CN114334102A - Emergency medical rescue resource scheduling optimization model for large-scale sports event emergencies - Google Patents
Emergency medical rescue resource scheduling optimization model for large-scale sports event emergencies Download PDFInfo
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Abstract
The invention provides an emergency medical rescue resource scheduling optimization model for a large-scale sports event, which is based on integer linear multi-objective programming and closely combined with the theory and practice of emergency medicine, and generates a resource scheduling optimization scheme from an emergency resource point to a demand venue according to the scale of the event and the number of injured people in a sports venue in an on-site treatment stage; and in the transferring and sending-back stage, according to the triage classification data returned in the site treatment stage, a resource allocation optimization scheme and a wounded transferring scheme from a demand venue to a rear hospital are generated. The model is applied to a hypothesis example of three-event emergencies of a large-scale sports event, the solving result meets the actual requirement, and the model has a reference guiding significance for emergency medical resource scheduling under the large-scale sports event emergencies.
Description
Technical Field
The invention relates to the field of emergency medical rescue resource allocation, in particular to an emergency medical rescue resource scheduling optimization model for a large-scale sports event.
Background
With the development of society, the number of various sports events held in China is obviously increased, and the scale of holding various sports events is also increased. In the process of holding a large-scale sports event, due to the fact that the personnel gathering scale is large and the personnel gathering density is high, if an emergency happens, serious consequences are likely to be caused. The major point for reducing the harm of such emergencies is that medical resources are scientifically called to timely rescue and transport the wounded, so more and more researchers put emphasis on establishing a more scientific and practical medical resource scheduling model. Different from common resource scheduling, emergency medical resource scheduling needs to be combined with the characteristics of emergency medicine, namely, the actual process of emergency medical rescue is classified treatment. The grading treatment is a grading treatment system which divides the medical treatment process into first-grade treatment on the disaster site, second-grade treatment in the transfer process, third-grade treatment in the rear hospital and fourth-grade treatment in rehabilitation treatment. The first-level and second-level treatment is divided into four basic stages, namely searching and positioning, on-site treatment, triage and transferring and then delivering. The classification treatment is to classify the wounded, distinguish the critically ill wounded, the severely wounded, the lightly wounded and the dead, and adopt different transferring and sending orders for different classes of the wounded.
Researchers have achieved a great deal of research results in emergency medical rescue resource scheduling, but these research results are ubiquitous in three weak links: firstly, emergency medical rescue resource scheduling is equal to ordinary resource scheduling, and an emergency medical rescue resource scheduling model is not reasonably established in combination with an emergency medical theory; secondly, only the number of the wounded is used as a model research object, the wounded is not classified according to the injury condition, and the wounded is distinguished according to the injury condition and used as the model research object; thirdly, only official medical rescue resources such as ambulances, rescue helicopters and the like are taken as model research objects, and the actually existing medical transportation force of volunteers is not listed in the model research objects. Aiming at the three problems existing in the traditional emergency medical resource scheduling model, the invention provides a multi-objective optimization model for scheduling large-scale sports event emergencies in stages, which is closely combined with emergency medical rescue theory and practice, scientifically formulates a resource scheduling scheme and effectively improves the medical resource scheduling efficiency.
Disclosure of Invention
Aiming at three weak links universally existing in the existing research results, the invention provides a staged emergency medical rescue resource scheduling optimization model aiming at emergency medical rescue resources of large-scale sports events, namely a staged emergency medical rescue resource scheduling optimization model which is based on integer linear multi-target programming, distinguishes different stages of emergency medical rescue and delivers wounded persons after being transferred according to triage classification results. The model is divided into two parts, wherein the first part is a multi-objective optimization model for emergency medical resource scheduling in a site treatment stage, and the second part is a multi-objective optimization model for emergency medical resource scheduling in a transfer and delivery stage. The model considers that the first purpose of emergency medical rescue is to keep vital signs of wounded persons and timely transport the wounded persons to a rear hospital for treatment, and the emergency medical resources are definitely rescue tools with the ability of carrying the wounded persons, such as ambulances, rescue helicopters, volunteer vehicles and the like, so that the model accords with the practical law of emergency medical rescue for many years. The model is applied to emergency medical rescue resource scheduling of large-scale sports events, can scientifically formulate a resource scheduling scheme by combining various factors such as resource transportation time, venue resource receiving capacity, rear hospital wounded receiving capacity, volunteer rescue capacity and the like, and ensures high resource scheduling efficiency and good emergency rescue effect.
In order to achieve the purpose, the technical scheme adopted by the model provided by the invention is as follows:
step 1: and establishing and solving an emergency medical resource scheduling multi-objective optimization model in the scene emergency treatment stage of the large-scale sports event, and generating a medical resource scheduling scheme from the emergency site to the disaster-stricken venue according to the type of the emergency and the number of injured people.
Step 2: and establishing and solving an emergency medical resource scheduling multi-objective optimization model in the post-transfer stage of the large-scale event emergency, and generating a resource allocation optimization scheme from a demand venue to a rear hospital and a wounded transfer scheme according to the triage classification data returned in the field treatment stage.
The implementation method of the step 1 comprises the following steps:
step 1.1: the emergency medical resource scheduling from an emergency site to a demand venue is required to be completed during rescue in the site rescue phase, and parameters of an emergency medical rescue resource scheduling model in the site rescue phase are set firstly.
The parameters are set as follows:
1) it is set that I emergency sites and J venues exist currently. I denotes the ith emergency station, and J denotes the jth venue, 1, 2, 3.
2) The number L of the types of the first-aid resources is set. L denotes different types of emergency resources, such as ambulances, rescue helicopters, volunteer vehicles, etc.
3) Setting the number of injured people P in the venuejAnd the number of injured people reported by the jth venue is shown.
4) Resource number E capable of being called by set first-aid stationilThe number of the ith emergency site can call the ith type emergency resources is shown.
5) Setting resource scheduling time t from first-aid site to rear venueijlAnd the time required for the ith type of resource to be dispatched from the ith emergency site to the jth venue is shown. As the special channel for the large-scale event is arranged during the holding period, the road can be considered not to be blocked, namely the resource scheduling time is stable and unchanged.
