利用计算机模拟优化神经毒剂大规模伤亡事件中的医疗护理。

IF 3.5 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Medical Systems Pub Date : 2024-09-05 DOI:10.1007/s10916-024-02094-8
De Rouck Ruben, Mehdi Benhassine, Debacker Michel, Van Utterbeeck Filip, Dhondt Erwin, Hubloue Ives
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引用次数: 0

摘要

导言:化学大规模伤亡事件(MCIs)对公众健康和安全构成严重威胁,有可能使医疗基础设施不堪重负,造成社会混乱。计算机模拟系统因其通用性、成本效益和较低的道德问题易感性,正在成为验证这些计划的既定机制:我们创建了一个类似于 1995 年东京沙林事件的城市地铁沙林袭击计算机模拟模型。我们利用 SIMEDIS 计算机模拟器创建并组合了疏散、扩散和受害者模型。我们分析了多种可能方法的影响,如疏散政策("舀起就跑 "与 "留下来玩")、三种策略(现场洗消与稳定、场外洗消与稳定、现场稳定与场外洗消)、初步分流、受害者分布方法、运输监督技能水平以及搜救能力的影响:结果:只有疏散政策、策略和初步分流对死亡率有显著影响。总平均死亡率从场外洗消和 "舀起就跑 "政策与初步分流相结合的 14.7 例死亡,到现场洗消和 "留下来玩 "政策与不进行初步分流相结合的 24 例死亡不等:我们的研究结果表明,在模拟的城市化学创伤事件中,采用现场洗消的 "留守与游玩 "方法会比采用医院洗消的 "舀起就跑 "方法导致更糟糕的结果。快速运送受害者并在现场施用解毒剂有可能挽救最多的生命,因为这样可以更快地到达医院进行最终治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Optimizing Medical Care during a Nerve Agent Mass Casualty Incident Using Computer Simulation.

Introduction: Chemical mass casualty incidents (MCIs) pose a substantial threat to public health and safety, with the capacity to overwhelm healthcare infrastructure and create societal disorder. Computer simulation systems are becoming an established mechanism to validate these plans due to their versatility, cost-effectiveness and lower susceptibility to ethical problems.

Methods: We created a computer simulation model of an urban subway sarin attack analogous to the 1995 Tokyo sarin incident. We created and combined evacuation, dispersion and victim models with the SIMEDIS computer simulator. We analyzed the effect of several possible approaches such as evacuation policy ('Scoop and Run' vs. 'Stay and Play'), three strategies (on-site decontamination and stabilization, off-site decontamination and stabilization, and on-site stabilization with off-site decontamination), preliminary triage, victim distribution methods, transport supervision skill level, and the effect of search and rescue capacity.

Results: Only evacuation policy, strategy and preliminary triage show significant effects on mortality. The total average mortality ranges from 14.7 deaths in the combination of off-site decontamination and Scoop and Run policy with pretriage, to 24 in the combination of onsite decontamination with the Stay and Play and no pretriage.

Conclusion: Our findings suggest that in a simulated urban chemical MCI, a Stay and Play approach with on-site decontamination will lead to worse outcomes than a Scoop and Run approach with hospital-based decontamination. Quick transport of victims in combination with on-site antidote administration has the potential to save the most lives, due to faster hospital arrival for definitive care.

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来源期刊
Journal of Medical Systems
Journal of Medical Systems 医学-卫生保健
CiteScore
11.60
自引率
1.90%
发文量
83
审稿时长
4.8 months
期刊介绍: Journal of Medical Systems provides a forum for the presentation and discussion of the increasingly extensive applications of new systems techniques and methods in hospital clinic and physician''s office administration; pathology radiology and pharmaceutical delivery systems; medical records storage and retrieval; and ancillary patient-support systems. The journal publishes informative articles essays and studies across the entire scale of medical systems from large hospital programs to novel small-scale medical services. Education is an integral part of this amalgamation of sciences and selected articles are published in this area. Since existing medical systems are constantly being modified to fit particular circumstances and to solve specific problems the journal includes a special section devoted to status reports on current installations.
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