优化大规模伤亡选:使用离散事件模拟来最大限度地减少恢复生命的时间
Noah M Igra1,2, Daniela Schmulevich3, Zhi Geng1
1From the Department of Surgery, Division of Traumatology, Surgical Critical Care & Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA (Igra, Geng, Cannon).
Journal of the American College of Surgeons
|October 23, 2023
概括
一个模拟发现,使用医院血液供应数据进行大规模伤亡事件 (MCI) 选改善了患者治疗时间. 这种以供应为导向的方法超过了最近的医院分拣,突出了需要数据驱动的灾难应对计划.
科学领域:
- 紧急医疗 紧急医疗
- 应对灾害的应对措施
- 卫生系统研究 卫生系统研究
背景情况:
- 城市紧急医疗服务越来越专注于大规模伤亡事件 (MCI) 响应.
- 医院前分类策略对于有效的MCI管理至关重要.
- 优化患者流动和治疗启动是一个关键的挑战.
研究的目的:
- 在大规模伤亡事件 (MCI) 中模拟医院前分拣场景.
- 评估是否使用医院血液产品库存进行现场分拣决策,尽量减少治疗的时间.
- 为了比较不同选策略的有效性.
主要方法:
- 离散事件模拟模拟MCI伤亡伤害和模拟爆炸事件后的患者流动.
- 伤亡被分类为中度 (伤害严重程度评分9-15) 或严重 (伤害严重程度评分>15).
- 他们比较了三个分拣场景:最近的,平等的分布和供应导向 (使用血液库存).
主要成果:
- 模拟的MCI平均造成302人伤亡,其中57人中度伤亡,15人严重伤亡.
- 供应导向策略 (91%) 和平等分配策略 (86%) 在目标时间框架内治疗伤亡者时显著超过了最接近的分拣 (55%) (p < 0.001).
- 差异主要是由中度伤亡造成的;严重伤亡治疗时间在各个策略中是相似的.
结论:
- 在MCI模拟中,最接近的医院分组低于平等分配或供应导向策略.
- 应对灾难的领导人应该模拟MCI场景,考虑医院容量和血液产品的可用性.
- 由实时库存提供信息的供应导向分类,提供了一种优越的方法来优化大规模伤亡事件期间的患者护理.
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