The Civil Aviation Administration of China reported that on March 21, a Boeing 737 of China Eastern Airlines lost contact over Wuzhou during the Kunming-Guangzhou flight. The plane has now been confirmed to have crashed. There were 132 people on board, including 123 passengers and 9 crew members. The health community interviewed Liu Zhongmin, the former chairman of the Disaster Medicine Branch of the Chinese Medical Association and the director of the Institute of Disaster Medicine Engineering of Tongji University, on the difficulties of first aid for air crash casualties, the shortcomings of China’s air crash rescue, the lack of air crash rescue and disaster preparedness hospitals, and the air rescue system. Not enough to discuss.
Health World: What are the characteristics of air crash victims? What is the unique difficulty of first aid?
Liu Zhongmin: There are four main characteristics:
1. Fall injury:
Fall injuries can cause damage not only to the extremities, but also to internal organs. Compared with ordinary traffic injuries and ordinary trauma, air crashes have more damaged organs, which often quickly lead to on-site death of the injured.
2. Burns:
Aircraft often disintegrates after a fall and can explode, causing burns to the casualty. Burns will aggravate the condition of the wounded and affect the doctor’s first aid judgment.
3. Rescue is more difficult:
Aircraft sometimes crashes into uninhabited mountains, and it takes a long time for rescuers to arrive at the scene, reducing the chance of survival for the wounded. (Editor’s note: The crash site was Mojiankaodong, Nianjuan, Langnan Town, Tengxian County, Wuzhou City, Guangxi. Due to the complex terrain, rescue vehicles cannot go up the mountain, but can only walk there)
Especially in cold weather, low temperatures can cause rapid death. (Editor’s note: The weather forecast shows that the local temperature was 19 degrees at the time of the incident. According to @GuangxiWeather: At present, the front of the cold air has reached the southern part of Guilin and the northern part of Hezhou, and it is expected to affect Teng County, Guangxi Province in the middle of the night on the 21st. As a result, there will be a cooling and rainy weather process in Teng County from the middle of the night on the 21st. It is expected that there will be heavy rain in Teng County from the evening of the 21st to the 22nd, and there will be heavy rain in some places; on March 23, there will be heavy rain and heavy rain in some places; On the 21st, it rained moderately, and there was heavy rain in some places. Relevant departments should pay attention to the adverse impact of the cooling and rainy weather process that began in the middle of the night on the 21st on the rescue work.)
Soafter the air is difficult, the most important thing is how quickly the search and rescue team arrives at the scene, which directly affects the survival rate of the wounded.
4. Drowning:
The casualty also faces drowning problems if the plane falls into the water. Both drowning and hypothermia from hypothermia can accelerate casualties.
In general, plane crashes are far more serious than normal trauma or traffic injuries. The survival rate of the wounded depends to a large extent on the degree of blood loss, the degree of visceral damage, the time to arrive at the search and rescue scene, the speed and extent of on-site rescue, and the scene environment.
Published by Xinhua News Agency (Photo provided by Guangxi Teng County Public Security Bureau) on March 21 Surroundings of the Fuji County plane crash (mobile phone photos).
Health sector: Looking back, the last major air accident in mainland China occurred in 2010, and China’s civil aviation has maintained 4227days flight safety record, which was once the world’s leading record, is now “zero”. The frequency of air accidents is low but the impact is huge. How is my country’s progress in emergency response and reserves? Are there weak points?
Liu Zhongmin: With the improvement of disaster awareness, our country has strengthened emergency rescue. However, There are still many shortcomings in air disaster rescue, which are reflected in five aspects:
1. Lack of rescue tools. Air crashes often occur in remote and remote areas, where there is a lack of air rescue tools and means.
2. Lack of experience in mountain rescue, especially alpine rescue, including lack of appropriate equipment.
3. Lack of professional rescue teams, especially search and rescue teams in deep mountains.
4. The daily disaster preparedness measures are not perfect, and how to quickly mobilize forces to the disaster relief site in a short period of time is also a shortcoming.
5. Insufficient training of rescue teams. This is still a challenge. Although air crashes are rare, the consequences are serious, and skilled and professional rescue teams are needed to improve the survival rate of the crash victims.
Photo by Xinhua News Agency, Wuzhou (Guangxi), March 21, 2022 China Eastern Airlines The Civil Aviation Administration has activated the emergency mechanism on March 21, and the police of the Guangxi Teng County Public Security Bureau searched and rescued around the crash site (mobile phone photo).
Health World:What are the gear and tools most needed right now? What role did it play in the rescue?
Liu Zhongmin: The most important thing is the means of transportation. How to get rescuers to the disaster site quickly?
In addition, consider how rescuers and rescue tools will be transported to the scene. This requires advanced tools, such as stretchers that are both lightweight and protect the casualty.
Air crash rescue often requires first aid at the scene. Not only the accompanying medical staff must have first aid capabilities, but also sufficient rescue equipment, including oxygen, ventilator, and hemostatic equipment.
In addition, the wounded may face severe bleeding and require equipment such as blood transfusions, bandaging, and immobilization.
