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Earthquakes and Trauma: Review of Triage and Injury-Specific, Immediate Care

Published online by Cambridge University Press:  28 June 2012

Oliver P. Gautschi*
Affiliation:
Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, Western Australia
Dieter Cadosch
Affiliation:
Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, Western Australia
Gunesh Rajan
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Fremantle Hospital, Western, Australia
René Zellweger
Affiliation:
Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, Western Australia
*
Department of Neurosurgery Cantonal Hospital St. Gallen, Rorschacher Strasse 95 9007 St. Gallen, Switzerland E-mail: ogautschi@datacomm.ch

Abstract

Earthquakes present a major threat to mankind. Increasing knowledge about geophysical interactions, progressing architectural technology, and improved disaster management algorithms have rendered modern populations less susceptible to earthquakes. Nevertheless, the mass casualties resulting from earthquakes in Great Kanto (Japan), Ancash (Peru), Tangshan (China), Guatemala, Armenia, and Izmit (Turkey) or the recent earthquakes in Bhuj (India), Bam (Iran), Sumatra (Indonesia) and Kashmir (Pakistan) indicate the devastating effect earthquakes can have on both individual and population health. Appropriate preparation and implementation of crisis management algorithms are of utmost importance to ensure a large-scale medical-aid response is readily available following a devastating event. In particular, efficient triage is vital to optimize the use of limited medical resources and to effectively mobilize these resources so as to maximize patient salvage. However, the main priorities of disaster rescue teams are the rescue and provision of emergency care for physical trauma. Furthermore, the establishment of transport evacuation corridors, a feature often neglected, is essential in order to provide the casualties with a chance for survival. The optimal management of victims under such settings is discussed, addressing injuries of the body and psyche by means of simple diagnostic and therapeutic procedures globally applicable and available.

