Emergency radiology after a massive earthquake: clinical perspective

Emergency Radiology in the First 24 h of Two Major Earthquakes on the Same Day and Radiologic Evaluation of Trauma Cases

BACKGROUND

On 6 February 2023, two major earthquakes occurred in Turkey on the same day. More than 50,000 people died, and more than 100,000 people were injured in these earthquakes. The aim of this study is to contribute to disaster management plans by evaluating the functioning of a radiology department and the imaging examinations performed after this disaster.

METHODS

The functioning of the radiology clinic at Malatya Training and Research Hospital in the first 24 h after the earthquake was evaluated. The images of 596 patients who were admitted to Malatya Training and Research Hospital for earthquake-related trauma between 6 February 2023, at 4:17 a.m. and 7 February 2023, at 4:17 a.m., and who underwent radiography and computed tomography (CT) were retrospectively reviewed.

RESULTS

The mean age of the patients was 37.3 ± 20.1 years. A total of 313 (52.5%) patients were male. The most frequently performed imaging test was a CT scan. In total, 437 (73.3%) of 596 patients underwent a CT scan. At least one body part was affected in 160 patients (26.8%). The most commonly affected regions were the thorax, vertebrae, and extremities. Thoracic findings were observed in 52 patients (32.5%), vertebral findings in 52 patients (32.5%), and extremity findings in 46 patients (28.7%). Fractures were the most common finding in our study. Of the 160 patients with pathologic findings, 139 (86.9%) had evidence of fractures.

CONCLUSIONS

The role of radiology in disasters is important. When disaster preparedness plans are made, radiology departments should be actively involved in these plans. This will ensure the quick and efficient functioning of radiology departments.

Comparing Doppler Ultrasonography and Computerized Tomography Angiography in Emergency Department Evaluation of Earthquake-Related Crush Injuries: A Case Series Analysis

OBJECTIVE

This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).

METHODS

This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.

RESULTS

A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).

CONCLUSION

Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.

Radiological management and challenges of the twin earthquakes of February 6th

Two major earthquakes measuring 7.8 and 7.7 on the Richter scale struck Turkey and Northern Syria on February 6, claiming more than 50,000 lives. In such an unprecedented disaster, radiologists were confronted with very critical tasks of stepping out of the routine reporting process, performing radiological triage, managing acute adverse events, and optimizing imaging protocols. In our experience, radiologists can take three different positions in such disasters: (1) in the scene of the disaster, (2) serving in teleradiology, and (3) working in tertiary hospital for transported patients. With this article, we aimed to describe the challenges radiologists face on the three main fronts and how we manage these challenges.

A needful, unique, and in-place evaluation of the injuries in earthquake victims with computed tomography, in catastrophic disasters! The 2023 Turkey-Syria earthquakes: part II

OBJECTIVE

This study aimed to determine the computed tomography findings associated with very recent catastrophic 2023 Turkey-Syria earthquake-related injuries and their anatomotopographic distribution in the adult population.

METHODS

The incorporated computed tomography scans of 768 adult cases who had been admitted to the hospital and had undergone computed tomography imaging after these tragic disasters had been examined on the Teleradiology Reporting System of the Turkish Ministry of Health. To this end, the injuries were classified into six categories: head, thoracic, spinal, pelvic, extremity, and abdominal injury, with three age groups (18-34, 35-64, and ³65 years) and four different imaging intervals (<24, 24-48, 49-72, and >72 h).

RESULTS

This study incorporated 316 (41.1%) cases on the first day, 57 (7.5%) on the second day, 219 (28.5%) on the third day, and 176 (22.9%) on the fourth day after the earthquake or later. Of the 768 cases, 109 (14.2%) had a head injury, 100 (13.0%) had a thoracic injury, 99 (12.9%) had a spinal injury, 51 (6.6%) had a pelvic injury, 41 (5.4%) had an extremity injury, and 11 (1.4%) had an abdominal injury.

CONCLUSION

In these regrettable earthquake disasters, we determined a high ratio of head injuries, which was closely followed by thoracic and spinal injuries, in our preliminary outcomes for the pediatric population, Part I. The frequency of abdominal injuries was low among individuals who experienced the earthquake. Last but not least, we have noticed a higher likelihood of spinal injury in individuals older than 65 years in the studied population.