城市破坏性地震响应处置情景下应急医学救援风险评估研究—基于脆弱性视角

Casualties caused by destructive earthquakes are the priority of earthquake hazards in China, and also a significant issue faced by public safety. Earthquake emergency medical rescue is the core of earthquake rescue and the key point of emergency management, characterized by highly dependent on scenario. Based on emergency medical rescue operations under circumstances of earthquake hazards response and management, and the results of complexity study of earthquake emergency medical rescue at earlier stage, and from the angle of vulnerability, this research proposed that the vulnerability is the key factor created by risks of the earthquake emergency medical rescue system. This study constructed a theoritical model and analytical framework of vulnerability of earthquake emergency medical rescue, and a vulnerability assessment indexes system, standard and method through analyzing vulnerability factors of various subjects. Supported by typical practices of earthquake emergency medical rescue in Wenchuan, Yushu and Lushan, the research carried out the risk assessment empirical analysis of earthquake emergency medical rescue based on vulnerability. This research found the influencing factors of system vulnerability under different risk conditions, and discovered the internal mechanism of the formation and evolution of earthquake emergency medical rescue risks caused by vulnerability, and analyzed the causes of vulnerability of earthquake emergency medical rescue. Based on the structure modeling and simulation, we would study the quantitative relation between the vulnerability indexes and the resuce effects. These results will provide countermeasures of risks for emergency medical rescue at the stage of earthquake hazards response and management, and also a good example for scientific innovation for risk researches of earthquake emergency medical rescue.

城市破坏性地震所致伤亡之巨是我国地震危害的重中之重，是公共安全面临的重大问题。地震应急医学救援是地震救援的核心与应急管理的关键环节，具有高度情景依赖特征。研究立足地震灾害响应处置情景下的应急医学救援行动，基于课题前期地震应急医学救援复杂性研究的结果，从脆弱性的视角，提出脆弱性是地震应急医学救援系统风险形成的重要因素，构建脆弱性理论模型与分析框架，通过分析系统各主体的脆弱性要素，建立脆弱性评价体系、标准与方法。以汶川、玉树、芦山、鲁甸地震应急医学救援典型实践为支撑，开展基于脆弱性的地震应急医学救援风险评估实证研究，分析脆弱性主要影响因素，探讨地震应急医学救援脆弱性成因；通过地震应急医学救援系统风险的结构建模，开展模拟实验，研究各子系统脆弱性指标与系统效能的量化关系，为不同风险因素下城市破坏性地震应急医学救援策略措施改进提供理论依据，为地震应急医学救援风险研究的科学创新提供有益借鉴。

脆弱性是导致地震应急医学救援系统风险的核心要素，地震伤病员救治与后送、医疗救援力量使用、救援行动组织指挥等系统运行环节的脆弱性涌现，均可导致系统风险，影响地震应急医学救援的系统效能。本项目立足响应处置情境下的地震应急医学救援行动，在深入调研分析汶川、玉树等地震应急医学救援行动的基础上，从脆弱性的角度研究地震应急医学救援的风险评估问题，提出地震应急医学救援脆弱性包括敏感性和应对能力两个方面，建立了地震应急医学救援数据库与风险案例库，提出了地震应急医学救援的6类风险事件和4种风险损失。筛选形成了地震应急医学救援脆弱性评估指标体系，包括5个方面，共61个评价指标，并初步确立了指标权重，建立了地震应急医学救援脆弱性评估模型，为进行地震应急医学救援的脆弱性评估提供了理论工具。进一步结合地震应急医学救援的6类风险事件，提出了具体的应对策略，研制了用于地震应急医学救援风险应对的预案管理模块，可用于提升参加应急医学救援的医疗力量的作业能力。项目执行期间，共发表标注本项目资助SCI 论文4篇、核心期刊论文2篇，负责人作为主编出版中文专著1部，参编英文专著1部，由Springer出版。项目部分研究内容纳入医疗救护分队智能医疗救治作业箱组，2018年获批全军医药卫生成果扩试项目。项目组成员参加国内学术会议2次，参与课题的4名博士研究生、1名本科生顺利毕业，招收硕士研究生1名。