To date, there is limited evidence for health care providers regarding the determinants of early assessment of poor outcomes of adult in-patients due to earthquakes. This study aimed to explore factors related to early assessment of adult earthquake trauma patients (AETPs).

The data on 29,933 AETPs in the West China Earthquake Patients Database (WCEPD) were analyzed retrospectively. Then, 37 simple variables that could be obtained rapidly upon arrival at the hospital were collected. The least absolute shrinkage and selection operator (LASSO) regression analyses were performed. A nomogram was then constructed.

Nine independent mortality-related factors that contributed to AETP in-patient mortality were identified. The variables included age (OR:1.035; 95%CI, 1.027-1.044), respiratory rate ([RR]; OR:1.091; 95%CI, 1.050-1.133), pulse rate ([PR]; OR:1.028; 95%CI, 1.020-1.036), diastolic blood pressure ([DBP]; OR:0.96; 95%CI, 0.950-0.970), Glasgow Coma Scale ([GCS]; OR:0.666; 95%CI, 0.643-0.691), crush injury (OR:3.707; 95%CI, 2.166-6.115), coronary heart disease ([CHD]; OR:4.025; 95%CI, 1.869-7.859), malignant tumor (OR:4.915; 95%CI, 2.850-8.098), and chronic kidney disease ([CKD]; OR:5.735; 95%CI, 3.209-10.019).

The nine mortality-related factors for ATEPs, including age, RR, PR, DBP, GCS, crush injury, CHD, malignant tumor, and CKD, could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies for AETPs. Based on these factors, a nomogram was constructed to screen for AETPs with a higher risk of in-patient mortality.

This study evaluates the effectiveness of our game-based pedagogical technique by comparing the learning, enjoyment, interest, and motivation of medical students who learned about best practices for patient surge in a natural disaster with a novel game-based computer application, with those of medical students who learned about it with a traditional lecture.

We conducted our study by modifying an existing optional course in disaster medicine that we taught at Sichuan University. More specifically, in 2017, while our application was still in development, we taught this course by lecture. In this iteration, 63 third-grade medical students voluntarily joined our course as our ‘lecture group.’ Once our application was complete in 2018, 68 third-grade medical students voluntarily joined this course as the ‘game group.’ We examined the different effects of these learning methods on student achievement using pre -, post -, and final tests.

Both teaching methods significantly increased short-term knowledge and there was no statistical difference between the 2 methods (p > 0.05). However, the game group demonstrated significantly higher knowledge retention than the traditional lecture group (p < 0.05).

Our game-based computer application proved to be an effective tool for teaching medical students best practices for caring for patient surge in a natural disaster.

Little is known about the trend and predictors of 21-year mortality and suicide patterns in persons with schizophrenia.

To explore the trend and predictors of 21-year mortality and suicide in persons with schizophrenia in rural China.

This longitudinal follow-up study included 510 persons with schizophrenia who were identified in a mental health survey of individuals (≥15 years old) in 1994 in six townships of Xinjin County, Chengdu, China, and followed up in three waves until 2015. Kaplan–Meier survival analysis and Cox hazard regressions were conducted.

Of the 510 participants, 196 died (38.4% mortality) between 1994 and 2015; 13.8% of the deaths (n = 27) were due to suicide. Life expectancy was lower for men than for women (50.6 v. 58.5 years). Males consistently showed higher rates of mortality and suicide than females. Older participants had higher mortality (hazard ratio HR = 1.03, 95% CI 1.01–1.05) but lower suicide rates (HR = 0.95, 95% CI 0.93–0.98) than their younger counterparts. Poor family attitudes were associated with all-cause mortality and death due to other causes; no previous hospital admission and a history of suicide attempts independently predicted death by suicide.

Our findings suggest there is a high mortality and suicide rate in persons with schizophrenia in rural China, with different predictive factors for mortality and suicide. It is important to develop culture-specific, demographically tailored and community-based mental healthcare and to strengthen family intervention to improve the long-term outcome of persons with schizophrenia.

In this study, we aimed to evaluate the correlation between the trauma score of individuals wounded in the Lushan earthquake and emergency workload for treatment. We further created a trauma score-emergency workload calculation model.