6) Setting the rescue capacity of a single class I resource in a field rescue stagelIndicating that a single class I resource can be rescuedlAn individual.
7) Setting a 0-1 variable h for indicating whether the venue accepts a certain type of resourcejl：
If 1 and 2 correspond to an ambulance and a rescue helicopter, respectively, h is1，1＝1、h1，20 means that the first venue cannot park the helicopter but is allowed to receive the ambulance, and therefore the helicopter cannot be scheduled to the first venue and only the ambulance can be dispatched for rescue.
8) Setting a decision variable XijlThe first-class emergency resources are allocated from the ith emergency site to the jth venue.
Step 1.2: and setting a target function of the emergency medical rescue resource scheduling model in the field rescue stage.
The objective function is set as follows:
the objective function (1) indicates that the on-site rescue phase model should minimize the total arrival time of all rescue resources.
The objective function (2) indicates that the total rescue capacity for dispatching rescue resources should be as large as possible.
And a linear weighting method is combined with the objective function (1) and the objective function (2) to serve as a final objective function of the model in the field rescue stage, namely the objective function (3), so that the model solving result can meet multiple objectives simultaneously, namely the total arrival time of the emergency resources is as small as possible, and the total rescue capacity of the emergency resources is as large as possible. Weight c of each branch target of final objective function11、c12Is determined by the decision-making emphasis of the decision-maker.
Step 1.3: and setting constraint conditions of the emergency medical rescue resource scheduling model in the site rescue stage.
The constraint conditions are set as follows:
the formula (4) shows that the rescue capacity of the emergency resources dispatched by all emergency sites to each venue is not lower than the expected number of injured people of each venue, and the minimum requirements of each venue are met.
Equation (5) indicates that the number of various emergency resources scheduled out from each emergency site should be no higher than the emergency resources equipped by each site, within the callable range of each site.
Equation (6) indicates that different venues have different receptivity to each emergency resource. If the jth venue can not accept the first-class emergency resources, the corresponding hjlEach emergency site does not have to schedule class i resources to the venue again at 0. The constraint of the formula (5) can be applied to any i site when h isjlWhen being equal to 0, X is always presentijl＝0。
Equation (7) represents the decision variable XijlIs a non-negative integer.
Step 1.4: and solving the multi-target model in the site rescue stage by using lingo18.0 or other operational research software to obtain an emergency medical rescue resource scheduling scheme in the site rescue stage.
The step 2 is realized by the following steps:
step 2.1: the emergency resource scheduling from the disaster-stricken venue to the rear hospital needs to be completed for the rescue in the post-transfer stage, and parameters of an emergency medical rescue resource scheduling model in the post-transfer stage are set firstly.
The parameters are set as follows:
1) the current number of stadiums I and the number of rear hospitals J are set. I denotes the ith venue and J denotes the jth back hospital, 1, 2, 3.
2) The number L of the types of the first-aid resources is set. 1, 2, 3, L, etc. denote different types of emergency resources, such as ambulances, rescue helicopters, volunteer vehicles, etc.
3) The number N of injury levels of the injured person is set to 3. The heavy grade is represented by n-1, the heavy grade is represented by n-2, and the light grade is represented by n-3.
4) Setting the number P of the wound people in the stadium counted after triageinThe number of injured persons in the ith stadium at injury level n is shown.
5) Setting the number E of the resources which can be called in each venueilThe number of the first-class emergency resources which can be called by the ith venue is shown.
6) Setting resource scheduling time t from venue to rear hospitalijlAnd the time required for the ith type of resource to be dispatched from the ith venue to the jth subsequent hospital is shown. As the special channel for the large-scale event is arranged during the holding period of the event, the road can be considered not to be blocked, namely the resource scheduling time is stable and unchanged.
7) Setting the total curing capacity of a single I type resource in the transfer after-delivery stage blRepresenting maximum transport of a single class I resourcelAnd (5) an injured person.
8) Setting the treatment capacity S of a single class I resource to the critically ill wounded in the transfer after-delivery stagelRepresenting maximum diversion of a single class I resourcelIs suitable for the critically ill wounded.
9) Setting the treatment capacity Z of a single class I resource in the transfer after-delivery stage to heavy wounded personslRepresenting maximum diversion of a single class I resourcelA weight-level wounded person;
10) setting a 0-1 variable h for indicating whether a rear hospital accepts a certain type of resourcejl：
If 1, 2, and 3 correspond to an ambulance, a rescue helicopter, and a volunteer vehicle, respectively, h is h11＝1、h12＝0、h 131 means that the first hospital cannot stop the helicopter but is allowed to receive an ambulance and a volunteer vehicle, and therefore it is not possible to schedule the helicopter to the first rear hospital, and only to dispatch the ambulance or the volunteer vehicle for rescue.
11) Set the maximum number of the people who can receive the doctor in the hospital at the rearjAnd the maximum number of the visitors which can be accepted by the jth hospital at one time is shown. Because the time for treating the light-grade wounded persons is short and the sick bed of the hospital is not occupied, the light-grade wounded persons transported to the rear hospital do not occupy the number of the patients accepted by the hospital.
12) Setting gold treatment time T of critical-grade wounded person1Means that the critical level wounded person can be at T after necessary emergency treatment1After the patient is transported in time, the patient is sent to a rear hospital to be further cured, the patient with the critical level is successfully cured, and otherwise, the patient with the critical level dies.
13) Setting the maximum curing time T of the heavy wounded2Means that the heavy-level wounded person can not be at T after the comparative emergency treatment2After the patient is transported within the time, the patient is sent to a hospital at the back to be further treated, and the serious-level wounded person can be converted into a critical-level wounded person.
14) Setting a variable D of 0-1ijnl、Rijnl、WijnlThe first-aid resource is used for indicating the situations that the wounded in the n-level injury grade from the ith stadium to the jth back hospital die, get cured and get cured with the identity of the critical wounded. In combination with the particularity of emergency medical rescue, the situation that heavy-level wounded persons can change into critical-level wounded persons after a certain time needs to be considered, so that the judgment standards of the values of the treatment effect parameters are different for the wounded persons with different injury levels.
