Triage of pediatric injuries after the 2008 Wen-Chuan earthquake in China.
OBJECTIVE
The study aimed to review the effect of modifying triage strategies on the consultation and operation waiting times during the Wen-Chuan earthquake in China in 2008.


METHODS
The triage during the post-earthquake period was categorized into 3 phases. The consultation and operation waiting times were analyzed.


RESULTS
Of the 119 admitted children, there were 58 boys and 61 girls. Most of the victims were school-aged. In phase 1 (24 hours after the quake), the triage waiting time was 78 minutes. The waiting time for pediatric subspecialty consultation was 3.5 hours. There was an additional 7.5-hour delay before operation. In phase 2 (24-72 hours after the quake), senior pediatric surgeons carried out the triage and consultation. The consultation waiting time was reduced to 31 minutes. Four rotating teams operated 24 hours a day. The waiting time for operation was reduced to 4.5 hours. In phase 3 (4-19 days after the earthquake), gas gangrene screening was implemented. The triage waiting times for closed and open injuries were 47 and 64 minutes, respectively. Operation waiting times of 4.4 and 4.8 hours were recorded for closed and open injuries, respectively. Compared to that of phase 1, the waiting times for both consultation and operation of phases 2 and 3 were significantly shortened (P < .05). Most of the (89%) of the injuries were orthopedic traumas with lower limb fracture being the most common injury. Intraabdominal and thoracic injuries were relatively uncommon.


CONCLUSIONS
(1) Triage by pediatric surgeons in the reception area greatly reduced the delay of treatment and (2) the predominance of orthopedic injuries resulting from the earthquake indicates the focus of medical resource allocation in natural disasters of this type in the future.
Xiang
Bo
B
Department of Paediatric Surgery, West China Hospital, Si-Chuan University, Si-Chuan 610041, China. xbljx@hotmail.com
Cheng
Wei
W
Liu
Juxian
J
Huang
Lugang
L
Li
Yuan
Y
Liu
Lijun
L
D002648:Child; D002681:China; D055866:Earthquakes / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D009985:Orthopedics / Q000379:methods*; D012017:Referral and Consultation / Q000458:organization & administration* / Q000592:standards; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D014218:Triage / Q000379:methods / Q000706:statistics & numerical data*; D014850:Waiting Lists; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy