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題名 | 社區協力策略在大量傷患事件緊急救護的系統韌性=System Resilience of Community Collaborative Strategy on Mass Casualty Incident Emergency Rescue |
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作 者 | 李宗勳; | 書刊名 | 警察行政管理學報 |
卷期 | 13 2017.05[民106.05] |
頁次 | 頁91-117 |
分類號 | 548.31 |
關鍵詞 | 社區協力策略; 大量傷患事件; 緊急救護; 系統韌性; Community collaborative strategy; Mass casualty incident; Emergency rescue; System resilience; |
語文 | 中文(Chinese) |
中文摘要 | 從相關文獻中發現,驗證協力過程中,「參與型」的社區協力防災治理的策略比「命令型」,更具系統韌性(Wang & Kuo,2014)。而協力內容中「前瞻型」與「防衛型」的社區協力防災治理的策略,比「回應型」更具系統韌性(Wang & Kuo,2014)。大量傷患事件(Multiple/Mass Casualty Incident,以下以簡稱 MCI 代表),是指一個事件同時產生多名傷患,而這些傷患無法以「一般」的方式來的處理,而必須做特殊的動員。所以,大量傷患事件雖然產生多名傷患, 量不見得是最主要參考,反而資源需求所導致的運作的流程改變才是判斷的重點。基本上,會影響流程改變的因素,主要為傷患的人 、傷患的嚴重 、當地的資源狀態(特別是緊急醫療救護及醫療機構)及特殊的危害(如燒燙傷、核生化及侷限空間救援)等,這幾項因素,皆為啟動大量傷患事件的主要依據。除了以大量傷患處理流程,分別依據現場處理、集結後送、急診與後續醫療、以及啟動大規模替代方案等模式進行研究外,本文現階段主要以政府相關實錄報告與文件資料作為分析對象,並重點進行三場焦點座談20人次與訪談關鍵人士5位,包括實際參與這次緊急救護的馬偕醫院淡水院區急診室及相關醫療志工、八里區公所區長與當地志工、民力組織以及新北市府警消、公衛、社福等局處代表等,本文最難能可貴的是同時也邀請到陽光基金會的執行長與傷友代表進行訪談,以了解掌握相關民間資源在事故發生現場、運送與急診過程、住院就醫後各階段相關行動者之協助方式與參與內容,從中了解其在協力過程中參與型與命令型及不同的協力治理策略內容(前瞻型、防衛型、回應型)在緊急救護系統的實際比例與影響,相對地同步檢視接受政府委託的非營利組織與當事人傷友的觀感。本文藉由三場焦點座談與深度訪談結果顯示,民間協助方式與參與內容有不同的效應與影響,參考研究發現提出粗淺建議。 |
英文摘要 | Recent papers have adopted an alternative view of the strategy-based approach to examine how different strategic styles affect organizational capability during a crisis response. For example, Chun-yuan Wang and Ming-feng Kuo (2014) highlighted the relationships among strategic content (three variables: prospector, defender, and reactor stance), strategic process (two variables: participatory and command model), and crisis response capability. The results reveal that a higher organizational capability with a prospecting or defending stance may facilitate local government response to a crisis better than a reactor stance. The results also point out that participatory mode still significantly and positively affects the crisis response capability, more so than the command model. These detrimental disasters raise not only the evolution but also the re-examination of rescue modes for multiple casualty incidents (MCI) in both community collaborative participation and medical systems. The current paper first conducts a content analysis of government records about each stage of the rescue process, including all kinds of community collaborative groups. It then conducts interviews 5 persons and roundtable discussions among all kinds of community collaborative groups and cross-sector government representatives 20 persons. The paper synchronizes the use of qualitative interviews and quantitative assessment methods to assess how different strategic styles affect the community collaborative organizational capability for MCI, focusing on the case of the dust explosion in the water park in New Taipei City. The conclusions obtained through our research can benefit the emergent medical care in both practical and academic aspects. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。