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Jabbour E, Mouawad Y, Abou Khater D, Helou M. Lessons From the February 2023 Turkish Earthquake. Cureus 2024; 16:e71042. [PMID: 39380782 PMCID: PMC11459074 DOI: 10.7759/cureus.71042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2024] [Indexed: 10/10/2024] Open
Abstract
On February 6, 2023, Turkey was struck by the most powerful earthquake recorded since 1939, leaving millions of people devastated and homeless with over 36,000 casualties. According to the Ministry of Health, at least 50% of the major health centers were damaged, with only about 30% of the pre-existing doctors able to help. The earthquake occurred during a harsh winter and amidst an ongoing humanitarian complex situation in Syria resulting from the Syrian civil war that started in 2011. This report aims to present the Turkish 2023 earthquake preparedness and mitigation efforts. The objective of this article is to extract valuable insights and identify measures that can be taken to improve response based on the lessons learned from this event.
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Affiliation(s)
- Elsy Jabbour
- Emergency, Lebanese American University School of Medicine, Beirut, LBN
| | - Yara Mouawad
- Emergency, Lebanese American University School of Medicine, Beirut, LBN
| | | | - Mariana Helou
- Emergency, Lebanese American University School of Medicine, Beirut, LBN
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Abimibayo Adeoya A, Sasaki H, Fuda M, Okamoto T, Egawa S. Child Nutrition in Disaster: A Scoping Review. TOHOKU J EXP MED 2022; 256:103-118. [DOI: 10.1620/tjem.256.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Akindele Abimibayo Adeoya
- International Cooperation for Disaster Medicine Laboratory, International Research Institute of Disaster Science (IRIDeS), Tohoku University
| | - Hiroyuki Sasaki
- International Cooperation for Disaster Medicine Laboratory, International Research Institute of Disaster Science (IRIDeS), Tohoku University
| | - Mikiko Fuda
- Nutrition Support Center, Tohoku University Hospital
| | - Tomoko Okamoto
- Department of Nutrition, Sapporo University of Health Sciences
| | - Shinichi Egawa
- International Cooperation for Disaster Medicine Laboratory, International Research Institute of Disaster Science (IRIDeS), Tohoku University
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A T2 Translational Science Modified Delphi Study: Spinal Motion Restriction in a Resource-Scarce Environment. Prehosp Disaster Med 2020; 35:538-545. [PMID: 32641192 DOI: 10.1017/s1049023x20000862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Emerging evidence is guiding changes in prehospital management of potential spinal injuries. The majority of settings related to current recommendations are in resource-rich environments (RREs), whereas there is a lack of guidance on the provision of spinal motion restriction (SMR) in resource-scarce environments (RSEs), such as: mass-casualty incidents (MCIs); low-middle income countries; complex humanitarian emergencies; conflict zones; and prolonged transport times. The application of Translational Science (TS) in the Disaster Medicine (DM) context was used to develop this study, leading to statements that can be used in the creation of evidence-based clinical guidelines (CGs). OBJECTIVE What is appropriate SMR in RSEs? METHODS The first round of this modified Delphi (mD) study was a structured focus group conducted at the World Association for Disaster and Emergency Medicine (WADEM) Congress in Brisbane Australia on May 9, 2019. The result of the focus group discussion of open-ended questions produced ten statements that were added to ten statements derived from Fischer (2018) to create the second mD round questionnaire.Academic researchers and educators, operational first responders, or first receivers of patients with suspected spinal injuries were identified to be mD experts. Experts rated their agreement with each statement on a seven-point linear numeric scale. Consensus amongst experts was defined as a standard deviation ≤1.0. Statements that were in agreement reaching consensus were included in the final report; those that were not in agreement but reached consensus were removed from further consideration. Those not reaching consensus advanced to the third mD round.For subsequent rounds, experts were shown the mean response and their own response for each of the remaining statements and asked to reconsider their rating. As above, those that did not reach consensus advanced to the next round until consensus was reached for each statement. RESULTS Twenty-two experts agreed to participate with 19 completing the second mD round and 16 completing the third mD round. Eleven statements reached consensus. Nine statements did not reach consensus. CONCLUSIONS Experts reached consensus offering 11 statements to be incorporated into the creation of SMR CGs in RSEs. The nine statements that did not reach consensus can be further studied and potentially modified to determine if these can be considered in SMR CGs in RSEs.
