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On February 6, 2018, a magnitude 6.2 earthquake struck Hualien, the eastern part of Taiwan. The quake resulted in 17 deaths and more than 300 people injured. Four buildings completely collapsed and hundreds of houses were damaged.
The aim of this research was to use the patient data to analyze the reasons for visits, the trauma sites, and the severity.
We obtained the patient information from the Taiwan Eastern Medical Emergency Operation Center. Medical records were reviewed to analyze the primary diagnosis, the trauma mechanisms, and the sites of injury. Injury severity score (ISS) was used to assess trauma severity.
Two hundred and eighty patients were included in the study, with 90.3% being traumatic patients. Among them, 18.2% was geriatric trauma, 4.7% was pediatric trauma, and 0.4% was obstetric trauma. The most common injury site was lower extremities (33.2%), followed by head (31.4%) and upper extremities (27.1%). The mean injury severity score (ISS) was 1.9. The geriatric population had an average ISS of 2.4, and the pediatric group had a mean ISS of 1.2.
In our study, the majority of the patients had minor trauma. Lower extremities may be more vulnerable during the evacuation of an earthquake, and thus, became the most common injury site. The elderly patients had a higher ISS, which may be explained by their immobility and fragility of the body. In the future, it is critical to educate citizens about self-protection during earthquakes, focusing on protecting the head and the extremities. Healthcare providers and emergency medical technicians need to be well-trained to handle geriatric trauma since it poses unique challenges and is associated with increased mortality.
On February 6, 2018, a magnitude 6.2 earthquake struck Hualien, Taiwan. Over 150 patients crammed into the emergency department of nearby hospitals within two hours. Mass casualty incident (MCI) management was activated. During the recovery phase, little attention was paid to the mental health of hospital staff.
To analyze the prevalence of post-traumatic stress disorder (PTSD) among healthcare providers (HCPs) and explore the possible risk factors.
63 HCPs in the emergency department of the single tertiary hospital near the epicenter were included. The Chinese version of the Davidson Trauma Scale (DTS-C) was used to evaluate the prevalence of PTSD. Questionnaires were sent to explore the possible contributing factors.
The average age of the HCPs was 32.7 years (30.3 years for nurses; 40.4 years for physicians). The prevalence of PTSD was 3.2% eight months after the incident. The mean DTS-C score was 8.9/136. Nurses had a higher score than physicians (10.8 and 4.7). HCPs with 6-10 years working experience had the highest score (14.2), while those with less than 3 years experience had the lowest (4.8).
We found HCPs had a lower prevalence of PTSD compared with earthquake survivors (Chou 2007), and physicians had longer working years and lower DTS-C scores. The professional training may help HCPs going through psychological impacts during the disaster. HCPs with 6-10 years of experience in the emergency department were found to have a higher risk of developing PTSD. Most of them were taking the responsibility of a team leader during the MCI, which may cause significant stress to these staff. Adequate training regarding MCI management could help to relieve tension and frustration, hoping to prevent the development of PTSD. Based on our study, PTSD among HCPs is an ignored issue, and we should follow-up HCPs’ psychological condition in the future.
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