This requires daily preparation, daily training, to be useful in rescues.
Health sector: According to the existing experience, what should be the configuration and proportion of the air disaster emergency rescue medical team?
Liu Zhongmin: At least 1 trauma surgeon and 1 doctor with cardiac surgery ability are needed to judge the degree of cardiac injury of the wounded. An anesthesiologist is required, who can complete the first aid work under anesthesia on the spot in time. 3-4 nurses with experience in aviation rescue training are needed, who can cooperate with doctors to carry out on-site first aid and transfer on the way.
At least 2 surgeons, 1 anaesthetist, and 3-4 nurses form an emergency team. Usually a first aid team can only undertake the treatment of 1-2 wounded. Then according to the prediction of the number of wounded, several emergency teams were dispatched to rescue.
Health community: What should airlines do to prepare for air crashes? Is there a chance to combine on-board rescue with offline rescue?
Liu Zhongmin: The safe navigation of the aircraft is the most important. In the event of an air crash, it is mainly relied on external rescue forces for treatment.
After a plane crash, the response speed and rescue ability of the rescue team closest to the crash site determine the survival probability of the wounded. Therefore, from a national perspective, it is necessary to establish a complete set of aviation disaster relief system.
The casualties of the crash are heavy and the probability of survival is low. It is too late to search and rescue on foot. Therefore, it is necessary to establish an aviation rescue system for aviation disasters.
We have been advocating the establishment of a mobile hospital composed of fixed-wing aircraft, in cooperation with helicopters, to carry out aviation disaster relief.
Helicopter is responsible for rescuing the wounded from remote areas, and then “emergency treatment” is carried out in the mobile hospital loaded by fixed-wing aircraft, and after the wounded is stabilized, it is transported to a better condition. Large hospitals carry out “final treatment”. This system is applicable to major aviation disasters and major geological disasters.
Be able to ensure that the wounded are “fished, saved, and transported.”
Photo by Xinhua News Agency, Wuzhou (Guangxi), March 21, 2022 China Eastern Airlines The Civil Aviation Administration has activated the emergency mechanism for the crash of the passenger plane. On March 21, the police of Guangxi Teng County Public Security Bureau searched and rescued around the crash site (mobile phone photo)
Health Industry: What kind of work should the receiving hospital do in advance in the air crash rescue?
Liu Zhongmin: Everyday, from a province to a large prefecture-level city, there should be a disaster-preparation hospital—the ability to quickly provide disaster-relief services in the event of a disaster, such as material reserves, bed vacancy (50 Zhang-100 beds that can accept a large number of wounded), disaster rescue capabilities, centralized blood collection capabilities, operating rooms, medical equipment, etc., can meet the diagnosis and rescue capabilities of a large number of wounded.
Health sector: In fact, the current domestic disaster preparedness hospital reserves are far from enough?
Liu Zhongmin: I think there is still room for improvement in this regard, especially public hospitals generally lack this awareness. The hospital only maintains the daily diagnosis and treatment capacity. Once a catastrophic event occurs, many public hospitals are caught off guard. Not only in the prevention and control of public health events, but also in response to disasters, Our concept and construction of disaster preparedness hospitals are far from meeting the requirements of emergency response.
Health Industry: According to CCTV News Weibo21Sunday19< strong>hours26released. After the accident, Guangxi Health and Health Commission dispatched an expert team to the scene to organize emergency medical rescue work immediately. Organized 12 experts in severe, burn and orthopedic surgery to go to Teng County for support. At present, the Wuzhou Municipal Health Commission has dispatched 80a number of medical staff and 36ambulances to the scene. , Set up rescue points on the scene, arrange first- and second-line treatment hospitals, and set up fast lanes. 21Sunday16, the staff of the emergency department of Tengxian People’s Hospital of Guangxi Zhuang Autonomous Region told the Beijing News reporter, The hospital has successively dispatched4ambulances to the site of the incident. 15hours54minutes, the emergency department members received an emergency notification in the work group. At 16:02, according to CCTV news Weibo, the rescue team has assembled and is approaching. In catastrophic rescue, what should the connection between medical rescue and fire rescue look like?
Liu Zhongmin: We still rely on firefighters as the main rescue force, and usually lack a cooperation mechanism to cooperate with the medical system and conduct drills.
Firefighters do not understand medical care, let alone the ability to rescue complex trauma. Often, after the firefighters arrive at the scene and pull people out, because of the lack of on-site treatment and medical evaluation, the wounded actually lose some chances of survival.
I think this is a mechanical and institutional flaw. Not only this incident, but also in many catastrophic incidents, the firefighters took the lead, but the medical staff lacked the cooperation with the firefighters, and also lacked a mechanism to extend the emergency scene beyond the hospital.
So this tends to reduce casualty survival, especially in air crashes.
Health community: So you think the first rescue team to arrive at the scene must have medical personnel? Whether there are survivors or not, there must be medical staff, right?
Liu Zhongmin: Yes.
Written by: And Stars
Producer: Zheng Yujun
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