The Civil Aviation Administration reported that on March 21, a Boeing 737 passenger plane of China Eastern Airlines disappeared over Wuzhou while performing a flight between Kunming and Guangzhou. At present, the crash of the aircraft has been confirmed. There were a total of 132 people on board, including 123 passengers and 9 crew members. The health community interviewed Liu Zhongmin, former chairman of the Disaster Medicine Branch of the Chinese Medical Association and dean of the Institute of Disaster Medicine Engineering of Tongji University, to discuss the difficulties of first aid for the injured in air crashes, the shortcomings of China's air disaster rescue, the lack of air disaster rescue and disaster preparedness hospitals, and the shortcomings of the aviation rescue system.
Health Community: What are the characteristics of air crash victims? What are the difficulties that are unique to first aid?
Liu Zhongmin: The main performance is 4 characteristics:
1. Fall injury:
Fall injuries can not only cause damage to the limbs, but also internal organs. Compared with general traffic injuries and ordinary trauma, air crashes have more organs damaged, often resulting in the on-site death of the injured.
2. Burns:
Planes often disintegrate after they fall, and there is a risk of explosions, resulting in burns to the wounded. Burns can add to the condition of a seriously injured person and affect the doctor's judgment of first aid.
3, rescue is more difficult:
Planes sometimes crash into uninhabited mountains, and rescuers take a long time to reach the scene, reducing the chances of the wounded surviving. (Editor's note: The crash site is Moqi Village, Langnan Town, Tengxian County, Wuzhou City, Guangxi Province, close to the highway, but the staff of the emergency department of Fujian County People's Hospital said at 17:00 on the 21st that medical staff have arrived near the crash site, due to the complex terrain, rescue vehicles cannot go up the mountain and can only walk)
Especially when the weather is cold, low temperatures can cause rapid death of injured people. (Editor's note: The weather forecast shows that the local temperature was 19 degrees at the time of the incident.) According to @Guangxi Weather: At present, the cold air forward has reached the southern part of Guilin to the northern part of Hezhou, and is expected to begin to affect Guangxi Teng County in the middle of the night of the 21st. Affected by it, starting in the middle of the night of the 21st, there will be a cooling rain weather process in Fujian County, and it is expected that there will be heavy rain and localized heavy rain during the day from the evening of the 21st to the 22nd in Fujian County; on March 23, heavy rain, local heavy rain; March 24, moderate rain, local heavy rain. Relevant departments should pay attention to the adverse impact of the cooling rain and rain weather process that began in the middle of the night of the 21st on the rescue work. ）
Therefore, after the air disaster, the most important thing is how the search and rescue team members quickly arrive at the scene, which directly affects the survival chances of the injured.
4. Drowning:
If the plane falls into the water, the wounded face drowning problems. Drowning and deregulation due to low water temperature can accelerate the death of injured people.
Overall, the injuries caused by aircraft crashes are much more serious than general trauma or traffic injuries. The survival rate of the injured depends largely on the degree of blood loss, the degree of visceral damage, the time to arrive at the search and rescue site, the speed and degree of on-site rescue, and the scene environment.
Xinhua News Agency (Photo provided by Guangxi Fujian County Public Security Bureau) Aerial photograph of the surrounding area of the plane crash in Fujian County taken on March 21 (mobile phone photo).
Health sector: Retrospectively, Chinese mainland last major air crash occurred in 2010, China's civil aviation maintained a flight safety record of 4227 days, which was once the world's leading record, and now "cleared". With the low frequency of air accidents but the impact is enormous, how is the mainland's progress in terms of emergency response and reserves? Are there weak points?
Liu Zhongmin: With the improvement of disaster awareness, the mainland has strengthened emergency rescue. However, in terms of air disaster rescue, there are still many shortcomings, which are manifested in five aspects:
1. Lack of rescue tools. Air disasters often occur in remote and remote areas, and there is a lack of tools and means for aviation rescue.
2. Lack of experience in mountain rescue, especially in mountains, and includes lack of corresponding equipment.
3. Lack of professional rescue teams, especially search and rescue teams in the 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. The rescue team is not adequately trained. This remains a challenge to this day. Although there are few air crashes, the consequences are serious, and it is more necessary to have a skilled and professional rescue team to improve the survival rate of the crash victims.
Xinhua News Agency photo, Wuzhou (Guangxi), March 21, 2022 A passenger plane of China Eastern Airlines crashed The Civil Aviation Administration has activated the emergency mechanism On March 21, the police of the Fujian County Public Security Bureau in Guangxi Search and Rescue around the crash site (mobile phone photo).
Health Community: What are the most urgently needed equipment and tools today? What role does it play in the rescue?
Liu Zhongmin: The most important thing is the means of transportation, how to let the rescuers quickly arrive at the scene of the disaster?
In addition, consider how to transport rescuers and rescue tools to the scene. This requires advanced tools, such as stretchers that are both lightweight and protect the wounded.
Air disaster rescue often needs to be carried out on the spot, not only need to accompany the medical staff to have emergency capabilities, but also to carry enough rescue equipment, including oxygen, ventilators, hemostasis equipment, etc.