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Abstract
In response to the International Liaison Committee on Resuscitation (ILCOR; Niel, Belgium) release of an updated recommendation related to out-of-hospital spinal immobilization (SI) practice in 2015, a systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist of English-language studies published from January 2000 through July 2019 on the use of SI in resource-scarce environments (RSEs). Studies meeting the following criteria were included in the analysis: peer-reviewed statistical studies or reports detailing management of potential traumatic spinal injury in RSE, civilian, and military environments; as well as consensus clinical guidelines, academic center, or professional association protocols or policy statements detailing management of potential traumatic spinal injury in RSE, civilian, and military environments; statistical analysis; and subsequent management of spinal injuries after mass-casualty incidents, in complex humanitarian events or conflict zones, low-to middle-income countries, or prolonged transport times published by government and non-government organizations. Studies excluded from consideration were those not related to a patient with a potential traumatic spinal injury after a mass-casualty incident, in complex humanitarian event or conflict zones, in low-to middle-income countries, or with prolonged transport times.There were one thousand twenty-nine (1029) studies initially identified. After removal of duplicates, nine hundred-nineteen (919) were screened with eight hundred sixty-three (863) excluded. The remaining fifty-six (56) received further review with fourteen (14) selected studies achieving inclusion. The reviewed articles comprised six (6) types of studies and represented research from institutions in seven (7) different countries (Israel, United States, Haiti, Wales, Pakistan, China, and Iran). Thirteen (13) references were case reports/narrative reviews, policy statements, retrospective observational studies, narrative literature reviews, scoping reviews, and one systematic review. The majority of literature describing spinal cord injury was predominantly associated with earthquakes and blast-related disasters. There were no SI evidence-based clinical guidelines (EBG) in RSE. Information was obtained that could be used to formulate statements in a modified Delphi study to present to experts to obtain consensus SI EBG in RSE.
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Extrication time and earthquake-related mortality in the 2016 Taiwan earthquake. J Formos Med Assoc 2019; 118:1504-1514. [PMID: 31371147 DOI: 10.1016/j.jfma.2019.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/04/2019] [Accepted: 07/12/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND/PURPOSE People with different age distributions and extrication times might have distinct injury characteristics and outcomes in earthquakes. METHODS A retrospective study was conducted to analyze the casualties in the 2016 Taiwan earthquake using data from the incident registry system and the field disaster operation system. The study subjects were assigned to 4 groups by age: preschool (<5 years), school (5-17 years), adult (18-64 years), and elderly (>64 years). Classification and regression tree analysis and receiver-operating characteristic curves were utilized to examine several factors, including extrication time, age group, floor height, and structural damage, for earthquake-related mortality. A two-sided p value less than 0.05 was considered statistically significant. RESULTS A total of 238 enrollees were assigned to the preschool (n = 18, 7.6%), school (n = 45, 18.9%), adult (n = 169, 71.0%), or elderly (n = 6, 2.5%) groups. Among the parameters, the extrication time exhibited the strongest association with mortality. Regarding the association between the extrication time and mortality hazard in multivariate models, we found significant odds ratios (ORs) at the extrication time cutoffs of 12, 24 and 72 h (OR = 42.61, 95% confidence interval [CI]: 13.92-130.37; OR = 37.58, 95% CI: 14.77-95.60; OR = 95.16, 95% CI: 23.02-393.48, respectively, all p < 0.001). The optimal extrication time cutoff for mortality was 12 h in the preschool group and 24 h in the school and adult groups. CONCLUSION Extrication time is strongly associated with earthquake-related mortality. These findings may facilitate strategic approaches for patients entrapped in damaged buildings and can contribute to future training for field search and rescues after earthquakes.
