Orthopaedic management in a mega mass casualty situation. The Israel Defence Forces Field Hospital in Haiti following the January 2010 earthquake

Amputations in natural disasters and mass casualties: staged approach

“…Syndrome victims had massive muscle damage and subsequently died from renal failure. During natural disasters, crush syndrome is a very common diagnosis [19,21,[26][27][28].…”

“…And there are some good results reported in cases of crush syndrome of a single extremity with early presentation [52,53]. In the presence of fracture, however, stabilisation of the affected extremityeither by use of a splint or spanning external fixation-is indicated, and any open reduction and fixation methods that convert closed fractures to open ones are associated with high rates of infection [28].…”

“…Primary or premature wound closure is associated with wound dehiscence and infection is not recommended in natural disaster or mass casualty settings [28,49,50,59].…”

“…The earthquake that hit Haiti on January 12, 2010, caused between 217,000 and 300,000 deaths, nearly 300,000 injuries, and left about one million homeless-revealing just how unprepared some countries are to deal with mass casualties and disaster-related injuries [1,28]. It also demonstrated the medical community's inadequate disaster preparedness and a surprising lack of knowledge about some of the most common injuries and effective surgical procedures to deal with them, e.g.…”

Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

“…The initial volunteers who arrived reported the majority of injuries were orthopaedic: crush injuries, open and closed fractures, and compartment syndromes [22,52,56,57]. Some of the deployed orthopaedic surgeons documented these experiences, recording injury patterns, caseload, procedures performed, and short-term outcomes data [3,14,16,34,37,40,56]. These accounts, however, do not measure the barriers to quality surgical care delivery faced by the orthopaedic community.…”