專題討論1:八仙樂園粉塵爆燃燒傷治療
Victims’ medical treatment of Formosa Fun Coast Dust Explosion

程 序 表

S1-4
八仙塵暴大量大面積燒傷病人的治療經驗
莊秀樹
林口長庚醫院整形外科灼傷ICU

  2015/06/27 21:30 急診啟動大量傷患的治療機制,急診,整外,行政中心全力投入,共收治50位病人,41人平均受傷面積45%,於3小時內簽住灼傷ICU等6個ICU,接受Resuscitation 治療,於10小時?將外圍全數轉回整外灼傷ICU及顯微手術ICU,06/30治療團隊完成41病人第一次完全清瘡及敷料覆蓋,經反復清瘡及植皮手術,營養,呼吸,感控,復健治療。於7/31最後一位90%病人?離呼吸器拔管。病人陸積出院外,9/15所有病人轉住一般病房。共2位死亡病歷。
Patients and Methods:
  On July 27th, 2015, five hundreds of people were injured at the night when a fire blast during a party at the water park in New Taipei City’s Bali District. Lifeguards and others have transport the numbers victims to nearby hospitals, Chang Gung Memorial Hospital at LinKou located beside the highway for 12 Kilometer to the disaster area, became epicenters of burn disaster response. In short time rushed 48 patients in emergency department. The Burn ICU and Micro ICU were evacuated, 41 patients were admitted in ICU, subsequently have 9 patients more were admitted. 22 in 41 patients sustained inhalation injury and been intubated. The treatment team include the Anesthetists, Chestman, Infection control, Nutritionists, Physical therapy. After the triage in Emergency, two subsequential triages have proceeded to move those Who need more intensive care to the Burn ICU.
Surgical approach with early total tangential excision and wound closure is one of the fundamental principles of acute burn care. The burn care provider and dressing material become restrictive. To keep the burn care in qualified, time saving procedure and applying effective dressing material are impotent. Repeated debridement and skin grafting with 1:4 mesh and 1:6 microskin grafting were proceeded.
Results:
2 mortality in 51 patients. ARDS and Acute renal failure were not present. All of the Patient were successful left the intubation without tracheostomy.