For a critically ill victim with n equal to 1If the transit time exceeds the gold rescue time T1Or the patient is not transported and the treatment is ineffective, and the patient dies, otherwise the patient can be treated by the identity of the critical patient.
For heavy wounded with n being 2, if the transfer time is at the maximum rescue time T2Within, the wounded is treated with the identity of the heavy-grade wounded; if transit time exceeds T2And is less than T1+T2The wounded is treated with the identity of the critical-grade wounded; if transit time exceeds T1+T2Or if not transported, the victim dies.
For the light-grade wounded person with n-3, there is no death, and the set treatment condition is only to be transported to the back hospital, and there is no time limit, so the corresponding D, R, W three parameters are constant values.
Dij3l＝0 Rij3l＝1 Wij3l＝0
15) Setting a decision variable Xijl、aijnl. Wherein XijlRepresenting the number of the first-aid resources allocated from the ith venue to the jth back hospital, aijnlThe first-class emergency resources are loaded on the roads from the ith venue to the jth back hospital, and the number of the wounded persons with the injury grade of n is represented.
Step 2.2: and setting a target function of the emergency medical rescue resource scheduling model in the post-transfer stage.
The objective function is set as follows:
the objective function (8) indicates that the post-transit phase model should minimize the total number of deaths. The number of deaths includes the total number of casualties above the light level that died because of the lengthy transit time and the lack of transit.
The objective function (9) shows that the number of wounded persons with heavy grade converted into dangerous grade due to too long transit time is reduced as much as possible.
The objective function (10) indicates that the total number of persons to be treated should be maximized, and since it is considered that the treatment cannot be performed in consideration of the fact that the light-level injured person is not transported, the objective function (9) is mainly considered to perform the treatment on more light-level injured persons.
The objective function (11) indicates that the average transit time of the emergency resources in the scheduling scheme should be as small as possible. Because there is no time-limiting requirement for the transportation of the light wounded, in order to further ensure that the wounded is treated as soon as possible, the requirement of minimum average time is added to avoid selecting a far route.
The objective function (12) indicates that the unused positions of the medical resources in the scheduling scheme are as few as possible, namely the resource utilization rate is as high as possible.
The above five objective functions, namely the objective function (8), are combined by using a linear weighting method) And (12) the solution is used as a final objective function of the model in the transferring and sending stage, namely an objective function (13), so that the solution result of the model can simultaneously meet a plurality of objectives, namely, the number of dead people is reduced as much as possible, the number of serious-grade to critical-grade wounded people is reduced as much as possible, the total number of cured people is increased as much as possible, the average transferring time is shortened as much as possible, and the resource utilization rate is increased as much as possible. Weight c of each sub-target of the final target function21、c22、c23、c24、c25Is determined by the decision-making emphasis of the decision-maker.
Step 2.3: and setting constraint conditions of the emergency medical rescue resource scheduling model in the post-transfer stage.
The constraint (14) indicates that the number of types of first aid resources scheduled out of each venue should be within the callable range of the respective venue.
Equation (15) indicates that all rescue resources can only be dispatched to the back-end hospital that can accept such rescue resources.
The formula (16) shows that the number of wounded persons actually transported in each venue is not more than the known number of wounded persons.
The formula (17) indicates that the number of the wounded persons who are transported to each rear hospital is within the acceptable number in the hospital.
Equation (18) indicates that the number of individuals transporting critically ill victims cannot exceed the upper limit.
Equation (19) indicates that the number of individuals with a single emergency resource transfer heavy wounded cannot exceed the upper limit.
The formula (20) shows that the total number of the wounded transported by the single first-aid resource does not exceed the upper limit of the total rescue capacity, and each first-aid resource should be transported by the wounded with the maximum rescue capacity as much as possible.
Equation (21) represents the decision variable Xijl、aijnlAre all non-negative integers.
Step 2.4: and reasonably arranging the wounded carrying scheme of each medical resource through the solving result of the transferring and sending stage to obtain the final transferring and sending scheme of the wounded in the transferring and sending stage. The concrete realization idea is as follows:
firstly, solving a model of a post-transfer stage by using lingo18.0 or other operational research software to obtain a solving result, wherein the solving result comprises XijlAnd aijnlThe two types of variables respectively correspond to the quantity of emergency resources on each route and the quantity of different wounded persons with different resource types. And for the medical resources and the wounded on each post-transfer delivery path, arranging the wounded to each first-aid resource according to the wounded injury priority and the medical resource category priority. Wherein the wounded injury priority is as follows: the critical wounded personnel, the heavy wounded personnel and the light wounded personnel are all arranged, namely the wounded personnel with heavy injury are transported and then sent; the resource type priority is: rescue helicopter, ambulance and volunteer vehicle, i.e. arranged to arrive firstThe time of the stadium is short, and the medical equipment is complete. In arranging the wounded, the ability of rescuing the critically ill wounded and the total ability of rescuing the wounded, which are all considered at the same time, need to be considered for each medical resource. The method can ensure that the wounded with serious injury preferentially and quickly transports, and can ensure that the wounded preferentially uses the rescue helicopter and the ambulance with complete medical equipment to transport.
Compared with the prior art, the resource scheduling model has the beneficial effects that:
1. the invention discloses an emergency medical rescue resource scheduling optimization model aiming at a large-scale sports event emergency, which combines a multi-objective planning theory with the actual operation process of emergency medical rescue and the practice of disaster rescue volunteers for many years, reduces the death rate to the maximum extent, improves the rescue rate to the maximum extent, systematically optimizes rescue resources such as helicopters, ambulances, volunteer vehicles and the like and a carrying scheme thereof by utilizing the rescue aging concept of emergency medical science, and overcomes the defects that the rescue force of the volunteers is not taken into consideration and the delivery is not transferred according to the wounded condition in the prior art.
