Intensive care unit treatment strategy and algorithm for critical patients from Lushan earthquake

Objective To explore the intensive care unit (ICU) strategy and algorithm of treatment for critical patients from the Lushan Earthquake. Methods Retrospective analyses were performed on the clinical characteristics and treatments for critical patients of Lushan Earthquake occurring on April 20, 2013. A total of 18 critical patients were admitted into 3 ICUs of Sichuan Provincial People's Hospital. There were 8 females and 10 males with an average age of 46±23 years and a mean score of APACHE Ⅱ 11±6. There were extremity fractures (n=16, 88.9%), chest traumas (n=11, 61.1%), head injuries(n=8, 44.4%)and pelvic fractures (n=9, 50%). All of them received VIPC plan for early stage resuscitation and CRASHPLAN for further evaluations. And individual treatment was planned and implemented by multidisciplinary specialists. Results During ICU stay, 7 patients(38.9%)suffered acute respiratory distress syndrome (ARDS). Among them, noninvasive ventilation (n=2) and intubation and mechanical ventilation (n=5) were implemented. Ten septic patients (55.6%) received antibiotic therapy, 6 with severe head injury accepted Lund's concept for brain protection and 13 (72.2%) underwent 20 operations. Sixteen patients(88.9%)were discharged and another 2 (11.1%) remained comatose in hospital. Conclusion Earthquake-related critical patients have complicated disease situations. And centralized salvage, optimal strategy and algorithm may improve their outcomes. Key words: Critical illness; Wounds and injuries; Natural disasters; Earthquake