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灾难医学

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在灾难时如何拯救最多的生命?
原作者: Andrea Tenner,肖锋译 文章来源: 中华急诊医学杂志编辑部 发布日期:2013-03-11

Title: Saving lives in a disaster
题目:在灾难时如何拯救最多的生命
Author 作者: Andrea Tenner

Background Information 背景资料:
Ever wonder what you would do if you were the first on scene after the earthquake in Haiti or in the Superdome as Hurricaine Katrina survivors started to arrive? How could you save the most lives? As is typical of emergency medicine, blood and gore tend to get the most attention, but if you want to save lives you have to think about what is the greatest life threat.  In a large-scale disaster, it turns out, lack of water and abundance of feces kill the most, the fastest and need to be addressed first.
你想过没有,如果你是在海地地震后第一个到达现场或看到第一批卡特里娜(Katrina)飓风生存者进入Superdome,你会做什么?你如何才能抢救最多的生命?与急诊医学典型例子一样,血和血块容易得到最多的注意力,但是你如果要抢救生命,你必须要考虑什么是最威胁生命的。在发生大规模灾难时,实际上缺水和太多的粪便将在第一时间内夺去最多的生命,需要第一时间解决。
The Sphere Proj:ect Handbook 全球计划手册:

-one of the core documents of humanitarian response
人类救援反应的关键文件之一
-outlines what should be done to save the most lives in the first days, weeks, and months of a disaster.
描述了在灾害的第一天,第一周,和第一月内如何拯救最多的生命
-available free online (see reference below)
可在网上免费查到(见下面的参考文献)

Pertinent Conclusions: (need-to-know recommendations for the first few days)
有关的结论(前几天内需要知道做什么的建议):

-Water: 15L/person/day (any quality--sanitize as per our previous pearl)
水:每人每天15升(任何质量-按前面的必知进行解毒处理)
-Latrines: max 20 people/latrine, <50m from dwellings, >30m from water sources
厕所:最多每20个病人一个厕所,离住处50米内,离水源30米外
       -What kind? 什么样的?
             -First 2-3 days: demarcated defecation area
在头2-3天:划定排粪区域
             -days-2 months: trench latrines (shallow trenches to defecate in)
几天-2月:挖出厕所(排便的浅沟)
Other hygiene 其它卫生方面:
-Solid waste disposal: one 100L refuse container/10 households, emptied at least 2x/week
固体废物处理:每10家要有一个100升的废物桶
-Dead bodies: dispose of according to local custom. Generally not an immediate source of infection
尸体:根据当地习俗处理,一般来说不是立即感染的原因
-Shelter: >3.5 sq. meters/person of covered floor space
庇护所:平均每人要有至少3.5平米覆盖的地面面积

Bottom Line 要点:
People's need for water and defecation will not stop in a disaster and too little water and too much excrement are the greatest immediate life threats to disaster survivors. Plan to deal with these early to save the most lives.
人对水和排便的需求并没有因为灾难的发生而停止,对灾害生存者来说,太少的水和太多的排泄物是最大最快的危及生命的因素。
References 参考文献
The Sphere Project. Sphere Handbook: Humanitarian Charter and Minimum Standards in Disaster Response, 2011, 2011, ISBN 92-9139-097-6, available at: http://www.sphereproject.org/handbook/

文章来源:中华急诊医学杂志编辑部