2. The invention discloses an emergency medical rescue resource scheduling optimization model aiming at large-scale sports events, which is closely combined with the actual operation process of emergency medical rescue, and the resource scheduling model is divided into two stages of site rescue and transportation and then delivery, so that the complexity of the model is reduced, and the model is more in line with the actual situation of emergency medical rescue.
3. According to the optimization model for scheduling the emergency medical rescue resources of the large-scale sports events, the decision variables are flexibly divided into two types of vehicles and wounded persons in the resource scheduling process of the post-transfer stage, so that the complexity of model calculation is reduced, and the efficiency of model calculation is improved.
Drawings
Fig. 1 is a flow chart of an emergency medical rescue resource scheduling optimization model for a large-scale sports event emergency according to the present invention.
Fig. 2 is a schematic diagram of the distribution of the on-site rescue stage venue and the emergency treatment sites assumed in the present invention.
Fig. 3 is a schematic diagram of the distribution of the terminal site and the back hospital in the transfer stage assumed in the present invention.
Fig. 4 is a flow chart of medical resource wounded person embarkation plan generation in the present invention.
Detailed Description
The technical solution of the present invention is further described below with reference to the accompanying drawings and examples.
As shown in fig. 1, the emergency medical rescue resource scheduling optimization model for a large-scale sports event disclosed in this embodiment specifically includes the following steps:
step 1: and establishing and solving an emergency medical resource scheduling multi-objective optimization model in the site treatment stage of the large-scale event emergency. As shown in fig. 2, the present embodiment assumes three race zones following the actual situation, wherein the relevant units relating to the on-site rescue phase are 5 venues and 11 emergency resource sites. Assuming that emergencies occur in all the three competition areas, the task of the on-site rescue stage model is to generate a medical resource scheduling scheme from the emergency site to the disaster site according to the number of injured people in each disaster site.
The following assumptions are made for the relevant data:
the number of injured persons in each venue is assumed to be as shown in table 1.
Table 1 venue number of injured people hypothesis
| | Venue | 1 | Venue 2 | |
Venue 4 | Venue 5 |
| Number of injured people | 32 | 25 | 40 | 30 | 28 |
The number of resources that each emergency site can call is assumed to be shown in table 2.
TABLE 2 assumptions of the number of resources available to each emergency site
The scheduling time of the different emergency resources from each emergency resource site to each venue is assumed as shown in table 3. As the special channel for the large-scale event is arranged during the holding period, the road can be considered not to be blocked, namely the time for dispatching the resource from the emergency site to the disaster-stricken venue is stable and unchanged.
TABLE 3 assumptions of scheduling time of different emergency resources from each emergency site to each venue
In addition, it is assumed that, in addition to the venue 4 not being able to receive a helicopter, each of the venues can receive an ambulance and a helicopter. According to the medical rescue resource related data, it is assumed that each ambulance can rescue 3 wounded persons at most, and each rescue helicopter can rescue 6 wounded persons at most.
Step 1.1: and setting parameters of an emergency medical rescue resource scheduling model in the site rescue stage.
1) The current existence of I is set to 11 emergency sites, and J is set to 5 venues. The ith emergency site is represented by i 1, 2, 3, 11, and the jth venue is represented by j 1, 2, 3, 4, 5.
2) The current emergency resources are classified into L ═ 2 types, namely two types of emergency resources which can be called in the field treatment stage are an ambulance and a helicopter, wherein L ═ 1 represents the ambulance, and L ═ 2 represents the rescue helicopter.
3) Setting the number of injured people P in the venuejThe number of injured people reported in the jth venue is shown, and P is shown in correspondence with Table 11＝32，P2＝25，P3＝40，P4＝30，P5＝28。
4) Resource number E capable of being called by set first-aid stationilThe number of the first-class emergency resources which can be called by the ith emergency site is shown, and E is corresponding to the table 211＝5，E12＝2，E21＝4，E22＝0，......，E11，1＝6，E11，2＝2。
5) Setting resource scheduling time t from first-aid site to rear venueijlIndicating the time required for the ith type of resource to be dispatched from the ith emergency site to the jth venue, corresponding to t in Table 3111＝28，t112＝15，t121＝30，t122＝15，......，t581＝73，t582＝40。
6) Setting the rescue capacity of a single class I resource in a field rescue stagel. From the assumptions, a13 stands for an ambulance to help 6 persons, a26 stands for a helicopter that can help 6 people.
7) Setting a 0-1 variable h for indicating whether the venue accepts a certain type of resourcejl：
From the assumption, except for h420, the rest of hjl＝1。
8) Setting a decision variable XijlThe first-class emergency resources are allocated from the ith emergency site to the jth venue.
Step 1.2: and setting a target function of the emergency medical rescue resource scheduling model in the field rescue stage.
The objective function is set as follows:
the objective function (1) represents that the on-site rescue phase model should minimize the total arrival time of all rescue resources.
The objective function (2) indicates that the total rescue capacity for dispatching rescue resources should be as large as possible.
And a linear weighting method is combined with the objective function (1) and the objective function (2) to serve as a final objective function (3) of the model in the field rescue stage, so that the model solving result can meet multiple objectives simultaneously, namely the total arrival time of the emergency resources is minimum, and the total rescue capacity of the emergency resources is as large as possible. According to the decision-making emphasis, in this embodiment, c is taken11＝1、c12＝1。
Step 1.3: and setting constraint conditions of the emergency medical rescue resource scheduling model in the site rescue stage.
The constraint conditions are set as follows:
the formula (4) shows that the rescue capacity of the emergency resources dispatched by all emergency sites to each venue is not lower than the expected number of injured people of each venue, and the minimum requirements of each venue are met.
Equation (5) indicates that the number of various emergency resources scheduled out from each emergency site should be no higher than the emergency resources equipped by each site, within the callable range of each site.
Equation (6) indicates that different venues have different receptivity to each emergency resource. If the jth venue can not accept the first-class emergency resources, the corresponding hjlEach emergency site does not have to schedule class i resources to the venue again at 0.
Equation (7) represents the decision variable XijlIs a non-negative integer.
