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Disaster Reanimatology Potentials: A Structured Interview Study in Armenia. III. Results, Conclusions, and Recommendations

  • Ernesto A. Pretto, Edmund Ricci, Miroslav Klain, Peter Safar, Victor Semenov, Joel Abrams, Samuel Tisherman, David Crippen, Louise Comfort and other members of the Disaster Reanimatology Study Group...

Abstract

National medical responses to catastrophic disasters have failed to incorporate a resuscitation component.

Purpose:

This study sought to determine the lifesaving potentials of modern resuscitation medicine as applied to a catastrophic disaster situation. Previous articles reported the preliminary results (I), and methodology (II) of a structured, retrospective interview study of the 1988 earthquake in Armenia. The present article (III) reports and discusses the definitive findings, formulates conclusions, and puts forth recommendations for future responses to catastrophic disasters anywhere in the world.

Results:

Observations include: 1) The lack of adequate construction materials and procedures in the Armenian region contributed significantly to injury and loss of life; 2) The uninjured, lay population together with medical teams including physicians in Armenia were capable of rapid response (within two hours); 3) Due to a lack of Advanced Trauma Life Support (ATLS) training for medical teams and of basic first-aid training of the lay public, and scarcity of supplies and equipment for extrication of casualties, they were unable to do much at the scene. As a result, an undetermined number of severely injured earthquake victims in Armenia died slowly without the benefit of appropriate and feasible resuscitation attempts.

Recommendations:

1) Widespread adoption of seismic-resistant building codes for regions of high seismic risk; 2) The lay public living in these regions should be trained in life-supporting first-aid (LSFA) and basic rescue techniques; 3) Community-wide emergency medical services (EMS) systems should be developed world-wide (tai-lored to the emergency needs of each region) with ATLS capability for field resuscitation; 4) Such systems be prepared to extend coverage to mass casualties; 5) National disaster medical system (NDMS) plans should provide integration of existing trauma-EMS systems into regional systems linked with advanced (heavy) rescue (public works, fire, police); and 6) New techniques and devices for victim extrication should be developed to enable rapid extrication of earthquake casualties within 24 hours.

Copyright

Corresponding author

Principal Investigator, Disaster Reanimatology Study Group, International Resuscitation Research Center and Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh, 3434 Fifth Avenue, Pittsburgh, PA 15260 USA

References

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1. Safar, P, Ramos, V, Mosquera, J, et al. : Anecdotes on resuscitation potentials following the earthquake of 1970 in Peru. Prehospital and Disaster Medicine 1987;3:124.
2. Molfese, A: 1980 earthquake in Basilicata. Prehospital and Disaster Medicine 1987;3:9698.
3. Safar, P. Resuscitation potentials in mass disasters. Prehospital and Disaster Medicine 1986;2:3447.
4. Klain, M, Ricci, E, Safar, P, et al. : Disaster reanimatology potentials: A structured interview study in Armenia. I. Methodology and preliminary results. Prehospital and Disaster Medicine 1989;4:135154.
5. Ricci, E, Pretto, E, Safar, P, et al. : Disaster reanimatology potentials: A structured interview study in Armenia. Prehospital and Disaster Medicine 1991;6:159166.
6. Gunn, SWA: Earthquakes. In: Medicine for Disasters, Baskett, P, Weller, R, (eds.), Butterworth and Co. publ., London, 1988, pp 285290.
7. Pretto, E, Safar, P: National medical response to mass disasters in the USA. Are we prepared? JAMA 1991;266:12591262.
8. Gunn, SWA: The coordination of governments and relief agencies. In: Medicine for Disasters. Baskett, P, Weller, R (eds.), Butterworth and Co., publ., London, 1988.
9. Ricci, E, Pretto, E: Assessment of prehospital and hospital response in disaster. Critical Care Clinics 1991;7:471484.
10. Cummins, R, Chamberlain, D, Abrahamson, NS, et al. : Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: The Utstein style. Circulation 1991;84:960975.

Keywords

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia. III. Results, Conclusions, and Recommendations

  • Ernesto A. Pretto, Edmund Ricci, Miroslav Klain, Peter Safar, Victor Semenov, Joel Abrams, Samuel Tisherman, David Crippen, Louise Comfort and other members of the Disaster Reanimatology Study Group...

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