We included data from patients wounded in the Lushan earthquake and treated at West China Hospital, Sichuan University. We calculated scores per the following models separately: Revised Trauma Score (RTS), Prehospital Index (PHI), Circulation Respiration Abdominal Movement Speech (CRAMS), Therapeutic Intervention Scoring System (TISS-28), and Nursing Activities Score (NAS). We assessed the association between values for CRAMS, PHI, and RTS and those for TISS-28 and NAS. Subsequently, we built a trauma score-emergency workload calculation model to quantitative workload estimation.

Significant correlations were observed for all pairs of trauma scoring models with emergency workload scoring models. TISS-28 score was significantly associated with PHI score and RTS; however, no significant correlation was observed between the TISS-28 score and CRAMS score.

CRAMS, PHI, and RTS were consistent in evaluating the injury condition of wounded individuals; TISS-28 and NAS scores were consistent in evaluating the required treatment workload. Dynamic changes in emergency workload in unit time were closely associated with wounded patient visits.

A simple evaluation tool for patients with novel coronavirus disease 2019 (COVID-19) could assist the physicians to triage COVID-19 patients effectively and rapidly. This study aimed to evaluate the predictive value of 5 early warning scores based on the admission data of critical COVID-19 patients.

Overall, medical records of 319 COVID-19 patients were included in the study. Demographic and clinical characteristics on admission were used for calculating the Standardized Early Warning Score (SEWS), National Early Warning Score (NEWS), National Early Warning Score2 (NEWS2), Hamilton Early Warning Score (HEWS), and Modified Early Warning Score (MEWS). Data on the outcomes (survival or death) were collected for each case and extracted for overall and subgroup analysis. Receiver operating characteristic curve analyses were performed.

The area under the receiver operating characteristic curve for the SEWS, NEWS, NEWS2, HEWS, and MEWS in predicting mortality were 0.841 (95% CI: 0.765-0.916), 0.809 (95% CI: 0.727-0.891), 0.809 (95% CI: 0.727-0.891), 0.821 (95% CI: 0.748-0.895), and 0.670 (95% CI: 0.573-0.767), respectively.

SEWS, NEWS, NEWS2, and HEWS demonstrated moderate discriminatory power and, therefore, offer potential utility as prognostic tools for screening severely ill COVID-19 patients. However, MEWS is not a good prognostic predictor for COVID-19.

Currently, Technical Advisors of the World Health Organization’s (WHO) Emergency Medical Teams (EMT) Secretariat are conducting standardized verification work for international emergency medical teams in various countries and organizations. However, a uniform and standard training course for an International EMT is lacking.

To design a training course model based on knowledge structure, teaching, and evaluation methods for an International EMT.

The first and second level catalogue defined as chapters and sections for the International EMT training curriculum were drafted based on literature and summaries of fragmentary experience. The teaching syllabus with the method of teaching and evaluation was initially outlined. The expert consultation form was designed and validated. Experts from International EMTs from various countries were consulted and investigated. The Delphi method was used, and the chapters and sections were adjusted and weighed according to experts’ advice through the Analytic Hierarchy Process. The teaching and evaluation methods for each knowledge module were obtained based on suggestions from experts.

A total of 25 experts were consulted. By 2 rounds of consultation with a Kendall coordination coefficient W value of 0.210 and chi-square value of 78.61 (p<0.05), consensus about the knowledge structure for the curriculum was achieved, which consisted of 6 chapters: (1) introduction of International EMT, (2) Disaster medicine, (3) Global health, (4) Care in austere condition, (5) Medical technology, (6) Field training, with the weights of 0.1415, 0.1584, 0.1536, 0.1827, 0.1728, and 0.1909, respectively, and 32 sections. Teaching methods for different knowledge modules were determined, which included lecture, demonstration, discussion, drills, and tabletop simulation. The evaluation methods were affirmed via a quiz, written examination, skill test, and teamwork test assessed by intra-group and inter-group evaluation.

Through scientific investigation of experts from International EMTs, a training course model for International EMT was established.

Classroom instruction of disaster medicine for medical students is complicated and lacks attraction. Nowadays a novel method, which is named Game-Based Learning (GBL), has been used in other fields and received good feedback.

To apply GBL to the teaching process of disaster medicine and discuss the effect of its application.

A computer game was devised based on a syllabus of disaster medicine and employed it in classes of disaster medicine for medical students. Then a questionnaire about the application of GBL in education was used inquiring the demands of medical students for the designing of GBL in disaster medicine, including their platform and game mode preferences. Feedback was collected and data was analyzed after the class.