Step 1.4: and (3) selecting the lingo18.0 to solve the multi-target model in the field treatment stage, wherein the solving result is shown in the table 4.
Table 4 solving results of scheduling resource quantity from each first-aid station to venue in on-site treatment stage
The solution result is analyzed, so that the resource scheduling only occurs between the stadium and the station in the same competition area, and the actual requirement of avoiding the transfer between different competition areas is met as much as possible. And the sites supported by the resources in each venue comprise sites with shorter distances, so that the requirement of reaching the scene as soon as possible is met. According to various first-aid resources, the rescue capacity under the scheme can be calculated to be 162 people, and is slightly larger than 155 people reporting the number of injured people. From the above analysis, it can be known that the solution result satisfies the real requirement.
Step 2: and constructing and solving a multi-objective optimization model for emergency medical resource scheduling in the post-transfer stage of the large-scale event emergency. As shown in fig. 3, the transfer back-off phase of the present embodiment is connected to the on-site rescue phase, and includes 5 venues and 8 back hospitals. The model tasks of the post-transfer stage are as follows: and generating a resource allocation optimization scheme and a wounded transfer scheme from a demand venue to a rear hospital according to the triage classification data returned in the field treatment stage.
The following assumptions are made for the relevant data:
after the rescue in the on-site treatment stage is completed, detailed wounded triage information of each venue is obtained through statistics of medical staff. The injury situation of the wounded in each venue is assumed as shown in table 5.
TABLE 5 Stadium wounded situation hypothesis
| Pin | Critical load stage | Heavy grade | |
| Venue | |||
| 1 | 4 | 11 | 15 |
| Venue 2 | 6 | 8 | 10 |
| |
5 | 15 | 20 |
| Venue 4 | 1 | 10 | 20 |
| Venue 5 | 3 | 6 | 20 |
The individual venue medical resource callable cases are assumed as shown in table 6, where the number of ambulances and helicopters is counted by the spot rescue phase dispatch resource.
Table 6 venue medical resource callable case assumptions
The time assumptions for different first aid resources from each venue to the back hospital are shown in table 7. In addition, it is considered that volunteers provide the same time from each venue to the hospital at the back as the ambulance. As the special channel for the large-scale event is arranged during the holding period, the phenomenon that the road is blocked is considered not to occur, namely the time for dispatching different emergency resources from each venue to the rear hospital is stable and unchanged.
Table 7 time assumptions for different first aid resources from each venue to the following hospital
The maximum number of wounded persons received in the back hospital is assumed as shown in table 8.
TABLE 8 maximum number of victims accepted in the rear Hospital
| | Hospital | 1 | Hospital 2 | |
Hospital 4 | Hospital 5 | Hospital 6 | Hospital 7 | Hospital 8 |
| The number of the receiving people | 15 | 10 | 10 | 10 | 10 | 15 | 5 | 10 |
In addition, other hospitals can receive the ambulance, the helicopter and the volunteer vehicle, provided that the back hospitals 2 and 5 cannot receive the helicopter, the back hospital 7 cannot receive the ambulance and the volunteer vehicle. According to the medical rescue resource related data, at most 3 wounded persons can be rescued in each ambulance, wherein the maximum number of the wounded persons comprises 1 critical-level wounded person; the rescue helicopter can rescue 6 wounded persons at most, wherein 2 dangerous-level wounded persons are contained at most; suppose that each volunteer vehicle can rescue 2 wounded persons at most, and the 2 wounded persons are all mild wounded persons due to the lack of necessary medical equipment. According to the relevant emergency medical data, the gold treatment time of the critically ill wounded is assumed to be 30 minutes, and the maximum treatment time of the heavily wounded is assumed to be 60 minutes.
Step 2.1: the emergency resource scheduling from the disaster-stricken venue to the rear hospital needs to be completed for the rescue in the post-transfer stage, and parameters of an emergency medical rescue resource scheduling model in the post-transfer stage are set firstly.
The parameters are set as follows:
1) the current venue number I is set to 5, and the rear hospital number J is set to 8. The ith venue is represented by i 1, 2, 3, 4, 5, and the jth back hospital is represented by j 1, 2, 3.
2) The number L of types of emergency resources is set to 3. The emergency resources that can be called in the transfer back-delivery phase include an ambulance and a helicopter, and also include a volunteer vehicle, wherein l 1 represents the ambulance, l 2 represents the rescue helicopter, and l 3 represents the volunteer vehicle.
3) The number N of injury grades of the wounded is set. The heavy grade is represented by n-1, the heavy grade is represented by n-2, and the light grade is represented by n-3.
4) Setting the number P of the wound people in the stadium counted after triageinThe number of injured persons in the ith stadium is n, and P is shown in the correspondence table 511＝4，P12＝11，P13＝15，...，P52＝6，P53＝20。
5) Setting the number E of the resources which can be called in each venueilThe number of the first-class emergency resources which can be called by the ith venue is shown, and E is shown in the corresponding table 611＝5，E12＝3，E13＝18，...，E52＝5，E53＝10。
6) Setting resource scheduling time t from venue to rear hospitalijlTime required for the ith type of resource to be dispatched from the ith venue to the jth subsequent hospital is shown, and t is shown in the corresponding table 7111＝18，t112＝15，t113＝18，...，t581＝25，t582＝15，t583＝25。
7) Setting the total curing capacity of a single I type resource in the transfer after-delivery stage bl。b 13 stands for a maximum of 3 persons transported in an ambulance, b26 stands for 6 persons delivered after maximum transfer of a helicopter, b32 represents a volunteer vehicle which can transport and deliver 2 persons at most.
8) Setting the treatment capacity S of a single class I resource to the critically ill wounded in the transfer after-delivery stagel。S11 represents an ambulance capable of transporting 1 critical wounded person at most, S22 stands for a helicopter to transport 2 critical victims at most, S3And 0 represents that the volunteer vehicle cannot transport the critically ill wounded.
