Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti

Bar‐On, Elhanan; Blumberg, Nehemia; Joshi, Amit; Gam, Arnon; Peyser, Amos; Lee, Evgeny; Kashichawa, Shree Krishna; Morose, Alexander; Schein, Ophir; Lehavi, Amit; Kreiss, Yitshak; Bader, Tarif

doi:10.1007/s00268-016-3581-3

Cited by 51 publications

(8 citation statements)

References 23 publications

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“…Similar results from Iran (25,31), Turkey (26,29), Haiti (32, 33), Nepal (34,35), China (27,36), and Pakistan (18, 37) were reported, demonstrating high prevalence of the lower limb fractures, followed by upper limbs, and pelvis. The proximal bone involvement is greater if the earthquake happens early in the morning (as most people are asleep) and it is assumed that proximal bones are more involved generally (25).…”

Section: Anatomic Distributionsupporting

confidence: 70%

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Mortazavi¹,

Ebrahiminasab²,

Farhoud³

et al. 2017

J Orthop Spine Trauma

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Objectives: This study aims to investigate the pattern of Musculoskeletal and soft tissue injuries in a series of referred patients in a tertiary medical center and review previous reports in the literature. Methods: In this study, we recorded musculoskeletal injuries of the victims, following the Kermanshah earthquake on November 12, 2017, with a total number of 38. All patients were admitted to the Imam Khomeini Hospital. Injury type, site of injury, gender, age, complications, mortality, and treatment modality were recorded for each case.Results: Among 38 patients, 18 were male (47%) and 20 were female (53%). The mean age was 37 ± 21.6 years. Most of them were aged between 18 and 65 (71.1%). Lower extremities were involved more than the upper (37% versus 24%) and distal limb involvement was more than the proximal (57.3% versus 43.7%). One patient died due to necrotizing fasciitis and septic shock after femoral shaft open fracture. Two patients developed compartment syndrome and underwent fasciotomy complications by skin necrosis and infection. Conclusions: Soft tissue injuries and fractures are the most common injuries following the earthquakes, hence orthopedic surgeries play a vital role in disasters. Despite patients overload and emergency situation in natural disasters like earthquakes, it is crucial to have a stepwise and evidence based approach for each patient. For the patients with open fractures referred to a tertiary center, careful contamination assessment even in the previously managed wounds is highly recommended, especially for those with early wound closure. Early fasciotomy in the crush syndrome is not beneficial as it has adverse effects such as skin necrosis and infection.

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Section: Anatomic Distributionsupporting

confidence: 70%

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Mortazavi¹,

Ebrahiminasab²,

Farhoud³

et al. 2017

J Orthop Spine Trauma

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“…14 The experience of the Israel Defence Force team was similar, reporting 74% of non-earthquake-related cases. 12 Likewise, the Indian Army reported that only one-third of their patients had traumatic injuries caused by the earthquake. 19 These figures reinforce the need for EMTs to have the appropriate capacities to manage the non-trauma and non-earthquake-related conditions normally presenting at health facilities in the country.…”

Section: Discussionmentioning

confidence: 99%

“…All titles and abstracts were screened and only 11 articles met the inclusion criteria. [10][11][12][13][14][15][16][17][18][19][20] The Google search returned over 300,000 hits for each word combination entered, and the first 200 hits for each search were examined; data were extracted from 20 sources (mainly official EMT webpages with limited information). More data were obtained from key web sites, especially from the web Humanitarian Response, including 10 WHO-MoHP coordination meeting…”

Section: Methodsmentioning

confidence: 99%

“…Several papers have presented I-EMT individual experiences of deployment after the Nepal earthquake. [10][11][12][13][14][15][16][17][18][19][20] Additionally, a report by the Nepal Health Research Council (NHRC; Kathmandu, Nepal) reviews the effectiveness of I-EMTs' deployment following the earthquake. 8 Building on the information already available, the aim of this study was to describe the characteristics, timing, and activities performed by I-EMTs deployed to Nepal after the 2015 earthquake, and to assess their adherence to WHO-EMT registration and minimum standards.…”

Section: Introductionmentioning

confidence: 99%

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International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake

Camacho

Karki

Subedi³

et al. 2019

Prehosp. Disaster med.

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Introduction:International Emergency Medical Teams’ (I-EMTs) response to disasters has been characterized by a late arrival, an over-focus on trauma care, and a lack of coordination and accountability mechanisms. Analysis of I-EMT performance in past and upcoming disasters is deemed necessary to improve future response.Objective:This study aimed to describe the characteristics, timing, and activities of I-EMTs deployed to the 2015 Nepal earthquake, and to assess their registration and adherence to the World Health Organization Emergency Medical Teams’ (WHO-EMT; Geneva, Switzerland) minimum standards compared to past disasters.Methods:An online literature search was performed and key web sites related to I-EMT deployments were purposively examined. The methodology used is reported following the STARLITE principles. All articles and documents in English containing information about characteristics, timing, and activities of I-EMTs during Nepal 2015 were included in the study. Data were retrieved from selected sources to compile the results following a systematic approach. The findings were validated by the Nepalese focal point for the coordination of I-EMTs after the earthquake.Results:Overall, 137 I-EMTs deployed from 36 countries. They were classified as Type I (65%), Type II (15%), Type III (1%), and specialized cells (19%). Although national teams remained the first responders, two regional I-EMTs arrived within the first 24 hours post-earthquake. According to daily reporting, the activities performed by I-EMTs included 28,372 out-patient consultations (comprising 6,073 trauma cases); 1,499 in-patient admissions; and 440 major surgeries. The activities reported by I-EMTs during their deployment were significantly lower than the capacities they offered at arrival. Over 80% of I-EMTs registered through WHO or national registration mechanisms, but daily reporting of activities by I-EMTs was low. The adherence of I-EMTs to WHO-EMT standards could not be assessed due to lack of data.Conclusion:The I-EMT response to the Nepal earthquake was quicker than in previous disasters, and registration and follow-up of I-EMTs was better. Still, there is need to improve I-EMT coordination, reporting, and quality assurance while strengthening national EMT capacity.Amat Camacho N, Karki K, Subedi S, von Schreeb J. International Emergency Medical Teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260–264.

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“…Emergency Medical Team refinements are made based on the specific disaster scenario and challenges that it is supposed to face. The authors classify the expected challenges into two major categories 16 . Category A: EMT-tailored mainly for disasters that damaged the country’s infrastructure and medical treatment facilities.…”

Section: Discussionmentioning

confidence: 99%

Emergency with Resiliency Equals Efficiency – Challenges of an EMT-3 in Nepal

Yitzhak

Merin

Halevy

et al. 2018

Prehosp. Disaster med.

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The 7.8 MW (moment magnitude scale) earthquake that hit Nepal on April 25, 2015 caused significant casualties and serious damage to infrastructure.The Israeli Emergency Medical Team (IEMT; later verified as EMT-3) was deployed 80 hours after the earthquake. A Forward Disaster Scout Team (FDST) that was dispatched to the disaster area a few hours after the disaster relayed pre-deployment information.The EMT staff was comprised of 42 physicians. A total of 1,668 patients were treated. The number of non-trauma cases increased as the days went by. The hospitalization rate was 31%. Wound debridement procedures were the most common operations performed.YitzhakA, MerinO, HalevyJ, TarifB. Emergency with resiliency equals efficiency- challenges of an EMT-3 in Nepal. Prehosp Disaster Med. 2018;33(6):673–677.

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Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti

Cited by 51 publications

References 23 publications

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake

Emergency with Resiliency Equals Efficiency – Challenges of an EMT-3 in Nepal

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