China is subject to several of the world’s most serious disasters and accidents. Especially in recent years, with the occurrence of many severe disasters, such as the Wenchuan earthquake, the Yushu earthquake, and the influenza A (H1N1) outbreak, Chinese state and local governments have been paying more attention to the creation of emergency medical rescue forces and corresponding equipment systems. In 2012, 22 state-level health emergency response teams were formed in China. Their responsibilities can be divided into emergency medical rescue, acute infectious disease control and prevention, emergency poisoning accident treatment, and emergency treatment for nuclear and radiation accidents. Additionally, corresponding rescue vehicles and equipment, such as operation vehicles, outpatient service vehicles, medical technical support vehicles, and equipment loader vehicles, have been assigned to every rescue team.Reference Yu, Shan and Wei 1 The equipment and treatment capacity is equivalent to a second-class hospital in China.
In 2009, China enacted the Law of the People’s Armed Police Forces (PAP), which clearly stipulates that emergency rescue and disaster relief should be one of the main tasks of the PAP. To strengthen the construction of the whole country’s emergency rescue capabilities, the State Health Ministry and the PAP published a joint-mandated document in 2011, which officially brought the PAP’s emergency medical rescue team into the national disaster medical rescue system.Reference Yu, Bai and Zhang 2
With the variety of large-scale disasters that occur frequently in China, the PAP will undertake increasingly frequent and diversified rescue tasks. The existing medical emergency equipment has certain shortcomings with respect to degree of integration, flexibility, and systemic use and has been unable to effectively meet the requirements of onerous medical service support.Reference Tan, Zhao and Duan 3 Therefore, the relevant departments of the PAP have attached great importance to the construction of professional medical rescue and support equipment in recent years. In light of changes in society and disaster awareness, the mobile rescue hospital system described in this article was successfully developed to provide more appropriate medical rescue equipment, to realize the integrated transport of rescue personnel and equipment, to form a treatment system composed of rescue vehicles combined with tents, and to further promote the development of the PAP’s emergency medical equipment system.
GENERAL OVERVIEW
This mobile rescue hospital system is primarily composed of 8 to 10 professional emergency medical and support vehicles, 3 to 4 frame-type health tents (approximately 30 m2), and a series of advanced medical equipment. The system is characterized by significant integration, rapid response, flexibility, and practicability. The vehicles primarily include field ambulances, surgery and inspection shelter vehicles, medical supply loader vehicles, medical service command and camping vehicles, epidemic prevention vehicles, self-propelled kitchen trucks, water transport and purification vehicles, and transport vehicles (Figure 1). Among these vehicles, the plans for the medical service command and camping vehicle, the surgery and inspection shelter vehicle, and the medical supply loader vehicle were approved in 2010, and the vehicles were successfully developed by 2012 by the Affiliated Hospital of the Logistics University of the PAP. The vehicles are mass produced and equipped for all of the PAP’s provincial-level emergency medical rescue teams. These vehicles have effectively improved the rescue capability of each rescue team.
Figure 1 Deployment Diagram of the Mobile Rescue Hospital System.
FUNCTIONAL LOCALIZATION
As a new emergency medical support platform for the PAP’s provincial-level emergency medical rescue teams and the corresponding emergency medical rescue teams, the system can be used to perform 3 types of tasks. First, the system can provide the army’s own health service support when the PAP is in the process of handling emergencies, maintaining social stability, and performing defensive combat missions. Second, the system can offer emergency medical rescue service for disaster-stricken areas after large-scale domestic disasters or accidents. Third, the system can provide medical inspection and diagnosis to the people of remote or poor areas in China.
The system can be assembled as a temporary medical aid station that can provide 20 beds and treat 100 wounded patients every day within an area of approximately 1200 m2. In principle, the system should not be employed for more than 1 month. However, according to the actual needs of a specific medical rescue task, any vehicles, tents, and medical equipment within this system can be rapidly drafted to realize the system’s rapid mobility and modular combination.
MAIN RESCUE VEHICLES
Medical Service Command and Camping Vehicle
The medical service command and camping vehicle is equivalent to a mobile camp and command post, and its design was based on the People’s Liberation Army camp bus. The vehicle adopts the body of a half-loaded bus and is primarily equipped with many foldable seats, a maritime satellite phone, a vehicular short-wave radio system, a single pawn knapsack communication terminal, handheld radio equipment, and other communications equipment, which allow the vehicle to perform its functions of communication and command, transportation of rescuers and emergency materials, and temporary camping (Figure 2A). The vehicle can transport 29 rescuers (including 1 driver) and their personal rucksacks and inflatable mattresses at one time. The vehicle adopts a double-expansion-type cabin body, and the unfolded cabin area is approximately 45 m2, which can meet the camping needs of 33 people and can greatly improve the rescue team’s camping conditions.Reference Lu, Fan and Fan 4
Figure 2 Appearance of the Main Rescue Vehicles. (A) Medical Service Command and Camping Vehicle. (B) Surgery and Inspection Shelter Vehicle. (C) Medical Supplies Loader Vehicle. (D) Field Ambulance.