9) Setting the treatment capacity Z of a single class I resource in the transfer after-delivery stage to heavy wounded personsl。Z13 stands for an ambulance to transport 3 heavy wounded persons at most, Z26 stands for a helicopter to transport 6 critical victims at most, Z30 represents the volunteer vehicle being unable to transport heavy victims.
10) Setting a 0-1 variable h for indicating whether a rear hospital accepts a certain type of resourcejl：
From the assumption, except for h22＝0、h52＝0、h71＝0、h730, the rest of hjl＝1。
11) Set the maximum number of the people who can receive the doctor in the hospital at the rearjShowing that the jth hospital is connected at one timeThe maximum number of patients who received a doctor is C in correspondence to Table 81＝15，C2＝10，C3＝10，...，C8＝10。
12) Setting gold treatment time T of critical-grade wounded person1When the patient can be transported within 30 minutes after necessary emergency measures are taken, the patient is transported to a hospital at the rear for further treatment, the patient is successfully treated, and the patient dies.
13) Setting the maximum curing time T of the heavy wounded2When the patient is not transported within 60 minutes after the emergency treatment measures are compared, the patient is sent to a hospital for further treatment, and the patient is turned into a critical patient.
14) Setting a variable D of 0-1ijnl、Rijnl、WijnlThe first-aid resource is used for indicating the situations that the wounded in the n-level injury grade from the ith stadium to the jth back hospital die, get cured and get cured with the identity of the critical wounded.
For the critically ill wounded with n equal to 1, if the transfer time exceeds the gold rescue time T1Or the patient is not transported and the treatment is ineffective, and the patient dies, otherwise the patient can be treated by the identity of the critical patient.
For heavy wounded with n being 2, if the transfer time is at the maximum rescue time T2Within, the wounded is treated with the identity of the heavy-grade wounded; if transit time exceeds T2And is less than T1+T2The wounded is treated with the identity of the critical-grade wounded; if transit time exceeds T1+T2Or the patient is not transported, and the wounded patient dies;
for the light-grade wounded person with n-3, there is no death, and the set treatment condition is only to be transported to the back hospital, and there is no time limit, so the corresponding D, R, W three parameters are constant values.
Dij3l＝0 Rij3l＝1 Wij3l＝0
15) Setting a decision variable Xijl、aijnl. Wherein XijlRepresenting the number of the first-aid resources allocated from the ith venue to the jth back hospital, aijnlThe first-class emergency resources are loaded on the roads from the ith venue to the jth back hospital, and the number of the wounded persons with the injury grade of n is represented.
Step 2.2: and setting a target function of the emergency medical rescue resource scheduling model in the post-transfer stage.
The objective function is set as follows:
the objective function (8) represents a model of the post-transit phase that minimizes the total number of deaths. The number of deaths includes the total number of casualties above the light level that died because of the lengthy transit time and the lack of transit.
The objective function (9) shows that the number of wounded persons with heavy grade converted into dangerous grade due to too long transit time is reduced as much as possible.
The objective function (10) indicates that the total number of persons to be treated should be maximized, because it is considered that the treatment cannot be performed in consideration of the fact that the light-level injured person is not transported, and therefore the objective function (10) is mainly considered that more light-level injured persons are treated.
The objective function (11) indicates that the average transit time of the emergency resources in the scheduling scheme should be as small as possible. Because there is no time-limiting requirement for the transportation of the light wounded, in order to further ensure that the wounded is treated as soon as possible, the requirement of minimum average time is added to avoid selecting a far route.
The objective function (12) indicates that the unused positions of the medical resources in the scheduling scheme are as few as possible, namely the resource utilization rate is as high as possible.
And (3) combining the five objective functions, namely objective functions (8) to (12), by using a linear weighting method to serve as a final objective function, namely an objective function (13), of the model in the transport and delivery stage, so that the model solving result can simultaneously meet a plurality of targets, namely, the number of dead people is reduced as much as possible, the number of serious-grade to critical-grade wounded people is reduced as little as possible, the total number of treated people is reduced as much as possible, the average transport time is shortened as much as possible, and the resource utilization rate is increased as much as possible. In this embodiment, c is re-fetched based on the decision side21＝1、c22＝1、c23＝1、c24＝1、c25＝1。
Step 2.3: and setting constraint conditions of the emergency medical rescue resource scheduling model in the post-transfer stage.
The constraint (14) indicates that the number of types of first aid resources scheduled out of each venue should be within the callable range of the respective venue.
Equation (15) indicates that all rescue resources can only be dispatched to the back-end hospital that can accept such rescue resources.
The formula (16) shows that the number of wounded persons actually transported in each venue is not more than the known number of wounded persons.
The formula (17) indicates that the number of the wounded persons who are transported to each rear hospital is within the acceptable number in the hospital.
Equation (18) indicates that the number of individuals transporting critically ill victims cannot exceed the upper limit.
Equation (19) indicates that the number of individuals with a single emergency resource transfer heavy wounded cannot exceed the upper limit.
The formula (20) shows that the total number of the wounded transported by the single first-aid resource does not exceed the upper limit of the total rescue capacity, and each first-aid resource should be transported by the wounded with the maximum rescue capacity as much as possible.
Equation (21) represents the decision variable Xijl、aijnlAre all non-negative integers.
Step 2.4: and reasonably arranging the wounded carrying scheme of each medical resource through the solving result of the transferring and sending stage. The realization mode is as follows:
firstly, solving a model of a transport back-delivery stage by using lingo18.0 to obtain a solving result, including XijlAnd aijnlThe two types of variables respectively correspond to the quantity of emergency resources on each route and the quantity of different wounded persons. And for the medical resources and the wounded on each post-transfer delivery path, arranging the wounded to each first-aid resource according to the wounded injury priority and the medical resource category priority. Wherein the wounded injury priority is as follows: the critical wounded personnel, the heavy wounded personnel and the light wounded personnel are all arranged, namely the wounded personnel with heavy injury are transported and then sent; the resource type priority is: the rescue helicopter, the ambulance and the volunteer vehicle are arranged, namely, the wounded carrying scheme of medical resources with short time for arriving at the venue and complete medical equipment is arranged. In arranging the wounded, the ability of rescuing the critically ill wounded and the total ability of rescuing the wounded, which are all considered at the same time, need to be considered for each medical resource. Fig. 4 shows a process of generating the wounded loading scenario for a certain type of resources on each post-transfer route.
