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Strategies in Evaluation and Management of Bam Earthquake Victims

  • Mohammad J. Emami (a1), Ali R. Tavakoli (a1), Hossein Alemzadeh (a1), Farzad Abdinejad (a1), Gholamhossain Shahcheraghi (a1), Mohammad A. Erfani (a1), Kamran Mozafarian (a1), Saeed Solooki (a1), Sorena Rezazadeh (a1), Ahmad Ensafdaran (a1), Hormoz Nouraie (a1), Feriedoon M. Jaberi (a1) and Maryam Sharifian (a1)...

Abstract

Background:

On 26 December 2003, an earthquake measuring 6.5 on the Richter scale occurred in the city of Bam in southeastern Iran. Bam was destroyed completely, >43,000 people were killed, and 30,000 were injured. The national and international responses were quick and considerable. Many field hospitals werecreated and large numbers of patients were evacuated from their homes and transported to hospitals throughoutIran. Nearly 700 patients were transferred to Chamran hospital in Shiraz within the first 48 hours after the earthquake.

Methods:

This is a retrospective study based on the medical records of earthquake casualties dispatched to Chamran Hospital. A screening tunnel composed of multiple stations was prepared before patients entered to facilitate the large influx of patients. Each of the victims was passed through this screening tunnel and assigned into one of three groups: (1) those needing emergency surgical intervention; (2) those needing less urgent surgery; and (3) those needing elective operations, supportive care, observation, and/or rehabilitation.

Results:

Among the 708 patients, 392 were male (male/female ratio: 1.24) with a mean value of their ages of 30.5 years. (range: 1.5 months–70 years). Extremity fractures (136, 19%) were more common than were axial skeleton fractures (28, 4%). Out of the total 708 patients, 152 (21.5%) patients needed emergency operations, 26 (4%) needed less urgent surgery, and 530 (74.5%) required wound care or antibiotic therapy and other forms of supportive care. Some complications occurred, such as two patients with compartment syndromes of theleg, three required below-the-knee amputation, eight suffered acute renal failure, two developed fat emboli syndrome, and one had a brain injury that resulted in death.

Conclusion:

A comprehensive disaster plan is required to ensure a prompt disaster response and coordinated management of a multi-casualty incident. This can influence the outcomes of patients directly. A patient screening tunnel has advantages in rapid and effective evaluation and management of victims in any multi-casualty incident.

Copyright

Corresponding author

Department of Orthopedic SurgeryChamran Hospital Shiraz, Iran E-mail: tavakola@sums.ac.ir

References

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1. WHO: WHO joins international effort to help Bam earthquake survivors. Bull World Health Organ 2004;82(2):156.
2.Moszynski, P: Cold is the main health threat after the Bam earthquake. BMJ 2004;328(7431):66.
3.Akbari, ME, Farshad, AA, Asadi-Lari, M: The devastation of Bam: An overview of health issues 1 month after the earthquake. Public Health 2004;118(6):403408.
4.Schnitzer, JJ, Briggs, SM: Earthquake relief—The US medical response in Bam, Iran. N Eng J Med 2004;350(12):11741176.
5.Zarocostas, J: WHO praises Bam response, but warns of disease. Lancet 2004;363(9404):218.
6.Ahmad, K: Iranian government draws up plans to rebuild Bam. Restoration of health-care facilities is a priority for the Iranian government and international aid agencies. Lancet 2004;363(9403):131.
7.Greene, WM: Developing an earthquake strategic plan for British Columbia. PrehospDisast Med 1999;14(Supplement 1):S30. (Abstract).
8.Yoshioka, T, Yamayoshi, S, Ikeuchi, H et al. : Disaster preparedness in Osaka: Role and relationship of the core medical institutes in a disaster. Prehosp Disast Med 1999;14(1):s38–s39. (Abstract).
9.Sheng, ZY: Medical support in the Tang-Shan earthquake: A review of the management of masscasualties and certain major injuries. J Trauma 1987;27(10):11301135.
10.Zhang, YB: The management of mass casualties of serious earthquakes in China. Prehosp Disast Med 2001;16(2):s90. (Abstract).
11.Maruo, S, Matumoto, M: Spinal fractures resulting from the 1995 Great Hanshin earthquake of the Kobe-Osaka area of Japan. Spinal Cord 1996;34(7):382386.
12.Kurt, N, Kucuk, HF, Celik, G et al. : Evaluation of patients wounded in the 17 August 1999 Marmara earthquake. Ulus Travma Derg 2001;7(1):4951.
13.Mhayan, G, Havhemes, S, Garen, K: Earthquake in Armenia of 1988.Prehosp Disast Med 2001;16(2):S50.
14.Kazzi, AA, Langdorf, MI, Handly, N et al. : Earthquake epidemiology: The 1994 Los Angeles earthquake emergency department experience at a community hospital. Prehosp Disast Med 2000;15(1):1219.
15.Gunal, AI, Celiker, H, Dogukan, A et al. : Early and vigorousfluid resuscitation prevents acute renal failure in the crush victims of catastrophic earthquakes. JAm Soc Nephrol 2004:15(7):18621867.
16.Sever, MS, Erek, E, Vanholder, R, Lameire, N: Effect of gender onvarious parameters of crush syndrome victims of the Marmora earthquake. J Nephrol 2004;17(3):399404.
17.Azolov, VV, Aleinikov, A, Kielman, VK, Kaiumov, Y: Tactics and general principles in the treatment of polytraumatized disaster victims. Clin Ortho Related Res 1995;320:1115.
18.Shaposhnikov, IG, Kozhin, NP, Nikogosian, RV et al. : The outcomes in crush syndrome of the extremities half a year after the earthquake in Armenia. Voen Med Zh 1990;(4):4445.
19. PAHO: PAHO guidelines for the use of foreign field hospitals in the aftermath of sudden-impact disaster. Prehosp Disast Med 2003;18(4):278-290.
20.Saliba, D, Buchenan, J, Kington, RS: Function and response of nursing facilities during community disaster. Am J Public Health 2004;94(8):14361441.
21.Bremer, R: Policy development in disaster preparedness and managment: Lessons learned form the January 2001 earthquake in Gujarat, India. Prehosp Disast Med 2003;18(4):372384.
22.Milston, A: Hospital response to acute-onset disasters: A review. Prehosp DisastMed 2000;15(1):3245.
23.Petitjean, F, Mougeslle, C, Meyoran, D: Crisis management: A possible improvised operational approach. Prehosp Disast Med 2001;16(2):S55. (Abstract).

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