201 questionnaires were issued, and the valid rate was 100%. From the responses, 77% of medical students considered the application of GBL in education on disaster medicine was necessary, and 73% of the respondents thought it was practical. Furthermore, over 90% of medical students expressed their expectation for the adoption of GBL. According to another survey of 51 medical students we conducted, after attending a class about knowledge of injury classification with one board game adopted, most of the students believed GBL was better than traditional methods of teaching.

There is a high approbation degree among medical students to the adoption of GBL in the teaching process of disaster medicine, which suggests a great possibility for the application of GBL in medical education. It is concluded that GBL can be used in the teaching process of disaster medicine.

Currently, there is no uniform and standard disaster medicine course for students in medical school.

To design a disaster medicine course model based on knowledge structure, teaching and evaluation methods according to experts’ advice and interest of undergraduates majoring in clinical medicine.

The first and second level catalog defined as chapters and sections for the disaster medicine curriculum were drafted based on literature and summary of fragmentary experience. The teaching syllabus with methods of teaching and evaluation was initially outlined. The expert consultation form and student questionnaire were designed and validated. Experts in disaster medicine in China were consulted and students in our medical school were investigated. Delphi Methods was used and the chapters and sections were adjusted and weighed according to experts’ advice through the Analytic Hierarchy Process. The teaching and evaluation methods for each knowledge module were obtained based on suggestions from experts and students.

A total of 31 experts were consulted. 320 students were inquired. By two rounds of consultation with Kendall coordination coefficient W value 0.207, chi-square value 128.781(p=0.01), consensus about the knowledge structure for the curriculum were achieved, which consisted of 6 chapters (as Introduction to disaster medicine, incident command, medical knowledge and skills in disaster, public health, ethics in disaster, information management, with the weights of 0.1486, 0.1999, 0.4209, 0.0785, 0.0748, 0.0774 respectively)and 25 sections. Teaching methods for different knowledge module were determined, which included lecture, demonstration, case discussion, drill and sand table simulation. And the evaluation methods were affirmed as a quiz, written examination, skill test and teamwork test assessed by intra-group and inter-group evaluation.

Through scientific investigation of experts in disaster rescue and undergraduates majoring in clinical medicine, a disaster medicine course model for clinical medical students was established.

Compared with traditional START Triage Method, the Sacco Triage Method is a new way to access death risk in disaster scenes. However, due to the difficulties in disaster medical research, there is still no evidence to prove which one is more effective.

To assess and compare the value of START Triage Method and Sacco Triage Method in the death risk assessment of transport and the one-month death risk assessment of the earthquake mass trauma patients.

A retrospective analysis was conducted on 1,612 patients who were transferred to the West China Hospital by assigning to different triage levels by Sacco Triage Method and START Triage Method respectively. Both of the triage methods were evaluated based on death cases on either during transport or in the emergency department, using the area under the receiver-operator curve.

For death during the transport and in the emergency department, the receiver-operator curve of two groups reflected as 0.721 and 0.649. For death in a consequence, the receiver-operator curve of the two groups was revealed as 0.667 and 0.519.

As an accurate triage method, the Sacco Triage Method may be used in a mass casualty incident. It is a more effective way than the START Triage Method for the evaluation of death risk assessment of the mass trauma patients.

First aid in a short time is the key to saving lives. As undergraduates step into society, they should have enough ability to save others. As a result, first aid knowledge and training are essential for them.

To investigate the cognition level of the first aid knowledge among undergraduates, and to improve the training for undergraduates.

A questionnaire was designed for this study. It includes the basic information of the test subjects, attitude towards first aid, level of first aid knowledge, etc. The subjects of the questionnaire were mainly undergraduates in Sichuan province.

There were 302 valid questionnaires. The percent correct of the first aid basic knowledge quiz was only 47.62%. Using Chi-Square tests to analyze, medical education can make a significant difference in the level of first aid knowledge. (Chi-Square=251.004, P<0.01) Additionally, 78.81% of undergraduates thought it was significant to learn and master first aid knowledge, and the most common way to learn first aid knowledge was through university (81.46%).

Universities should strengthen the training for undergraduates to improve their first aid skills. This is a feasible approach to promote a public level of first aid knowledge.