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Pan ST, Cheng YY, Wu CL, Chang RH, Chiu C, Foo NP, Chen PT, Wang TY, Chen LH, Chen CJ, Ong R, Tsai CC, Hsu CC, Hsieh LW, Chi CH, Lin CH. Association of injury pattern and entrapment location inside damaged buildings in the 2016 Taiwan earthquake. J Formos Med Assoc 2018; 118:311-323. [PMID: 29857951 DOI: 10.1016/j.jfma.2018.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/16/2018] [Accepted: 05/16/2018] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND/PURPOSE To explore the association of patient injury patterns and entrapped locations inside damaged buildings in the 2016 Taiwan earthquake. METHODS A retrospective analysis was conducted using the Tainan incident registry system. Residents inside nine conjunctive, 16-story (49.3 m in height) reinforced concrete buildings were categorized as non-injured, injured, and dead. Residents were classified into different groups according to their entrapped locations in height and the severity of building damage. The field triage acuity and trauma severity among groups were compared. Statistical significance was set at the level of 0.05. RESULTS There were 309 enrollees with 76 (24.6%) non-injured, 118 (38.2%) injured, and 115 (37.2%) dead. Residents either in the high floors (odds ratio [OR] = 2.9, 95% CI: 1.5-5.8, p = 0.003) or in the collapsed buildings (OR = 18.2, 95% CI: 7.6-43.6, p < 0.001) were more likely to be dead. Injured patients who were located in the high floors were more likely to have severe field triage acuities (adjusted OR = 14.7, 95% CI: 1.8-118.0, p = 0.012); intracranial hemorrhage (12.5%), intrathoracic injury (18.8%), or intra-abdominal damage (12.5%) (All p < 0.05); the need for emergency surgical intervention (31.3%, p = 0.035); and major trauma (18.8%, p = 0.001). Residents in the collapsed buildings were more likely to have a crush injury (80.0%, p < 0.001) or crush syndrome (80.0%, p < 0.001). CONCLUSION People entrapped at different heights of floors or in differently damaged buildings could have a distinct pattern of injury. Our findings may facilitate strategic approaches of patients entrapped in damaged buildings and may contribute to future training for field searches and rescues after earthquakes.
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Affiliation(s)
- Shih-Tien Pan
- Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
| | - Ya-Yun Cheng
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chen-Long Wu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Environmental and Occupational Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Ray Hsienho Chang
- Department of Political Science, College of Arts and Sciences, Oklahoma State University, Oklahoma, USA.
| | - Chihsin Chiu
- Department of Real Estate and Built Environment, College of Public Affairs, National Taipei University, New Taipei City, Taiwan.
| | - Ning-Ping Foo
- Department of Emergency Medicine, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan.
| | - Pao-Tien Chen
- Department of Emergency Medicine, Tainan Municipal Hospital, Tainan, Taiwan.
| | - Tai-Yuan Wang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan.
| | - Li-Hsing Chen
- Department of Nursing, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan.
| | - Chien-Jung Chen
- Department of Emergency Medicine, Tainan Sin Lau Christian Hospital, Tainan, Taiwan.
| | - Roger Ong
- Department of Emergency Medicine, Tainan Sin Lau Christian Hospital, Tainan, Taiwan.
| | - Chang-Chih Tsai
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
| | - Li-Wei Hsieh
- Department of Nursing, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
| | - Chih-Hsien Chi
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Indexes of Caring for Elderly in Earthquakes According to the Iranian Experience: A Qualitative Study. Disaster Med Public Health Prep 2018; 12:493-501. [PMID: 29382404 DOI: 10.1017/dmp.2017.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The elderly are especially susceptible to death and injury in disasters. This study aimed to identify indexes of caring for elderly people in an earthquake according to the Iranian experience. METHODS This qualitative study was conducted during 2014-2016 by use of the content analysis technique. Data were collected through individual deep interviews with the elderly and people with experience providing services to the elderly during earthquakes in an urban area of Iran. The data were analyzed by use of the Graneheim and Lundman method. RESULTS Seven categories emerged: vulnerability of elderly people, physiological indexes, psychological indexes, economic indexes, religious and spiritual indexes, health indexes, and security indexes. There were 3 uncategorized issues: "There is no specific protocol for the elderly," "The need to design plans based on age care," and "Aid organizations." CONCLUSIONS Implementing a comprehensive plan would not only save lives but decrease suffering and enable effective use of available resources. Due to the crucial role of the prehospital care system in disasters, there is a need for further investigation based on the results of this study to develop strategies for improving the system. (Disaster Med Public Health Preparedness. 2018;12:493-501).
