The relationship between timing of admission to a hospital and severity of injuries following 2005 Pakistan earthquake

Prehospital management of earthquake crush injuries: A collective review

Earthquakes are natural disasters which can destroy the rural and urban infrastructure causing a high toll of injuries and death without advanced notice. We aim to review the prehospital medical management of earthquake crush injuries in the field. PubMed was searched using general terms including rhabdomyolysis, crush injury, and earthquake in English language without time restriction. Selected articles were critically evaluated by three experts in disaster medicine, emergency medicine, and critical care. The medical response to earthquakes includes: (1) search and rescue; (2) triage and initial stabilization; (3) definitive care; and (4) evacuation. Long-term, continuous pressure on muscles causes crush injury. Ischemia-reperfusion injury following the relieving of muscle compression may cause metabolic changes and rhabdomyolysis depending on the time of extrication. Sodium and water enter the cell causing cell swelling and hypovolemia, while potassium and myoglobin are released into the circulation. This may cause sudden cardiac arrest, acute extremity compartment syndrome, and acute kidney injury. Recognizing these conditions and treating them timely and properly in the field will save many patients. Majority of emergency physicians who have worked in the field of the recent Kahramanmaraş 2023, Turkey, earthquakes, have acknowledged their lack of knowledge and experience in managing earthquake crush injuries. We hope that this collective review will cover the essential knowledge needed for properly managing seriously crushed injured patients in the earthquake field.

Using Logistic Regression to Identify Leading Factors to Prepare for an Earthquake Emergency during Daytime and Nighttime: The Case of Mass Earthquake Drills

Historical data have demonstrated that earthquakes can happen any time of the day and night. Drills may help communities to better prepare for such emergencies. A cross-sectional survey was conducted from 4 October to 20 November 2017, in Mexico City. The sample size was 2400. The addressed research questions were “what factors predict the likelihood that respondents would report that they agree on conducting mass evacuation drills: (a) any time of the day and (b) any time at night?” The logistic regression technique was employed to identify the factors leading to the outcome. In relation to (a), five variables were significantly associated with the outcome, i.e., age, frequency of drills, warning time, knowledge on what to do, and “perception vulnerability city”. Regarding (b), five variables were also significantly associated with the outcome variable, i.e., age, level of education, frequency of drills, negative emotions, and fear of house/building collapsing. More generally, several drills should be conducted any time of the day and night; further, 50% of them should be announced and 50% unannounced. Furthermore, the time of earthquake drills should be randomly selected. In this way, we may just match the spatial–temporal dimension of an earthquake emergency. It is hoped that the findings will lead to better preparedness of the residents of the capital city during an earthquake occurrence.