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Strategies in Evaluation and Management of Bam Earthquake Victims

Published online by Cambridge University Press:  28 June 2012

Mohammad J. Emami ,
Ali R. Tavakoli ,
Hossein Alemzadeh ,
Farzad Abdinejad ,
Gholamhossain Shahcheraghi ,
Mohammad A. Erfani ,
Kamran Mozafarian ,
Saeed Solooki ,
Sorena Rezazadeh  and
Ahmad Ensafdaran
...Show all authors
Mohammad J. Emami
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Ali R. Tavakoli*
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Hossein Alemzadeh
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Farzad Abdinejad
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Gholamhossain Shahcheraghi
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Mohammad A. Erfani
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Kamran Mozafarian
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Saeed Solooki
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Sorena Rezazadeh
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Ahmad Ensafdaran
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Hormoz Nouraie
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Feriedoon M. Jaberi
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
Maryam Sharifian
Affiliation:
Shiraz University of Medical Sciences Medical School, Orthopedic Surgery Department, Shiraz University, Shiraz, Iran
*
Department of Orthopedic SurgeryChamran Hospital Shiraz, Iran E-mail: tavakola@sums.ac.ir
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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.

Keywords

Bamcatastrophedisaster preparednessearthquakeemergency medical servicesmass casualtiesmedical disaster responsemulti-casualty incidentstrauma care
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 20 , Issue 5 , October 2005 , pp. 327 - 330
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2005

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