The outbreak of coronavirus disease 2019 (COVID-19) is a major global public health event, which has brought great impact on people's lives and health and economic development around the world, and has also brought major challenges to China's social governance system and governance management capacity. In the face of sudden large-scale infectious disease events, whether medical treatment services can be provided in a timely, accurate, and effective manner according to demand is the key to epidemic prevention and control. In the process of responding to COVID-19, the main challenges are the coordination of the basic medical system and the emergency medical rescue system, and the requirement of a large number of spaces and places for the treatment of confirmed cases that far exceed the load of normal medical facilities in all countries. In order to help reduce the pressure on basic medical facilities, ensure normal order, carry out emergency medical rescue in a timely and effective manner, and coordinate the prevention, control, and treatment at the same time, this study discusses the establishment of makeshift hospitals, the rescue mode of integrating clinical, medical, and information technology, the concept of healing landscape, and the models of "point management" (coordinated and classified care for patients with severe and mild cases and asymptomatic infections in batches), "flow path management" (coordinated and classified care for patients with severe and mild cases and asymptomatic infections in batches), "load management" (operations prior to patient screening and transportation), "screen management" (triage according to the illness and disease course), " whole domain management" (infection control in terms of the whole environment, all staff, the whole process, and the full path), with an aim to provide ideas for rational utilization of emergency medical resources in global public health crises.

国家紧急医学救援队是我国突发事件紧急医学救援工作的重要成果 [1].每支队伍拥有医疗帐篷单元、特种医学救援作业车辆及相应的辅助设备和物资,配备经过培训的医疗、护理、医技、药事、后勤人员,相当于一所二级甲等综合医院,能独立开展救治工作.成建制救援是国家紧急医学救援队的重要特点.专业技术人员配合默契、目标统一,从而保证了救援的高效.但成建制同时要求强大的后勤保障,能在灾害环境下实现自给自足,不增加灾区负担 [2].后勤保障是体现队伍胜任力和提高队伍战斗力的重要因素.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:调查评估紧急医学救援人员进入现场前装备配置行为能力,为应急培训演练的重点人员和侧重方向提供参考。方法:通过特别重大突发事件批量伤员救援现场情景模拟,对四川省30支市（州）、县级救援队伍的救援人员装备配置行为进行横断面调查,对其完成情况进行测评分析。结果:纳入调查287名救援人员,装备配置总体得分中位数M （P25, P75）为55.56（44.44, 100）,防护器材33.33（16.67, 100）,医疗器材100（100, 100）。职业分层得分,卫生管理55.56（0, 83.33）,临床医生55.56（44.44, 91.67）;职称分层得分,高级44.44（0, 77.78）,中级55.56（44.44, 100）,初级55.56（44.44, 100）。防护器材与医疗器材间比较,卫生管理与临床医生间比较,高级与中级、初级间比较,差异有统计学意义。结论:本次被调查医学救援人员,防护器材配置较差,对灾难现场的安全防护观念和防护器材使用训练不足;需对能力不足人员进行针对性培训。</span>

目的 调查四川省紧急医学救援人员在救援现场进行信息收集和联络资源的能力,为应急培训演练提供证据.方法 模拟突发公共性事件批量危重伤员救治现场,对四川省各市(州)、县级救援人员进行横断面调查,使用现场信息联络能力评分量表对其表现进行测评,因得分分布不符合正态分布,使用中位数及其四分位间距描述得分,多个计量资料间比较采用秩和检验.结果 共纳入287名救援演练人员.信息联络能力总体得分M (P25,P75)为19.57(13.04,28.26).各维度得分分别为:安全区域设置为0(0,10),现场危险识别为0(0,16.67),对外联络协调为50(0,50),对内协调指挥为50 (16.67,50),现场灾情统计为40(10,70),现场资源状况为0(0,0),现场增援需求为0(0,0).按照职业进行分层:临床医生为19.57 (12.50,28.26),护士为19.57 (14.13,34.78),医技为25 (14.67,32.61),公卫医生为21.74(14.13,30.44),卫生管理为17.39 (9.78,21.74).按照职称分层:中级为21.74 (13.04,28.26),高级为17.39 (10.33,23.91).分别对不同维度、不同职业、不同职称得分进行比较,差异均有统计学意义(P＜0.05).结论 本次调查结果显示,四川省各市(州)、县级紧急医学救援人员存在现场信息联络总体能力不足,需针对能力不足人员进行培训,培训内容重点为现场资源状况、现场增援需求、安全区域设置、现场危险识别维度能力.

<正>患者女性,49岁,因"腹泻3个月,发现腹部包块1个月"于2012年10月31日入住我院消化内科,入院前3+月患者无明显诱因出现腹泻,大便呈黄色稀水样便,不含粘液脓血,伴里急后重,不伴肛门坠胀感,大便约4～5次/d,每次量少,不伴腹痛、畏寒高热,不伴恶心呕吐,患者于当地医院就诊,诊断为"肠炎",经对症治疗后腹泻次数有所减少,但仍有腹泻。1个月前患者在上述症状基础上扪及右上腹包块,质硬,无压痛,不伴畏寒高热、皮肤巩膜黄染,不伴腹痛、黑便、恶心呕吐。体格检