In addition, the injured may face heavy bleeding conditions, and equipment such as blood transfusion, bandaging, and immobilization is also required.
This requires daily preparation, daily training, to be useful in rescue.
Health community: According to the existing experience, what should the configuration and proportion of the air disaster emergency rescue medical team look like?
Liu Zhongmin: At least 1 trauma surgeon and 1 doctor with cardiac surgery ability are needed to determine the extent of heart damage of the injured person. An anesthesiologist is required to be able to complete the first aid work under anesthesia on the spot in a timely manner. It takes 3-4 nurses with aviation rescue training experience who can cooperate with doctors to carry out on-site first aid and on-the-way transport.
At least 2 surgeons, 1 anesthesiologist and 3-4 nurses form a first aid team. Usually, an emergency team can only undertake the treatment of 1-2 injured people. According to the prediction of the number of wounded, several emergency teams were dispatched to rescue them.
Health community: What should airlines do to plan for air accidents? Does the on-board rescue have the opportunity to combine with offline rescue?
Liu Zhongmin: The safe navigation of aircraft is the most important. In the event of an air disaster, it is mainly relied on external rescue forces for rescue and treatment.
After the crash, the rescue team closest to the crash site, its reaction speed and rescue ability, determine the chance of survival of the injured. Therefore, from the national point of view, it is necessary to establish a complete set of aviation disaster rescue system.
The crash was a serious injury, the chance of survival was low, and it was too late to rely on foot search and rescue. Therefore, aviation disasters should establish an aviation rescue system.
We have been advocating for the establishment of a mobile hospital composed of fixed-wing aircraft, and helicopters have cooperated to carry out aviation disaster relief.
Helicopters are responsible for rescuing the wounded from remote areas, then carrying out "emergency treatment" in mobile hospitals loaded with fixed-wing aircraft, and after the wounded are more stable, they are transferred to larger hospitals with more conditions for "final treatment". This system is suitable for both major aviation disasters and major geological disasters.
It is necessary to ensure that the wounded are "fished, saved and transported away."
Xinhua News Agency photo, Wuzhou (Guangxi), March 21, 2022 A passenger plane of China Eastern Airlines crashed The Civil Aviation Administration has activated the emergency mechanism On March 21, the police of the Fujian County Public Security Bureau in Guangxi Province searched and rescued around the crash site (mobile phone photo)
Health community: In the air disaster rescue, what kind of work should the receiving hospital do in advance?
Liu Zhongmin: In daily life, from provinces to large prefecture-level cities, there should be a disaster preparedness hospital - the ability to quickly provide disaster relief services in the event of a disaster, such as material reserves, beds vacated (50-100 beds that can accept a large number of wounded), disaster relief capabilities, centralized blood collection capabilities, operating rooms, medical equipment, etc., which can meet the diagnosis and rescue capabilities of large numbers of injured people.
Health community: In fact, the current reserves of domestic disaster preparedness hospitals are far from enough?
Liu Zhongmin: I think that this aspect still needs to be strengthened, especially the general lack of this awareness in public hospitals. Hospitals have only maintained their daily diagnosis and treatment capabilities, and many public hospitals are caught off guard in the event of a catastrophic event. Not only in the prevention and control of public health events, but also in the case of responding to disasters, our concept and construction of disaster preparedness hospitals are far from meeting the requirements of emergencies.
Health sector: According to CCTV News Weibo released at 19:26 on the 21st, after the accident, the Guangxi Health Commission sent a team of experts to the scene to organize emergency medical rescue work. Organized 12 specialists in severe, burn and orthopedic surgery to go to Fujian County to provide support. At present, the Wuzhou Municipal Health Commission has sent more than 80 medical personnel and 36 ambulances to the scene, set up rescue points at the scene, arranged first- and second-line treatment hospitals, and set up fast tracks. At 16:00 on the 21st, the staff of the emergency department of the Tengxian People's Hospital of Guangxi Zhuang Autonomous Region told the Beijing News that the hospital has successively sent 4 ambulances to the site of the incident. At 15:54, members of the emergency department received an urgent notification within the working group. At 16:02, according to CCTV News Weibo, the rescue team had gathered and was approaching. In a catastrophic rescue, what should the connection between medical rescue and fire rescue look like?
Liu Zhongmin: At present, we still have firefighters as the main rescue force, and we lack a cooperation mechanism with the medical system and drills.
Firefighters do not understand medical treatment, let alone the ability to rescue complex trauma. It is often after the firefighters arrive at the scene to pull people out, but because of the lack of on-site treatment and medical assessment, the injured actually lose some chances of survival.
I think this is a lack of institutions and institutions. Not only in this incident, but also in many catastrophic events, firefighters take the lead, but the medical staff lacks cooperation with firefighters, and also lacks the mechanism to extend the emergency scene forward beyond the hospital.
So this tends to reduce the survival rate of the wounded, especially in air crashes.
Health Community: So you think the first rescue teams to arrive at the scene must have medical staff? Whether there are survivors or not, there have to be medical personnel, right?
Liu Zhongmin: Yes.
Author: And the stars
Producer: Zheng Yujun
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