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Toward a Better Nutritional Aiding in Disasters: Relying on Lessons Learned during the Bam Earthquake. Prehosp Disaster Med 2017; 32:382-386. [PMID: 28345496 DOI: 10.1017/s1049023x17006355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Introduction Examining various problems in the aftermath of disasters is very important to the disaster victims. Managing and coordinating food supply and its distribution among the victims is one of the most important problems after an earthquake. Therefore, the purpose of this study was to recognize problems and experiences in the field of nutritional aiding during an earthquake. METHODS This qualitative study was of phenomenological type. Using the purposive sampling method, 10 people who had experienced nutritional aiding during the Bam Earthquake (Iran; 2003) were interviewed. Colaizzi's method of analysis was used to analyze interview data. RESULTS The findings of this study identified four main categories and 19 sub-categories concerning challenges in the nutritional aiding during the Bam Earthquake. The main topics included managerial, aiding, infrastructural, and administrative problems. CONCLUSIONS The major problems in nutritional aiding include lack of prediction and development of a specific program of suitable nutritional pattern and nutritional assessment of the victims in critical conditions. Forming specialized teams, educating team members about nutrition, and making use of experts' knowledge are the most important steps to resolve these problems in the critical conditions; these measures are the duties of the relevant authorities. Nekouie Moghadam M , Amiresmaieli M , Hassibi M , Doostan F , Khosravi S . Toward a better nutritional aiding in disasters: relying on lessons learned during the Bam Earthquake. Prehosp Disaster Med. 2017;32(4):382-386.
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Vaishya R, Agarwal AK, Vijay V, Hussaini M, Singh H. Surgical Management of Musculoskeletal Injuries after 2015 Nepal Earthquake: Our Experience. Cureus 2015; 7:e306. [PMID: 26430580 PMCID: PMC4578712 DOI: 10.7759/cureus.306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
We report our experience of handling 80 major musculoskeletal injuries in a brief span of three days immediately after the major earthquake of Nepal in April 2015. Planning, proper utilization of resources, and prioritizing the patients for surgical intervention is highlighted. The value of damage control by orthopaedics in these disasters is discussed. Timely and appropriate surgical treatment by a skilled orthopaedic team not only can save these injured limbs but also the lives of the victims of a major disaster.
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He CQ, Zhang LH, Liu XF, Tang PF. A 2-year follow-up survey of 523 cases with peripheral nerve injuries caused by the earthquake in Wenchuan, China. Neural Regen Res 2015; 10:252-9. [PMID: 25883624 PMCID: PMC4392673 DOI: 10.4103/1673-5374.152379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2014] [Indexed: 12/02/2022] Open
Abstract
We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classified into three types: type I injuries were nerve transection injuries, type II injuries were nerve compression injuries, and type III injuries displayed no direct neurological dysfunction due to trauma. In this study, 31 patients had type I injuries involving 41 nerves, 419 had type II injuries involving 823 nerves, and 73 had type III injuries involving 150 nerves. Twenty-two patients had open transection nerve injury. The restoration of peripheral nerve function after different treatments was evaluated. Surgical decompression favorably affected nerve recovery. Physiotherapy was effective for type I and type II nerve injuries, but not substantially for type III nerve injury. Pharmacotherapy had little effect on type II or type III nerve injuries. Targeted decompression surgery and physiotherapy contributed to the effective treatment of nerve transection and compression injuries. The Louisiana State University Health Sciences Center score for nerve injury severity declined with increasing duration of being trapped. In the first year after treatment, the Louisiana State University Health Sciences Center score for grades 3 to 5 nerve injury increased by 28.2% to 81.8%. If scores were still poor (0 or 1) after a 1-year period of treatment, further treatment was not effective.
