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https://ir.csmu.edu.tw:8080/ir/handle/310902500/3282
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| 题名: | 台灣地區緊急醫療網責任醫院對重大災難臨時收治場所規劃研究
The Study of the Taiwan Ems Hospitals' Planning for Field Hospitals and Temporary Shelters, in the Event of a Major Disaster |
| 作者: | 周明智;周志中;楊大羽;周希諴;陳永福;何世平;林錦源
Chou, Ming-Chih;Chou, Tz-Chong;Yang, Dar-Yu;Chou, Hsi-Hsien;Chen, Yung-Fu |
| 贡献者: | 私立中山醫學院醫學研究所 |
| 关键词: | 緊急醫療救護;責任醫院;臨時收治場所;重大災難;台灣地區
Emergency medical service (EMS);Responsibility hospital;Temporary shelter;Major disaster;Taiwan area |
| 日期: | 2001 |
| 上传时间: | 2010-12-17T02:58:13Z (UTC)
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| 摘要: | 研究目的：本計畫之目的在瞭解臺灣地區各縣市緊急醫療網之責任醫院，對重大災難時如何規劃臨時收治場所，以收容來自院內及院外的大量傷病患。研究方法: 計畫施行初期為專家會商，由衛生署、消防署、營建署及醫院醫師等擬定臨時收治場所必備條件，如建築物、建材形態，與醫院的距離，交通、水、電、氣體及通訊管路的設備等收集現有國內外有資料，定一套比較合乎國情的標準，並製作一份對臨時收治場所規劃設置的細節及實務困難之問卷。計畫中程由研究小組成員會同各縣市當地緊急醫療網執行單位到各責任醫院進行實地的訪查。計畫的後段為實地訪查問卷及資料分析，並製作成報告供地方及中央規劃機構參考。主要發現：本研究共訪視經衛生署評鑑合格的緊急醫療責任醫院，其中有16家醫學中心及66家區域醫院，合計82家。當醫院遇到災害發生而迫切需要設置臨時收治場所時，綜合現況如下：大部分醫院所規劃的地點為停車場(63家，76.8%)，52家(63.4%)的場地所有權為醫院財產，僅有口頭約定或只具共識者有48家(58.5%)；63家(76.8%)醫院所規劃的場地面積在1000平方公尺以上；78家(95.1%)所規劃的場地容量在50人以上；備用發電機的的設置上，有79家(96.3%)醫院的放置點在地下室，未具移動式發電裝置者有35(42.7%)家醫院；帳篷的規劃上，有自備、或書面、或口頭約定者，只有10家(12.2%)醫院，而有7家(8.5%)醫院與軍方有合作協定，大部分受訪者均認為可利用婚喪喜慶業者的外燴式帳篷；場地書面計畫書方面，具獨立式的規劃書者有40家(48.8%)醫院，其他則與相關防災計畫共用或無；以本次研究的設計標準與評分結果，我們發現醫學中心及區域醫院的規劃平均值皆在及格邊緣(52.8-64.7分)，其中最高分與最低分均是區域醫院。結論：在我國的緊急醫療網推行屆滿十年之際，各地區責任醫院針對大量傷患處置之計畫與能力，已經具有相當的準備與加強。不過，對於醫院本身遭受災害的影響，導致無法運作之撤離，而必須建立臨時收治場所的規劃普遍不夠完備。在實際取得的資料發現，只有半數(40家)的醫院有書面的場地設置計畫。依評分發現，區域醫院得最高分的原因是全體動員與靈活性最高，不過最低分也位在此組，此與醫院人力較缺乏、以及經營者的重視程度有關。建議事項：場地的設置地點應該兼顧方便性、實用性、安全性及靈活性。而場地的功能區可事先預設如指揮中心、檢傷區、診療區、手術區、檢驗區、衛材存放與供應區、家屬休息區、浴廁區、以及供食區等，尤其是動線更需要完善的規劃。為求發揮臨時收治場所的功能，我們建議取得週遭可利用的資源，彼此預作充分的溝通與協調。醫院的各項評鑑會直接影響醫院經營者的策略與努力方向。而目前醫院的評鑑並未納入臨時收治場所，我們建議將之明定為醫院評鑑的評分項目之一，以提高各家醫院去規劃臨時收治場所的意願與重視的程度。
Objective: The purpose of this plan is to understand the emergency medical service's responsible hospitals of various cities and counties within Taiwan area that they plan to carry out providing temporary shelter to accommodate massive patients in and out of hospital. Methods: The initial phase of this plan is to consult the professional experts of health department, fire department, builders and construction agencies, and hospital doctors to discuss and to propose what the constituted a ideal temporary shelters. For instance, gathering information from domestic and international communities about building, construction materials, distance from the hospital, traffic, water, electricity, gas, and communication equipment to create a standard model that best fit for us. The middle phase is carried out by the study groups and members from every individual city or county emergency medical service-executing units for an on-site survey and evaluation. The final phase of the plan is to analyze data, make report, and to make it available to the local and central planning agencies for reference. Finding: Our study had taken on site survey and evaluation the 82 EMS responsible hospitals, included 16 medical centers and 66 regional hospitals. The present situation of those hospitals response to "hospital disaster" in setting the "temporary shelter" to care show as follows: Most of them choose the planed space are car parking lots (63 hospitals, 76.8%), 52 hospitals (63.4%) own the property, 48 hospitals (58.5%) only have oral permission or some degree of consensus to use the place; 63 hospitals (76.8%) have the place with more than 1000 m/sup 2/ in area; 78 hospitals (95.1%) have the capacity to care for more than 50 patients; About the electric power preparedness, 79 hospitals (96.3%) located at basements, 35 hospitals (42.7%) do not have portable machines to generate electric power; For the tent (shelter), only 10 hospitals (12.2%) have self-owned or documented or oral agreement, 7 hospitals (8.5%) have cooperation with military bases. Most of the hospitals prefer the special type of shelter (tent) that popular use in out-door actives; About the temporary shelter planning, there are 40 hospitals (48.8%) have independent plans, the rest all included in other disaster planning or even no record about it; The average scores of medical centers and regional hospitals by our study design and evaluation standard where located at the edge of pass (52.8 to 64.7 scores), both the higher and the lower score were distributed in regional hospitals. Discussion: In our country, the Emergency Medical Service System has been promoted for ten years already, the planning and ability of mass patient care had tremendous improvement and preparation. Within hospital disaster, under the situation of withdraw from regular working place and set up the temporary shelter for care, the preparation mostly have deficiency. The real obtain data shows that only half of hospitals (40 hospitals) have individual plans of temporary shelter. According to the evaluation scores, the regional hospitals with higher score due to their flexibility and large members' participation, the lower score also noted in this group which related to the shortage of manpower and paid less attention by the hospital. Proposition: The special place for setting temporary shelter needs the characteristics of feasibility, stability, flexibility, and safety. The functional area can be pre- |
| URI: | https://ir.csmu.edu.tw:8080/handle/310902500/3282 |
| 显示于类别: | [醫學研究所] 研究計劃
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