The final triage protocol for the post-delivery phase is shown in table 9.
TABLE 9 post-transfer phase wounded transfer protocol
The analysis of the transfer scheme shows that the actual number of injured people in the transfer back-delivery stage is 154, and volunteer vehicles are added on the basis of the scheme results in the field treatment stage, so that the overall rescue capacity completely meets the requirements. Under the scheme, the wounded persons are all transported in a classified mode, the number of dead people is 0, the number of people treated by the critical grade identity is 19, the total number of people treated is 154, no serious wounded persons are converted into critical grade, and the treatment success rate reaches 100%. The wounded transfer is all taken place between the short venue of same race area resource transfer time and rear hospital, does not have the condition of transshipping in the cross-race area. In addition, single emergency resources are used to the maximum extent, and transportation under full load is basically realized. From the above analysis, it can be known that the solution result satisfies the real requirement.
The above detailed description is intended to illustrate the objects, aspects and advantages of the present invention, and it should be understood that the above detailed description is only exemplary of the present invention and is not intended to limit the scope of the present invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the scope of the present invention.
Claims (3)
1. An emergency medical rescue resource scheduling optimization model for a large-scale sports event emergency is characterized by comprising the following steps:
step 1: establishing and solving an emergency medical resource scheduling multi-objective optimization model in the scene emergency treatment stage of the large-scale sports event, and generating a medical resource scheduling scheme from an emergency site to a disaster-stricken venue according to the type of the emergency and the number of injured people;
step 2: and establishing and solving an emergency medical resource scheduling multi-objective optimization model in the post-transfer stage of the large-scale event emergency, and generating a resource allocation optimization scheme from a demand venue to a rear hospital and a wounded transfer scheme according to the triage classification data returned in the field treatment stage.
2. The optimization model for scheduling emergency medical rescue resources for large-scale sports events emergencies according to claim 1, wherein in step 1, the resource scheduling model is established and solved by the following steps:
step 1.1: setting parameters of an emergency medical rescue resource scheduling model in a site rescue stage:
1) setting that I emergency stations and J venues exist at present, wherein I is 1, 2, 3.. the ith emergency station is represented by I, and J is 1, 2, 3.. the jth venue is represented by J;
2) setting the current emergency resources to be classified into L types, wherein L is 1, 2 and 3, and L represents different emergency resources, such as ambulances, rescue helicopters, volunteer vehicles and the like;
3) setting the number of injured people P in the venuejRepresenting the estimated number of injured people in the jth venue;
4) resource number E capable of being called by set first-aid stationilThe number of the first-class emergency resources which can be called by the ith emergency station is represented;
5) setting resource scheduling time t from first-aid site to rear venueijlThe time required for the ith type of resource to be dispatched from the ith emergency site to the jth venue is represented;
6) setting the rescue capacity of a single class I resource in a field rescue stagelIndicating that a single class I resource can be rescuedlAn individual wounded;
7) setting a 0-1 variable h for indicating whether the venue accepts a certain type of resourcejl：
8) Setting a decision variable XijlThe number of the first-class emergency resources allocated from the ith emergency site to the jth venue is shown;
step 1.2: setting a target function of an emergency medical rescue resource scheduling model in a site rescue stage;
the objective function is set as follows:
a linear weighting method is combined with the objective function (1) and the objective function (2) to serve as a final objective function of the model in the site rescue stage, namely the objective function (3), so that the model solving result can meet multiple objectives simultaneously, namely the total arrival time of the emergency resources is minimum, and the total rescue capacity of the emergency resources is as large as possible; weight c of each sub-target of target function (3)11、c11The decision is made by the decision maker;
step 1.3: the method comprises the following steps of setting constraint conditions of an emergency medical rescue resource scheduling model in a site rescue stage, wherein the constraint conditions comprise constraint formulas (4) to (7):
step 1.4: and solving the multi-target model in the field rescue stage by using lingo18.0 or other operational research software to obtain an emergency medical rescue resource scheduling scheme in the field rescue stage.
3. The optimization model for scheduling emergency medical rescue resources for large-scale sports events emergencies according to claim 1, wherein in the step 2, the steps of establishing and solving the resource scheduling model are as follows:
step 2.1: setting parameters of an emergency medical rescue resource scheduling model in a post-transfer stage;
1) setting the current number I of venues and the number J of back hospitals, wherein the ith venue is represented by I which is 1, 2, 3.