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Affiliation(s)
- Chun-Qing He
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Li-Hai Zhang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Xian-Fei Liu
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Pei-Fu Tang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
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Awais S, Saeed A. Study of the severity of musculoskeletal injuries and triage during the 2005 Pakistan earthquake. INTERNATIONAL ORTHOPAEDICS 2013; 37:1443-7. [PMID: 23842631 DOI: 10.1007/s00264-013-2013-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 06/24/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE On 8 October 2005 a massive earthquake hit the northern mountainous areas of Pakistan and Kashmir causing 73,338 deaths and leaving over 125,000 severely injured. In a region which was less prepared for such an enormous disaster, mobilising rescue, relief and rehabilitation posed great challenges. The first author (SMA) established two level 1 orthopaedic trauma and rehabilitation units in each of two severely hit major cities through private philanthropy. According to the severity of injuries, the patients were triaged and treated. The aim of this study is to improve the future strategies in similar scenarios. METHODS This is a retrospective review of medical records of patients suffering from musculoskeletal injuries in the aftermath of the 2005 earthquake who were managed in these centres in the order of triage priority. The patients were received, categorised, worked up and provided definitive surgical procedures. All patients were provided assistance for the fitting of a prosthesis and rehabilitation. RESULTS Of 128,304 (total of injured patients), 19,700 were managed in two centres established by SMA during the first months after the earthquake. Of these, 112 patients underwent amputations of upper and lower limbs. CONCLUSIONS In a massive calamity over a wide geographical area away from big university hospitals, such as the 2005 Pakistan earthquake, the level 1 operating theatre facilities must be established within the area to meet the immediate needs of the patients nearest to their homes and families, and run forever so that patients can have excellent follow-up and can use the same facilities regularly. In the aftermath of this earthquake the need to practise triage in the first 72 hours was thoroughly realised and effectively practised in our centres.
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Affiliation(s)
- Syed Awais
- Department of Orthopaedic Surgery and Traumatology, King Edward Medical University, Lahore, Pakistan.
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Gosney JE, Reinhardt JD, von Groote PM, Rathore FA, Melvin JL. Medical rehabilitation of spinal cord injury following earthquakes in rehabilitation resource-scarce settings: implications for disaster research. Spinal Cord 2013; 51:603-9. [PMID: 23752263 DOI: 10.1038/sc.2013.50] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 03/12/2013] [Accepted: 04/27/2013] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Narrative literature review. OBJECTIVES To (1) summarize epidemiological and scientific research on spinal cord injury (SCI) populations from three severe earthquakes (EQs) in rehabilitation resource-scarce settings; (2) summarize SCI rehabilitation services by local and foreign providers in response to these EQs and (3) provide implications including research gaps for a supporting global scientific research agenda. SETTING International. METHODS A literature review was conducted using PubMed to identify epidemiological studies reporting data on SCI survivors of the 2005 Kashmir EQ in Pakistan, the Sichuan EQ of 2008 in China and the 2010 Haiti EQ. A follow-up review on the SCI rehabilitation services provided by local and foreign providers in response to these EQs was also performed. RESULTS Review of the scientific literature revealed the qualitative trends in focused EQ victim epidemiological data, including SCI classification and types of medical complications. Selected EQ country narratives showed that post-disaster SCI rehabilitation services were expanded by adapting local resources with international assistance to manage the significant numbers of SCI survivors. The resulting SCI research was limited. CONCLUSION A global disaster research agenda for SCI in EQs in rehabilitation resource-scarce settings is needed to strengthen the evidence base for improvement of clinical management and outcomes for SCI EQ survivors. Expansion of this limited narrative review into a systematic review to identify additional research gaps is a proposed next step. Effective disaster setting data management and research collaborations of foreign and local SCI disability and rehabilitation stakeholders will be required for agenda implementation.
