Population-based triage management in response to surge-capacity requirements during a large-scale bioevent disaster
Population-based triage management in response to surge-capacity requirements during a large-scale bioevent disaster
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DOI：
10.1197/j.aem.2006.06.040
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发表时间：
2006-11-01
影响因子：
4.4
通讯作者：
Burkle, Frederick M., Jr.
中科院分区：
文献类型：
--
作者：
Burkle, Frederick M., Jr.
生物剂在人群中的自然发生和故意释放都可能带来灾难性后果。虽然这些生物事件与其他灾害有相似之处，但也有重大差异，特别是在对激增能力资源进行分类管理的方法方面。传统的大规模伤亡事件使用统一的方法，根据表现的严重程度进行分类，而不考虑暴露、持续时间或传染性，从而阻碍了对传播的控制，并延迟了对需要立即护理的受害者的识别。生物事件分类管理必须以人群为基础，目标是从接触点开始预防二次传播，以控制流行病的爆发。无论使用何种分类系统，它必须首先认识到那些易感但未暴露的人、那些暴露但尚未传染的人、那些传染的人、那些因死亡或康复而被移除的人以及那些受疫苗接种或预防性药物保护的人（SEIRV方法）的要求。人口中的每个人福尔斯这五类之一。本文讨论了一个人口的方法，SEIRV为基础的分诊，决策福尔斯下的两个阶段的系统与具体措施的有效性，以增加医疗成功的可能性，流行病控制，和稀缺资源的保护。
Both the naturally occurring and deliberate release of a biological agent in a population can bring catastrophic consequences. Although these bioevents have similarities with other disasters, there also are major differences, especially in the approach to triage management of surge capacity resources. Conventional mass-casualty events use uniform methods for triage on the basis of severity of presentation and do not consider exposure, duration, or infectiousness, thereby impeding control of transmission and delaying recognition of victims requiring immediate care. Bioevent triage management must be population based, with the goal of preventing secondary transmission, beginning at the point of contact, to control the epidemic outbreak. Whatever triage system is used, it must first recognize the requirements of those Susceptible but not exposed, those Exposed but not yet infectious, those Infectious, those Removed by death or recovery, and those protected by Vaccination or prophylactic medication (SEIRV methodology). Everyone in the population falls into one of these five categories. This article addresses a population approach to SEIRV-based triage in which decision making falls under a two-phase system with specific measures of effectiveness to increase likelihood of medical success, epidemic control, and conservation of scarce resources.