329 Use of a Modified Trauma Score in the Prehospital Assessment of Disaster Victims

Angus, Derek C.; Pretto, Ernesto A.; Shen, Bern; Bissell, Rick; Ceciliano, Norma; Watch, Y; Abrams, J.I.; Ricci, Edmund M.

doi:10.1017/s1049023x00049013

Cited by 2 publications

(1 citation statement)

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“…The others were national coordinators or medical relief personnel who arrived later and were involved in the response efforts. Of the 160, 66% (105) were lay survivors, 12% (19) local SAR personnel (seven police and 12 soldiers), 12% (19) medical personnel, and 11% (17) were involved in the coordination of the local medical response (e.g., hospital administrators, military officers at a nearby military base, police officers, and officials of the mayor's office). Most of the lay respondents (71, 68%) were men, as were most SAR personnel (17, 89%), and all of the coordinators.…”

Section: Epidemiologic Assessmentmentioning

confidence: 99%

Epidemiologic Assessment of Mortality, Building Collapse Pattern, and Medical Response after the 1992 Earthquake in Turkey

Angus

Pretto

Abrams

et al. 1997

Prehosp. Disaster med.

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Background:Post-earthquake engineering and epidemiologic assessments are important for the development of injury prevention strategies. This paper describes mortality and its relationship to building collapse patterns and initial medical responses following the 1992 earthquake in Erzincan, Turkey.Methods:The study consisted of: 1) background data collection and review; 2) design and implementation of a field survey; and 3) site inspection of building collapse patterns. The survey included: 1) national (n = 11) and local (n = 17) officials; 2) medical and search and rescue (SAR) workers (n = 38); and 3) a geographically stratified random sample of lay survivors (n = 105). The survey instruments were designed to gather information regarding location, injuries, initial actions and prior training of survivors and responders, and the location, injuries, and management of dead and dying victims. A case-control design was constructed to assess the relationship between mortality, location, and building collapse pattern.Results:There was extensive structural damage throughout the region, especially in the city where mid-rise, unreinforced masonry buildings (MUMBs) incorporating a “soft” first floor design (large store windows for commercial use) and one story adobe structures were most vulnerable to collapse. Of 526 people who died in the city, 87% (n = 456) were indoors at the time of the earthquake. Of these, 92% (n = 418) died in MUMBs. Of 54 witnessed deaths, 55% (n = 28) of victims died slowly, the majority of whom (n = 26) were pinned or trapped (p <0.05). Of 42 MUMB occupants identified through the survey, those who died (n = 25) were more likely to have been occupying the ground floor when compared with survivors (n = 28) (p <0.01). Official medical and search and rescue responders arrived after most deaths had occurred. Prior first-aid or rescue training of lay, uninjured survivors was associated with a higher likelihood of rescuing and resuscitating others (p <0.001).Conclusion:During an earthquake, MUMBs with soft ground floor construction are highly lethal, especially for occupants on the ground floor, suggesting that this building type is inappropriate for areas of seismic risk. The vulnerability of MUMBs appears due to a lack of lateral force resistance as a result of the use of glass store fiont windows and the absence of shear walls. The prevalence of this building type in earthquake-prone regions needs to be investigated further. A large portion of victims dying in an earthquake die slowly at the scene of injury. Prior public first-aid and rescue training programs increase participation in rescue efforts in major earthquakes and may improve survival.

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Section: Epidemiologic Assessmentmentioning

confidence: 99%

Epidemiologic Assessment of Mortality, Building Collapse Pattern, and Medical Response after the 1992 Earthquake in Turkey

Angus

Pretto

Abrams

et al. 1997

Prehosp. Disaster med.

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Perceived Preparedness for a Mass Casualty Disaster in the United States: A Survey

Glick

Birnbaum

1998

Prehosp. Disaster med.

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Introduction:A mass casualty disaster (MCD) never has occurred in the United States, but such an event remains a fearful possibility. The purpose of this study was to establish baseline information concerning the perceptions relative to the capabilities of the United States to respond to a MCD of persons most likely to involved in the responses to such an event when it does occur.Methods:A survey was constructed in 1995 to query the perceptions of persons in authority in federal, state, and local agencies who would participate in the medical responses to a MCD. Participants were asked to select the most likely scenario, a hurricane or earthquake, that could generate 30,000 casualties within their respective region. The survey requested respondent's perceptions as to the timing of the federal responses and the quality and sufficiency of these responses. The survey also sought information about the availability of plans to meet such a catastrophe in the region, and the frequency with which such plans have been exercised.Responses were grouped by phase of the responses and whether the respondents were employed by federal, state, or local agencies. Descriptive statistics were used to summarize the data. When appropriate, a one-tailed t-test was used to compare the responses of the groups. A p-value = 0.05 was considered statistically significant.Results:A total of 104 surveys were distributed of which 88 were completed and returned (85%). Both the federal and state respondents had considerable experienced in this area.Overall, the federal respondents were more optimistic about the availability, utility, and timely arrival of federal resources to assist regions in meeting the medical needs. In each of the three phases of MCD responses evaluated (medical response, patient evacuation, and definitive care), there was concern that there were insufficient resources to meet the requirements. States and local respondents perceived that initially, they will be on their own for field rescue, life-supporting first-aid, and casualty evacuation. Respondents acknowledged that a combination of local, state, federal, and private resources eventually would be needed to meet the huge demand. Only 31% federal and 26% state/local respondents believed that there will be sufficient combined local, state, federal, and private resources to meet the requirements for the evacuation of casualties to definitive care facilities outside of the region, and another 50% acknowledged the resources would only partially meet these requirements. Sixty-eight percent of state/local respondents believed that there would be insufficient local, state, federal, and private definitive care resources to meet the requirements for definitive care.Conclusion:While three years have elapsed since the survey was conducted and there have been some improvements in preparedness and responses, concerns center around the perceived lack of resource capability or lack of ability to get the resources to the MCD scene in time to meet requirements. Such perceptions by experienced professionals warrant further review by those at all levels of government responsible for planning and responding to mass casualty disasters.

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329 Use of a Modified Trauma Score in the Prehospital Assessment of Disaster Victims

Cited by 2 publications

References 0 publications

Epidemiologic Assessment of Mortality, Building Collapse Pattern, and Medical Response after the 1992 Earthquake in Turkey

Epidemiologic Assessment of Mortality, Building Collapse Pattern, and Medical Response after the 1992 Earthquake in Turkey

Perceived Preparedness for a Mass Casualty Disaster in the United States: A Survey

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