摘要
目的了解目前全世界范围内大规模伤亡事件伤员分类方法及应用情况,为今后实施大规模伤员分类和制定统一分类方法提供参考。方法借鉴系统评价的原理和方法,系统收集MEDLINE(1950～2008),Cochrane图书馆(Issue 2,2008)和CBM(创刊至2008年5月)数据库的中英文文献并分大规模伤亡事件伤员分类和地震伤员分类两类,提取大规模伤员分类方法的名称、等级次序、分类依据、主要特点及应用情况,提取地震伤员分类实施地点、实施人员、等级次序、方法特点,比较不同分类标记方法的颜色、代码和标记材料。结果最终纳入英文文献38篇,中文文献6篇。大规模伤员初级分类方法7种,均分4个等级,3种方法有文献报道应用情况;二次分类方法6种,分3～5个等级,未见文献报道应用情况。分类结果标记方法4种。地震伤员分类7个实例,2次发生在中国,均为二次分类。结论目前缺乏经信度和效度验证并普遍接受的大规模伤员分类方法,且未明确说明适用于所有大规模伤亡事件。未见专门针对地震伤员的分类方法,地震伤员分类实例与大规模伤亡事件伤员分类有很大差异。有待进一步研究大规模伤员分类方法的信度和效度,提供可靠依据,提高医学救援能力。
Objective To investigate the mass casualty triage system and its application, to provide evidence and advice for its future standardized use. Method Based on the principles and methods of systematic reviews, we searched MEDLINE （1950 to 2008）, The Cochrane library （Issue 2, 2008） and CBM （from establishment to May 2008） to identify papers written in English of Chinese which described mass casualty triage systems or triage systems specific to the aftermath of earthquakes. We extracted information on name, grades, criteria, main characteristics and application of each triage system from the papers involving mass casualty triage systems. We also extracted information on setting, personnel performing the triage, grades, and characteristics from those papers describing any specific triage system for earthquake. We compared the colour of tags, codes and other materials used in different triage systems. Result We included 38 English and 6 Chinese papers. For mass casualty triage systems, we identified 7 primary triage methods with 4 grades.Three of these had relevant application reports. There were 6 secondary triage methods with 3-5 grades, and none had relevant application reports. Four tag methods were identified. Seven papers, 2 of which were published in China, reported specific secondary triage methods for earthquakes. Conclusion Based on the current evidence, there is no universally accepted mass casualty triage system with documented reliability and validity. No triage system has been developed specifically for the wounded in earthquakes. There are large differences between the triage methods for earthquake and other mass casualty incidents. Future research should focus on the development of a reliable and valid mass casualty triage system, aimed at maximizing the capacity for medical rescue.
出处
《中国循证医学杂志》
CSCD
2008年第7期469-476,共8页
Chinese Journal of Evidence-based Medicine
