军区总医院应急医学救援模块化研究

【作者】 高鸿雁；

【导师】 陈俊国；

【作者基本信息】 第三军医大学 ， 社会医学与卫生事业管理， 2009， 博士

【摘要】 近年来,随着国家利益的拓展和经济社会的发展,我国既面临难得的发展机遇期,也正处于社会矛盾多发期。境内外敌对势力加紧进行渗透破坏,恐怖主义趋于国际化,民族分裂主义和宗教问题可能成为恐怖活动和动乱的根源。传染病流行、食物中毒屡见不鲜,给社会生活秩序、国民经济发展、公民健康带来巨大影响。同时,由于我国自然地理环境的特殊性,洪涝、地震、地质和海洋灾害频发,给国民经济建设和人民群众的财产安全构成严重威胁。为此,国家提出“军民结合、寓军于民”的方针,要求建立军民一体的应急医学救援体系,健全应急反应机制,做好一切应急准备,实行军民联防联控。军队医院作为国家应急医学救援体系中的一支重要力量,不仅承担军队战时医疗保障和平时医疗服务任务,而且越来越多地承担起地方突发事件的应急医学救援任务。由于保障范围扩大,保障内容增多,医疗需求多变,医院的应急救援任务具有不确定性和多样性:既要做好医疗救治应急准备、实施军队伤病员分级救治和军人医疗保健,还要积极参与国家、地方突发公共卫生事件、重大自然灾害、暴力事件及事故灾难的应急医学救援工作。因此,军队医院必须灵活组织保障,进行模块化抽组,建立完善应对多种安全威胁、完成多样化任务的医疗保障体系,改善卫生装备,提高机动能力,以适应多任务的需要。模块化是指在特定的系统中建立模块和运用模块的活动。应急医学救援模块化是在军队应急医学救援系统中建立模块和运用模块的活动。即采取“系统分解→规范模块→模块组合→模块运用”的一系列措施和方法来改造和重建应急医学救援系统,改善系统功能和效益,使军队应急医学救援系统具有多适应性的一种组织活动。应急医学救援模块化的基本目标是追求“1+1>2”的功效,与以往的编组相比,其合成的程度更高,层次更多,方法更活。本研究以军区总医院抽组的野战医疗所、专科手术队、急救医疗队(一所两队)为基础,借鉴模块化原理,结合近年来遂行的非战争军事行动应急医学救援(保障)实践经验,采用专家咨询法,建立了应急医学救援基本医疗模块库,包括基本医疗模块、辅助医疗模块、防疫防护模块、适应模块、组织指挥模块5种一级模块,12种二级模块,37种三级模块。在此基础上,请专家就军区总医院近年来承担的主要应急医学救援任务进行了筛选,构建了5种任务模块:反恐维稳医疗保障模块、抢险救灾医学救援模块(包括抗洪抢险医疗保障任务模块、抗震救灾应急医学救援任务模块、扑火救灾医疗保障任务模块)、突发公共卫生事件应急医学救援任务模块、安保警戒医疗保障任务模块和国际维和医疗保障任务模块。军区总医院应急医学救援模块化编组,实现了各专业的合成化,系统性增强,对于提升医院应急救援系统的功能,增强应急救援系统的灵活性,促进应急医学救援系统的高效使用,提高管理效能,具有较好的理论指导和实践意义。有助于医院应急医学救援建设向一体化方向发展1,统一规划医学救援组织、所需装备,做到成套论证、成套研制、成套生产、成套装备,达到互联互通、互相支援、互相保障的目的,提高与其他部队接轨的能力,增强适应性。更多还原

【Abstract】 In recent years, with China’s economic and social development and the expansion of national interests, China is faced with not only rare opportunities for development, but also in a period of social conflict-prone. Domestic and foreign hostile forces have stepped up to the infiltration and sabotage, terrorism is becoming more and more international, and national separatism and religious issues could be the root cause of terrorist activities and unrest. Prevalence of infectious diseases, food poisoning happened time and time again.The prevalence of infectious diseases of unknown causes may bring about many huge negative influences to the order of social life, development of national economy , and the health of the citizens. At the same time, due to the unique natural geographical environmental factors of China,it occurred quite frequently with floods, earthquakes, geological and marine disasters. All of them pose a grave threat to the national economic construction and the security of people’s property. Therefore, the authority has raised a policy of " uniting the army with the people, having reserve soldiers among the people " and called for the establishment of emergency medical rescue system integrating military and civilian, Improving the emergency response mechanism, to take all emergency preparedness, to carry on the implementation of joint defence and joint control of combining military with civilian.As an important force of the national emergency medical rescue system, military Hospitals not only shouldered the protection of the armed forces in wartime and medical mission of medical services in peacetime, but also shouldered more and more emergency medical rescue missions of local incidents. As a result of extending the scope of safeguard, increase of social security contents, and varied medical needs. The emergency rescue mission of hospitals had the diversity of uncertainty: it is necessary to do a good job in the medical treatment of emergency preparedness, the implementation of classification with the sick and wounded troops and military health care, but also active participation in national, local public health emergencies and major natural disasters, violent incidents and accident emergency medical rescue work. Therefore, the military organization must be flexible to protect the hospital to carry out modular pumping groups, establish a medical security system which can do perfect response to a variety of security threats and to complete various tasks.In this way,we can improve the medical equipment to enhance mobility in order to adapt to the needs of multi-tasking.Modularization refers to the establishment of a specific system modules and application modules activities. The emergency medical rescue modular is the establishment of the system modules and application modules activities in the army. That is, it’s a kind of activity to adopt a series of measures and methods of "system decomposition→Module specification→Modules Combination→Modules application" to reform and reconstruct the emergency medical rescue system, to improve system functionality and efficiency. Which can ensure the military emergency medical rescue system have a number of adaptabilities. The basic target of Emergency medical rescue modular is the the effectiveness of pursuit of the "1 +1> 2" . Compared with the past, this kind of organization has higher degree of synthesis, and more levels, and more flexible methods.In this study, drawing on the modular principle, based on the medical field pumping Group, the specialist surgical teams, emergency response unit (a health-center and two teams) drafted from Military Region General Hospital and combining the recent years’experience of the emergency medical rescue in non-war military operations, it adopts expert advice methods, and establishes emergency medical rescue basic medical module library, including basic health care modules, para-medical modules, immunization protection module, adaptation modules, Altogether 5 kinds of first-class modules, 12 kinds of second-class modules, 37 kinds of three-class modules.On this basis, I invited experts to filter on the main emergency medical rescue missions assumed by Military General Hospital in recent years, and build five kinds of task modules: anti-terror modules of maintaining social stability, emergency rescues and disaster relief work module (including the medical insurance modules in flood fighting and rescue tasks, emergency medical modules in earthquake relief mission, the medical insurance modules in fire disaster relief tasks), emergency medical rescue mission modules in unexpected public health incidents, medical protection module in safety security alert and the health insurance module in international peacekeeping missions.The emergency medical rescue organization modular of Military General Hospital achieves a synthesis of various professions, strengthened its systematicness. It has a good theoretical guidance and practical significance to enhance the functionality of emergency rescue system of hospital, enhance the flexibility of emergency rescue system and to promote efficient use and improve the effectiveness of management in emergency medical rescue system. It can contribute to the construction of integration of hospital emergency medical relief, unified planning of medical and rescue organizations, the necessary equipment to ensure complete verification, complete the development, production sets, complete sets of equipment, to achieve the purposes of interoperability, mutual support and mutual protection. And enhancing the capacity of integrating with other forces to improve adaptability.更多还原