Tropical cyclone Fani–perspective from the trauma and emergency department of an affected tertiary hospital

Abstract

Purpose To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster. Methods A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated. Results Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7–53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14–28), 7.84 (7.841–7.841), and 97.4 (91.6–98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure. Conclusion In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.

The Value of Emergency Nursing Mode in the Treatment of Patients with Traumatic Shock

“…Traumatic shock refers to the rapid decline of effective circulating blood volume in the body and the serious lack of blood perfusion in the tissue after severe trauma, which eventually leads to the body's important organs hypoxia, ischemia, and tissue cell metabolism disorders and other systemic pathological process [ 18 ]. Traumatic shock is one of the common surgical emergencies, which mostly occurs in young men.…”

Timing of Exposure to ICU Diaries and Its Impact on Mental Health, Memories, and Quality of Life: A Double-Blind Randomized Control Trial

“…The “Fani,” a rare severe summer cyclone, hit the state on May 3, 2019. It created acute devastation and disrupted power supply and essential services for weeks ( 21 ). Four patients in ID1 did not receive diaries on time due to postal disruption and were counted as “ID3” in the “as- treated” analysis.…”

Epidemiology of mass casualty incidents in a tertiary care trauma center in eastern India: A retrospective observational study

“…Male predominance was noted in the trauma-related MCI victims, which is concurrent with the findings of other epidemiological studies related to trauma from India and other nations. [ 5 12 15 ] Females exhibited a preponderance in the gas cylinder blast injuries due to their increased involvement in household activities. A significant difference was observed in the median age of various trauma MCI victims, with RTA victims being the youngest of all.…”

“…Odisha is a tribal-dominated coastal Indian state that is regularly ravaged by natural disasters (ND) such as cyclones and other man-made MCIs. [ 12 ] Since these MCIs are typically managed by routine hospital resources without a major disaster response system, the local hospital resources may be temporarily overwhelmed to meet the situation requirements and patient demands even in organized medical systems. [ 1 13 ] The epidemiology of such MCIs, which is lacking in Indian literature, must be evaluated to strengthen our emergency response to any untoward event.…”