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可預防的天然災害—由711水災探討責任醫院之緊急應變

Preventable Natural Disaster-The Survey of Emergency Response of Designated Hospitals in Flood 711

摘要


研究目的:民國90年7月11日輕度颱風「潭美」重創南台灣,造成所謂的「711水災」;短時間內暴雨導致高雄市嚴重電力受阻及幾近全市交通癱瘓。本研究分析災區醫院於「711水災」中受損情形,嘗試提出此類天然災害發生時醫院應有的緊急災難應變措施。 材料與方法:本研究係針對「711水災」對高雄地區緊急醫療網所屬責任醫院進行回顧性、描述性的災後調查。利用實地踏勘的方式進行災區醫院「重要醫療空間」及「功能性設施」的損害評估。所謂「重要醫療空間」定義為責任醫院於災難發生時應立即啟動並能處理大量傷病患之緊急單位,主要包括各院急診室、加護病房及手術室等醫療單位;而「功能性設施」則定義為維持「重要醫療空間」運作之供電、供水等設施,尤其是醫院「非結構物元素」之維護。我們嘗試經由分析災區醫院急門診人數的變化及回顧急診病歷來評估該院受創的情形。 結果:本研究共電話訪問高雄地區36家醫院,選擇其中10家災情較嚴重的醫院作進一步的調查。研究結果發現多家醫院「功能性設施」,特別是機電、管線等設施因水災受損導致「重要醫療空間」無法進行緊急醫療。此外,由於嚴重積水,造成存放於低樓層病歷、貴重儀器和電腦設備毀損。所幸此次颱風的雨勢在十二小時後趨緩,並未造成該區嚴重的災情及後續疫情的發生。我們彙整「711水災」受損資料後,透過「專家會議」邀請具有實務經驗的專家學者與會,提出有效、可行的防災措施及實務建議。 討論:緊急醫療網責任醫院在水災發生時,是否能立即有效的運作為減少此類災害發生的重要指標,因此建議各區責任醫院應建立水災的緊急應變流程,因應水災可能造成的衝擊以達到減災、預防的效果。

並列摘要


Objectives: Flooding on July 11 2001 (so called the ”Flood 711”), caused by Typhoon Trami, hit southern Taiwan and led a significant disaster in Kaohsiung City. As the abundant rainfall fell in this area at very short time, the ”Flood 711” almost overwhelmed the network of transportation and caused a significant loss of electric power in whole city. We analyzed the impact of ”Flood 711” on these designated hospitals in Kaohsiung City and attempted to propose the response plan for mitigation of the flood-related disaster in affected hospitals. Method: A retrospective, descriptive study was conducted in order to evaluate the real damage of designated hospitals in Kaohisung City during ”Flood 711”. The evaluation method was composed of two evaluation teams to investigate the dysfunction of ”important medical spaces” and ”operational and functional components” in affected hospitals. The ”important medical spaces” was defined the emergency units of designated hospital that could activate and maintain mass medical capability (”surge capacity”) when disaster stroke, in which included emergency department, intensive care unit and operation room etc. The ”operational and functional components” was defined the facilities (especially the nonstructural components) that could maintain electricity and water supply in important medical space. We measured the number of patients visiting affected hospitals and reviewed the medical charts during flooding to evaluate the damage of medical service in these affected hospitals. Results: Thirty-six affected hospitals were contacted by telephone and invited into our survey, ten of them were chosen for evaluation of the flood impact. Failure of operational and functional components, especially electricity and water supply, caused by the flash flood directly incapacitated the medical surge capacity of affected hospitals. Moreover, unrecognized literature of medical charts, sinking of high-tech equipments and computer network were noted in affected hospitals by floodwater. Fortunately, there were no mass casualty incidents and infectious diseases following this event due to the flooding fade away quickly in this area. We also held the specialist meeting, inviting expert from the Kaohsiung Rapid Transit Company, to discuss the mitigation designs and attempted to envision the emergency preparedness plans. Conclusion: Maintaining the effective medical service for both surge medical capability and surge capacity is the primary goal for local designated hospitals during floods. A practical emergency response procedure focusing flood was proposed. In order to mitigate the damage of affected hospitals following flood after typhoon or flash rainfall.

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