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Affiliation(s)
- J E Gosney
- Rehabilitation Disaster Relief Committee, International Society of Physical and Rehabilitation Medicine, Geneva, Switzerland.
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Doocy S, Daniels A, Packer C, Dick A, Kirsch TD. The human impact of earthquakes: a historical review of events 1980-2009 and systematic literature review. PLOS CURRENTS 2013; 5. [PMID: 23857161 PMCID: PMC3644288 DOI: 10.1371/currents.dis.67bd14fe457f1db0b5433a8ee20fb833] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction.
Population growth and increasing urbanization in earthquake-prone areas suggest that earthquake impacts on human populations will increase in the coming decades. Recent large earthquakes affecting large populations in Japan, Haiti, Chile and New Zealand are evidence of this trend and also illustrate significant variations in outcomes such damage and mortality levels. The objectives of this review were to describe the impact of earthquakes on human populations in terms of mortality, injury and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters.
Methods.
Data on the impact of earthquakes were compiled using two methods, a historical review from 1980 to mid 2009 of earthquake events from multiple databases and a systematic literature review of publications, ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between earthquake mortality and characteristics using STATA 11.
Findings.
From 1980 through 2009, there were a total of 372,634 deaths (range 314,634-412,599), 995,219 injuries (range: 845,345-1,145,093), and more than 61 million people affected by earthquakes, and mortality was greatest in Asia. Inconsistent reporting across data sources suggests that the numbers injured and affected are likely underestimates. Findings from a systematic review of the literature indicate that the primary cause of earthquake-related death was trauma due to building collapse and, the very young and the elderly were at increased mortality risk, while gender was not consistently associated with mortality risk.
Conclusions.
Strategies to mitigate the impact of future earthquakes should include improvements to the built environment and a focus on populations most vulnerable to mortality and injury.
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Affiliation(s)
- Shannon Doocy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
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Dong ZH, Shao H, Chen TW, Chu ZG, Deng W, Tang SS, Chen J, Yang ZG. Digital radiography of crush thoracic trauma in the Sichuan earthquake. World J Radiol 2011; 3:273-8. [PMID: 22132298 PMCID: PMC3226961 DOI: 10.4329/wjr.v3.i11.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 08/07/2011] [Accepted: 08/14/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the features of crush thoracic trauma in Sichuan earthquake victims using chest digital radiography (CDR).
METHODS: We retrospectively reviewed 772 CDR of 417 females and 355 males who had suffered crush thoracic trauma in the Sichuan earthquake. Patient age ranged from 0.5 to 103 years. CDR was performed between May 12, 2008 and June 7, 2008. We looked for injury to the thoracic cage, pulmonary parenchyma and the pleura.
RESULTS: Antero-posterior (AP) and lateral CDR were obtained in 349 patients, the remaining 423 patients underwent only AP CDR. Thoracic cage fractures, pulmonary contusion and pleural injuries were noted in 331 (42.9%; 95% CI: 39.4%-46.4%), 67 and 135 patients, respectively. Of the 256 patients with rib fractures, the mean number of fractured ribs per patient was 3. Rib fractures were mostly distributed from the 3rd through to the 8th ribs and the vast majority involved posterior and lateral locations along the rib. Rib fractures had a significant positive association with non-rib thoracic fractures, pulmonary contusion and pleural injuries (P < 0.001). The number of rib fractures and pulmonary contusions were significant factors associated with patient death.
CONCLUSION: Earthquake-related crush thoracic trauma has the potential for multiple fractures. The high number of fractured ribs and pulmonary contusions were significant factors which needed appropriate medical treatment.
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Djalali A, Khankeh H, Öhlén G, Castrén M, Kurland L. Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study. Scand J Trauma Resusc Emerg Med 2011; 19:30. [PMID: 21575233 PMCID: PMC3114771 DOI: 10.1186/1757-7241-19-30] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 05/16/2011] [Indexed: 12/04/2022] Open
Abstract
Background Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. Methods The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. Results The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. Conclusions The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels.