2) Setting the type quantity L of emergency resources, and using L as 1, 2, 3, L and other numbers to represent different emergency resources, such as ambulances, rescue helicopters, volunteer vehicles and the like;
3) setting the number N of injury grades of the wounded as 3, wherein N is 1 to represent a dangerous weight grade, N is 2 to represent a heavy grade, and N is 3 to represent a light grade;
4) setting the number P of the wound people in the stadium counted after triageinThe number of wounded persons with the injury grade n in the ith stadium is shown;
5) setting the number E of the resources which can be called in each venueilThe number of the first-class emergency resources which can be called by the ith venue is represented;
6) setting resource scheduling time t from venue to rear hospitalijlThe time required for the ith type of resource to be dispatched from the ith venue to the jth subsequent hospital is represented;
7) setting the total curing capacity of a single I type resource in the transfer after-delivery stage blRepresenting maximum transport of a single class I resourcelAn individual wounded;
8) setting the treatment capacity S of a single class I resource to the critically ill wounded in the transfer after-delivery stagelRepresenting maximum diversion of a single class I resourcelThe critical wounded;
9) setting the treatment capacity Z of a single class I resource in the transfer after-delivery stage to heavy wounded personslRepresenting maximum diversion of a single class I resourcelA weight-level wounded person;
10) setting a 0-1 variable h for indicating whether a rear hospital accepts a certain type of resourcejl：
11) Set the maximum number of the people who can receive the doctor in the hospital at the rearjThe number of the maximum patients can be accepted by the jth hospital at one time, and the number of the patients which can be accepted by the hospital is not influenced by the light-grade wounded in the rear hospital because the treatment time of the light-grade wounded is short and the hospital bed is not occupied;
12) setting gold treatment time T of critical-grade wounded person1Means that the critically ill wounded can be treated at T after receiving the necessary emergency treatment1After the patient is transported in time, the patient is sent to a rear hospital to be further cured, the patient with the critical level is successfully cured, otherwise, the patient with the critical level dies;
13) setting the maximum curing time T of the heavy wounded2It means that the heavy-grade wounded person cannot be treated at T after the necessary first aid treatment2After the patient is transported in time, the patient is sent to a rear hospital to be further treated, and the serious-level wounded patient can be converted into a critical-level wounded patient;
14) setting a variable D of 0-1ijnl、Rijnl、WijnlThe system is used for indicating the situations that the wounded in the n-level injury grade die, get cured and get cured with the identity of the critical wounded in the scheme that the wounded are sent to the jth rear hospital from the ith stadium by using the first-class emergency resources; in combination with the particularity of emergency medical rescue, the situation that heavy-level wounded persons can be changed into critical-level wounded persons after a certain time needs to be considered, so that the judgment standards of the values of the treatment effect parameters are different for the wounded persons with different injury levels;
for the critically ill wounded with n equal to 1, if the transfer time exceeds the gold rescue time T1Or the treatment is ineffective if the transfer is not obtained, and the wounded death, otherwise, the identity of the critical wounded can be treated;
for heavy wounded person with n-2, if the transfer time is at the maximum, the wounded person is rescuedRelief effect time T2Within, the wounded is treated with the identity of the heavy-grade wounded; if transit time exceeds T2And is less than T1+T2The wounded is treated with the identity of the critical-grade wounded; if transit time exceeds T1+T2Or the patient is not transported, and the wounded patient dies;
for the light-grade wounded with n-3, no death condition exists, the condition for obtaining treatment is set as that the wounded is transported to a rear hospital, and the time is not limited, so that corresponding D, R, W three parameters are constant values;
Dij3l＝0 Rij3l＝1 Wij3l＝0
15) setting a decision variable Xijl、aijnl(ii) a Wherein XijlRepresenting the number of the first-class emergency resources allocated from the ith venue to the jth subsequent hospital, aijnlRepresenting the total number of wounded persons with the injury grade of n grade carrying the first-class emergency resources on the road from the ith venue to the jth back hospital;
step 2.2: setting a target function of an emergency medical rescue resource scheduling model in a post-transfer stage:
the linear weighting method is combined with the objective functions (8) to (12) to serve as the final objective function of the model in the transfer and delivery stage, namely the objective function (13), so that the model solving result can meet multiple objectives simultaneously, namely the number of dead people is reduced as much as possible, the number of serious-stage to critical-stage wounded people is reduced as much as possible, the total number of treated people is increased as much as possible, the average transfer time is shortened as much as possible, and the resource utilization rate is increased as much as possible; weight c of each sub-target of the target function (13)21、c22、c23、c24、c25The decision is made by the decision maker;
step 2.3: setting constraint conditions of an emergency medical rescue resource scheduling model in a transport back-delivery stage, wherein the constraint conditions comprise constraint formulas (14) - (21);
step 2.4: reasonably arranging the wounded carrying scheme of each medical resource through the solving result of the post-transferring stage to obtain a final transferring and delivering scheme of the wounded in the post-transferring stage; the arrangement concept of the wounded carrying scheme is as follows:
firstly, solving a model of a post-transfer stage by using lingo18.0 or other operational research software to obtain a solving result, wherein the solving result comprises XijlAnd aijnlThe two types of variables respectively correspond to the quantity of first-aid resources on each route and the quantity of different wounded persons; for the medical resources and the wounded on each transfer post-delivery path, arranging the wounded to each first-aid resource according to the wounded injury priority and the medical resource category priority; wherein the wounded injury priority is as follows: the critical wounded personnel, the heavy wounded personnel and the light wounded personnel are all arranged, namely the wounded personnel with heavy injury are transported and then sent; the resource type priority is: the rescue helicopter, the ambulance and the social vehicle are arranged, namely, a wounded carrying scheme of medical resources with short time for reaching the venue and complete medical equipment is arranged; in arranging the wounded, the ability of rescuing the critically ill wounded and the total ability of rescuing the wounded, which are all considered at the same time, need to be considered for each medical resource.
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN114997653A (en) * | 2022-06-07 | 2022-09-02 | 中国人民解放军空军军医大学 | Treatment resource scheduling method based on efficiency specificity iterative computation |
| CN116313018A (en) * | 2023-05-18 | 2023-06-23 | 北京大学第三医院（北京大学第三临床医学院） | System and method for improving emergency efficiency of skiing field and near-field hospital |
| WO2023221956A1 (en) * | 2022-05-17 | 2023-11-23 | 浙江大学 | First-aid medical evacuation decision making system and method based on multi-agent reinforcement learning |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2023221956A1 (en) * | 2022-05-17 | 2023-11-23 | 浙江大学 | First-aid medical evacuation decision making system and method based on multi-agent reinforcement learning |
| CN114997653A (en) * | 2022-06-07 | 2022-09-02 | 中国人民解放军空军军医大学 | Treatment resource scheduling method based on efficiency specificity iterative computation |
| CN114997653B (en) * | 2022-06-07 | 2023-09-01 | 中国人民解放军空军军医大学 | Treatment resource scheduling method based on efficiency specificity iterative computation |
| CN116313018A (en) * | 2023-05-18 | 2023-06-23 | 北京大学第三医院（北京大学第三临床医学院） | System and method for improving emergency efficiency of skiing field and near-field hospital |
| CN116313018B (en) * | 2023-05-18 | 2023-09-15 | 北京大学第三医院（北京大学第三临床医学院） | Emergency system and method for skiing field and near-field hospital |
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