修訂，事後遺憾的發現大多數的傷患在現場未經適當的檢傷和醫療處置，傷患後送的情況與原計劃未盡吻合。
本研究的目的有三：(1)檢討中正國際機場空難緊急醫療應變程序中傷患到院前緊急醫療救護的團隊組成與協調機制。(2)回顧新航空難中正機場的醫療應變過程，提供團隊整合的綜合建議。(3)察覺現有法律與組織結構的限制，改善空難緊急醫療受傷旅客到院前醫療救護的計畫。
本研究經由歷史比較法，比較分析中正國際機場現行民用航空器失事處理作業要點、空難醫療動原計劃和國際民航組織規範的差異。再經由問卷調查與深入訪談，回顧新航空難的緊急醫療救護，並做綜合建議。
主要結論包括：(1)中正國際機場的空難緊急醫療應變計畫，需要進一步的修正。原規劃機場的消防隊的初級救護技術員，為緊急應變體系中僅有的主要反應與指揮部門，不足以處理重大傷亡空難。(2)中正機場應積極針對機場內的相關組織，協調、整合以建立災難應變的標準程序。(3)由不同醫療機構派遣多支醫療隊的支援方式，不應被當作空難緊急醫療的初級反應模式；如果需要授權地區醫療隊的參與，一支就近、事先規劃而且訓練精良的團隊將是最好的選擇。(4)即時的而且是多管道的災難通報系統，是災難管理計畫中，必需建立的重點。(5)政府部門和負責災難管理的公共組織，必須依據災難的特質，因地制宜的建立各種不同災難應變計畫的評鑑標準，因為每一個災難狀況和需求都是不同的。

關鍵字

災難醫療 ； 空難 ； 危機管理 ； 緊急醫療團隊

並列摘要

At 23:17 on October 31,2000,a Booing 747, flight SQ006 of the Singapore airline crashed at the runway of the Chiang Kai-Shek(CKS) international airport in Taoyuan county, during a torrential rains as Typhoon Xangsane drenched the island. There were 72 injured transported to hospitals and 79 dead bodies were found on crashed site. Thought the mass casualty incident (MCI) plan of CKS airport was just revised four months prior to this accident. But most of the victims did not receive field triage and medical treatment. Transportation of the victims was not performed as the plan.
The goals of this study are: (1) To examine the impact of the EMS teams structural characteristics and the coordinating mechanisms in CKS airport on aircraft disaster preparation and emergency medical care of the pre-hospital patient. (2) Review the EMS management of SQ006 aircraft crushed disaster, to provide an integration of organization suggestion to the airport. (3) Given current legal restrictions, advanced air-crush disaster EMS plan in pre-hospital treatment.
By historical/comparative method, we compared the mass casually plan of CKS airport with that International Civil Aviation Organization (ICAO) airport emergency planning. Then we reviewed the emergency medical care of that accident by collecting materials through questionnaire and deep interview, and we combined the improvement from expects.
Main conclusions are: (1) The MCI plan of the CKS airport must be revised again, and the airport fire department should not been designated to be the only key responding agency on commanding and operating the plan. (2) To integration and cooperation of concerned organizations in the CKS airport, can be established through disaster drill. (3) Multiple site medical teams should not be the first responding agency, if site medical teams are warranted; a nearly-by pre-arranged and well-trained team is the optimal choice. (4) A real-time and multiple channel of communication system should be established for disaster management. (5) The government and public organizations in charged must created a model to access all kinds of MCI planning in different disaster, it is important that each plan be well identified.

並列關鍵字

Disaster Medicine ； Aircraft Disaster ； Crisis Management ； Emergency Medical Teams

參考文獻

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