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1、CHAPTER25THESURGEON’SROLEINMASSCASUALTYINCIDENTSAsherHirshbergandMichaelSteinmedicalresponsetocivilianmasscasualtyincidentsanddisasterskeyconceptsfromtheperspectiveoftheclinicalsurgeonpracticinginahos-masscasualtyandmoderntraumasystemspitalthatispartofamoderntraumasystem.clinicalaspectsof
2、hospitaldisasterplanssurgeon’sroleinnaturaldisastersKEYCONCEPTSblasttrauma:clinicalpatternsandsystemimplicationsconclusionClassificationofDisastersandImplicationsforTraumaCareInamasscasualtyincident(MCI),amedicalsystemissuddenlyInthepastdecade,therehasbeenasurgeofinterestamongconfrontedby
3、alargenumberofcasualtiesneedingcarewithinsurgeonsinthemedicalconsequencesofmasscasualtyincidentsashortperiodoftime.Thisunexpectedsurgecreatesadiscrep-andciviliandisasters.Themegaterroristactsof9/11focusedancybetweenthenumberofpatientsandtheresourcesavailableattentiononthewaveofurbanterror
4、ismthatissweepingacrosstotreatthem.AnMCIcanbeclassifiedbycause(naturalversustheglobe,causingtensofthousandsofcasualtieseachyearandman-made),duration,location,andmanyothercharacteristics,challengingtraumaandemergencysystemsfromNewYorktobutthereisnosingleuniversallyacceptedclassificationofd
5、isas-BaliandfromMadridtoMumbai.Atthesametime,aseriesofters.Fromtheclinicalperspectiveofmedicalcare,itisimportantlarge-scalenaturaldisasters,suchasthe2004tsunamiinSouth-todistinguishamongthreeclassesofdisasterscenariosand1,2eastAsia,whichclaimedalmost250,000livesin10countries,understandthe
6、implicationsfortraumacare(Table25-1).andHurricaneKatrina,whichdevastatedNewOrleansinAugust2005,helpedfocuspublicattentiononthemedicalMultipleCasualtyIncidentsconsequencesofnaturalcatastrophes.AsthischapterisbeingTheseinvolvedozensofcasualtiesandcanbeeffectivelymanagedwritten,thehorribleco
7、nsequencesoftheHaitiearthquakeinusinglocalhospitalresources.Inotherwords,thearrivingcasu-January2010arebecomingclearandtheuniquechallengesaltiesstrainthehospitalresourcesbeyondnormaldailyopera-facingmedicalteamsandotherreliefworkersarethecenteroftions,butdonotoverwh