Strategies in Evaluation and Management of Bam Earthquake Victims

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.

Patient influx and trauma types in a front-line hospital and a secondary referral hospital after the Wenchuan earthquake: a retrospectively comparative study

“…This is in line with other studies [8,10,14,15]. The fact that the proportions of head injuries and trunk injuries were greater in the first-line hospital than those in the second-line hospital indicates that the distribution of quake-related trauma types and locations differed between the hospital types at varying distances from the epicenter, and can be explained by the fact that lots of victims with head or trunk injuries died at the scene or at the front-line hospital.…”

“…Considering the fact that the proportion of critical patients (ISS [15) was greater in the second-line hospital, the following two factors might be related to the circumstances. On one hand, the fact that a large number of casualties poured into the front-line hospital in a very short interval made the surgeons and nurses unavailable to many who needed them; on the other hand, West China Hospital (the referral hospital), as a national medical center, provided sufficient human resources, devices, and drugs for the casualties, and consequently a relatively high standard of care.…”

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

“…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).…”

An Investigation of Hospital Disaster Preparedness in Turkey

“…For appropriate medical responses to these disasters, local medical services must have an effective disaster management plan, adequate equipment and, most importantly, trained workers (Emami et al, 2005).…”