Surgery and Inspection Shelter Vehicle
The vehicle consists of a 4.5-m double-expansion cabin and a military off-road vehicle chassis, which is primarily used for fixing and carrying related equipment and facilities, such as operation and inspection equipment and heating and sterilization devices (Figure 2B). When the cabin of the vehicle unfolds, it can form an operation shelter and an inspection shelter (approximately 26 m2 area). In addition, an affiliated preoperative tent can be unfolded (approximately 23 m2 area) and is connected to the back door of the cabin. Therefore, the vehicle effectively realizes the integration of surgery and inspection functions, and it can simultaneously support 1 surgical operation and biochemical, blood, and urine testing.Reference Fan, Lu and Fan 5 The surgery vehicle can support many emergency surgeries, such as tracheotomy, decompression craniotomy, debridement, surgical hemostasis, and reduction of fracture.
Medical Supply Loader Vehicle
The medical supply loader vehicle is equivalent to a mobile equipment storeroom and is formed by a 4.5-m large-sheet square cabin body and a military off-road vehicle chassis of a Dongfeng EQ2102, which is mainly used for the storage and transportation of medical equipment, epidemic prevention equipment, and sanitary tents (Figure 2C). Under nonemergency conditions, the vehicle can be used instead of a warehouse; in a war or disaster rescue, the vehicle can leave quickly with other vehicles, accelerating the rapid response of the emergency medical rescue team. To meet the electricity demands of the mobile rescue hospital system, the anterior of the square cabin is integrated with a set of 13-kW super-silent diesel generator sets. The interior of the square cabin is outfitted with 15 groups of bearing drawers and 4 shelved areas to meet the needs of storing box-grouped medical equipment and sanitary tents. When the square cabin is unfolded, the cabin body can form extract pedals on both sides and the back of the square cabin, which makes the removal and placement of equipment more convenient.Reference Lu, Fan and Wen 6
Field Ambulance
This vehicle is formed by a military off-road vehicle chassis of the Nanjing Iveco NJ2045 and a large-board insulated van cabin body (Figure 2D). The vehicle is mainly installed and equipped with a defibrillation monitor, portable ventilators, a cardiopulmonary resuscitation machine, and other emergency equipment, which facilitate the functions of bandaging, fixation, stemming of traumatic bleeding, ventilation, infusion, providing oxygen supply, monitoring, and other emergency functions. This vehicle is primarily used for first aid and evacuating the wounded. It can transport 6 patients at one time. This vehicle has played an important role in previous stability maintenance in conflict, emergency rescue, and disaster relief medical support tasks.
GROUPING SITUATION
In addition to the new mobile rescue hospital system, a PAP provincial-level emergency medical rescue team is equipped with 30 to 50 professional rescue workers. The team is typically divided into 8 groups (more details are given in Table 1). Team members are usually distributed across every division of the hospital, and once an order is given, the members immediately gather along with the corresponding equipment to go into action.Reference Zhang, Guo and Wang 7 When performing a task, the team can adjust the composition of each group in a timely and reasonable way.
Table 1 The Mobile Rescue Hospital System Groups and Primary Assignments
CONCLUSIONS
In recent years, many types of emergencies, such as natural disasters and national security incidents, have occurred with increasing frequency and intensity throughout the world and have seriously affected human life and social development. To respond effectively to emergencies and to reduce damage, countries around the world have made significant efforts on research and operation of emergency medical rescue, which has greatly improved the construction and development of emergency medical rescue equipment systems.Reference Koenig and Schultz 8 Professional medical rescue equipment is the material foundation for a rescue team to implement an emergency medical rescue mission. The construction level of the equipment will partly determine the success or failure of the entire rescue project.
At present, many countries (eg, America, Germany, France, Japan, and China) have developed various types of health emergency vehicles. Certain vehicles have been mass produced and have equipped armed forces and civilian organizations. Generally, emergency medical vehicles are developed with the operation vehicle as the core and involve certain auxiliary support vehicles, such as the X-ray diagnostics vehicle, the disinfection car, or the water tender.Reference Tan, Gao and Xu 9 Through effective combinations, more perfect equipment systems can be formed, which will further promote the overall national emergency rescue level.
China has experienced several serious disasters and accidents. Especially in recent years, with an increasingly frequent variety of large-scale disasters and accidents in China, the PAP has undertaken increasingly frequent and diversified tasks, which has placed greater requirements on the integrated, large-scale, and systematic construction of health emergency rescue equipment. Based on the construction of box and tent equipment, a PAP provincial-level mobile rescue hospital system has been successfully developed, which is significant for the rapid response and emergency treatment quality of all of the PAP’s provincial-level emergency medical rescue teams. This system improves the abilities and levels of medical rescue teams, such as their rapid response ability, rapid mobility, efficient expansion and roll-up, and comprehensive medical treatment level. This statement is supported by several data: for example, the time for emergency response and deployment has been shortened from the original 2 hours to 20 minutes, and the number of wounded patients who can be treated every day has increased from 40 to 100. However, we did not perform a detailed analysis of the data in this article.
Equipped for more than 1 year, the system has played an important role in several critical missions, such as earthquake medical rescue in Sichuan Ya’an and Yunnan Ludian, adenovirus epidemic disposal, and medical services for the Tibetan garrison. Without a doubt, with further construction and application, the system will become a very important rescue force in China and will provide more powerful medical support and health services to both the PAP and disaster areas.
Acknowledgments
The authors thank all of the individuals who participated in this study for their support.
Funding
This work was supported by grants from the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (2014BAK05B01) and the Projects of the Ministry of Logistics of the PAP (WH2011-01, WHKL-18).