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Affiliation(s)
- Ahmadreza Djalali
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden
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ROBINSON BRUCE, ALATAS MOHAMMADFAHMI, ROBERTSON ANDREW, STEER HENRY. Natural disasters and the lung. Respirology 2011; 16:386-95. [DOI: 10.1111/j.1440-1843.2011.01923.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Xu J, You C, Zhou L, Wu B, Li X, Li Z, Fan X, Zeng Y, Jiang L, Yuan Y. Long-Term Results of Patients with Head Injuries Treated in Different Hospitals After the Wenchuan, China, Earthquake. World Neurosurg 2011; 75:390-6. [DOI: 10.1016/j.wneu.2011.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Revised: 11/21/2010] [Accepted: 02/02/2011] [Indexed: 11/17/2022]
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Gosney JE. Physical medicine and rehabilitation: critical role in disaster response. Disaster Med Public Health Prep 2010; 4:110-2. [PMID: 20526131 DOI: 10.1001/dmphp.4.2.110] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Peranteau WH, Havens JM, Harrington S, Gates JD. Re-establishing surgical care at Port-au-Prince General Hospital, Haiti. J Am Coll Surg 2010; 211:126-30. [PMID: 20610258 DOI: 10.1016/j.jamcollsurg.2010.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 04/18/2010] [Accepted: 04/21/2010] [Indexed: 11/29/2022]
Affiliation(s)
- William H Peranteau
- Department of Surgery, The Brigham and Women's Hospital, Boston, MA 02115, USA
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Smith SM, Gorski J, Vennelakanti HC. Disaster preparedness and response: a challenge for hospitals in earthquake-prone countries. INTERNATIONAL JOURNAL OF EMERGENCY MANAGEMENT 2010. [DOI: 10.1504/ijem.2010.037006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Disasters come in all shapes and forms, and in varying magnitudes and intensities. Nevertheless, they offer many of the same lessons for critical care practitioners and responders. Among these, the most important is that well thought out risk assessment and focused planning are vital. Such assessment and planning require proper training for providers to recognize and treat injury from disaster, while maintaining safety for themselves and others. This article discusses risk assessment and planning in the context of disasters. The article also elaborates on the progress toward the creation of portable, credible, sustainable, and sophisticated critical care outside the walls of an intensive care unit. Finally, the article summarizes yields from military-civilian collaboration in disaster planning and response.
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Affiliation(s)
- Saqib I Dara
- Critical Care Medicine, Al Rahba Hospital-Johns Hopkins International, Abu Dhabi, United Arab Emirates
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Radonovich LJ, Magalian PD, Hollingsworth MK, Baracco G. Stockpiling supplies for the next influenza pandemic. Emerg Infect Dis 2009; 15:e1. [PMID: 21970033 PMCID: PMC2727308 DOI: 10.3201/eid1506.081196] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Faced with increasing concerns about the likelihood of an influenza pandemic, healthcare systems have been challenged to determine what specific medical supplies that should be procured and stockpiled as a component of preparedness. Despite publication of numerous pandemic planning recommendations, little or no specific guidance about the types of items and quantities of supplies needed has been available. The primary purpose of this report is to detail the approach of 1 healthcare system in building a cache of supplies to be used for patient care during the next influenza pandemic. These concepts may help guide the actions of other healthcare systems.
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Affiliation(s)
- Lewis J Radonovich
- North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
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The Needs of Children in Natural or Manmade Disasters. INTENSIVE AND CRITICAL CARE MEDICINE 2009. [PMCID: PMC7120869 DOI: 10.1007/978-88-470-1436-7_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Disasters have been described as “events of sufficient scale, asset depletion, or numbers of victims to overwhelm medical resources” [1] or as “a serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses that exceed the ability of the affected community or society to cope using its own resources” [2]. Importantly, that definition goes on to state: “A disaster is a function of the risk process. It results from the combination of hazards, conditions of vulnerability and insufficient capacity or measures to reduce the potential negative consequences of risk.”
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