Type
Comprehensive Review
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. Briggs, SM: Earthquakes. Surg Clin North Am 2006;86:537544.CrossRefGoogle ScholarPubMed
2. Knudson, P, Frecceri, CA, DeLateur, SA: Improving the field triage of major trauma victims. J Trauma 1988;28:602606.CrossRefGoogle ScholarPubMed
3. Yates, DW: Major disasters. Surgical triage. Br J Hosp Med 1979;22:323326.Google ScholarPubMed
4. Ashkenazi, I, Isakovich, B, Kluger, Y, et al. : Prehospital management of earthquake casualties buried under rubble. Prehospital Disast Med 2005;20:120133.CrossRefGoogle ScholarPubMed
5. Schultz, CH, Koenig, KL, Noji, EK: A medical disaster response to reduce immediate mortality after an earthquake. New Eng J Med 1996; 334:438444.CrossRefGoogle ScholarPubMed
6. Coupland, RM, Parker, PJ, Gray, RC: Triage of war wounded: The experience of the International Committee of the Red Cross. Injury 1992;23:507510.CrossRefGoogle ScholarPubMed
7. Gray, R: Surgery of war and disaster. Tropical Doct 1991;21:5660.CrossRefGoogle ScholarPubMed
8. Peleg, K, Reuveni, H, Stein, M: Earthquakes disasters—Lessons to be learned. Isr Med Assoc J 2002;4:361365.Google ScholarPubMed
9. Baker, MS: Creating order from chaos:Part I: Triage, intitial care, and tactical considerations in mass casualty and disaster response. Mil Med 2007;172:232236.CrossRefGoogle Scholar
10. Emami, MJ, Tavakoli, AR, Alemzadeh, H, et al. : Strategies in evaluation and management of Bam earthquake victims. Prehospital Disast Med 2005;20:327330.CrossRefGoogle ScholarPubMed
11. Peek-Asa, C, Kraus, JF, Bourque, LB, et al. : Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. Int J Epidemiol 1998;27:459465.CrossRefGoogle ScholarPubMed
12. Armenian, HK, Melkonian, A, Noji, EK, et al. : Deaths and injuries due to the earthquake in Armenia: A cohort approach. Int J Epidemiol 1997;26:806813.CrossRefGoogle Scholar
13. Shoaf, KI, Sareen, HR, Nguyen, LH, et al. : Injuries as a result of California earthquakes in the past decade. Disasters 1998;22:218235.CrossRefGoogle ScholarPubMed
14. Tanaka, H, Oda, J, Iwai, A, et al. : Morbidity and mortality of hospitalized patients after the 1995 Hanshin-Awaji earthquake. Am J Emerg Med 1999;17:186191.CrossRefGoogle ScholarPubMed
15. Tanaka, H, Iwai, A, Oda, J, et al. : Overview of evacuation and transport of patients following the 1995 Hanshin-Awaji earthquake. J Emerg Med 1998,16:439444.CrossRefGoogle ScholarPubMed
16. Esposito, TJ, Offner, PJ, Jurkovich, GJ, et al. : Do prehospital trauma center triage criteria identify major trauma victims? Arch Surg 1995;130:171176.CrossRefGoogle ScholarPubMed
17. Wardrope, J, Laird, C, Driscoll, P: The ABC of community emergency care: Introduction, series summary, the system of care. Emerg Med J 2004;21:8994.CrossRefGoogle ScholarPubMed
18. Chesnut, RM: Management of brain and spine injuries. Crit Care Clin 2004;20:2555.CrossRefGoogle ScholarPubMed
19. Siegel, JH, Gens, DR, , Mamantov, et al. : Effect of associated injuries and blood volume replacement on death, rehabilitation needs, and disability in blunt traumatic brain injury. Management of the acute head injury patient. Crit Care Med 1991;19:12521265.CrossRefGoogle Scholar
20. Roberts, JR: Pathophysiology, diagnosis and treatment of head trauma. Top Emerg Med 1979;1:41.Google Scholar
21. Rhee, KJ, Green, W, Holcroft, JW, et al. : Oral intubation in the multiply injured patient: The risk of exacerbating spinal cord damage. Ann Emerg Med 1990;9:511514.CrossRefGoogle Scholar
22. Levi, L, Wolf, A, Belzberg, H: Hemodynamic parameters in patients with acute cervical cord trauma: Description, intervention and prediction of outcome. Neurosurgery 1993;33:10071016.Google ScholarPubMed
23. Bracken, MB, Shephard, MJ, Holford, TR, et al. : Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA 1997;277:15971604.CrossRefGoogle ScholarPubMed
24. Tahmasebi, MN, Kiani, K, Mazlouman, SJ, et al. : Musculoskeletal injuries associated with earthquake. A report of injuries of Iran's December 26, 2003 Bam earthquake casualties managed in tertiary referral centers. Injury 2005;36:2732.Google ScholarPubMed
25. Latenser, BA, Gentilello, LM, Tarver, AA, et al. : Improved outcome with early fixation of skeletally unstable pelvic fractures. J Trauma 1991;31:2831.CrossRefGoogle ScholarPubMed
26. Stein, H, Hoerer, D, Weisz, I, et al. : Orthopedics 2000;23:10851087.CrossRefGoogle Scholar
27. Reis, ND, Better, OS: Mechanical muscle-crush injury and acute musclecrush compartment syndrome:With special reference to earthquake casualties. J Bone Joint Surg Br 2005;87:450453.CrossRefGoogle ScholarPubMed
28. Huang, KC, Lee, TS, Lin, YM, et al. : Clinical features and outcome of crush syndrome caused by the Chi-Chi earthquake. J Formos Med Assoc 2002;101:249256.Google ScholarPubMed
29. Johansen, K, Daines, M, Howey, T, et al. : Objective criteria accurately predict amputation following lower extremity trauma. J Trauma 1990;30:568572.CrossRefGoogle ScholarPubMed
30. Feliciano, DV, Cruse, PA, Spjut-Patrinely, V, et al. : Fasciotomy after trauma to the extremities. Am J Surg 1988;156:533536.CrossRefGoogle Scholar
31. Ozdogan, S, Hocaoglu, A, Caglayan, B, et al. : Thorax and lung injuries arising from the two earthquakes in Turkey in 1999. Chest 2001;120:11631166.CrossRefGoogle ScholarPubMed
32. Ghodsi, SM, Zargar, M, Khaji, A, et al. : Chest injury in victims of Bam earthquake. Chin J Traumatol 2006;9:345348.Google ScholarPubMed
33. Jackimczyk, K: Blunt chest trauma. Emerg Med Clin North Am 1993;11:8196.CrossRefGoogle ScholarPubMed
34. Ciraulo, D, Elliott, D, Mitchell, K, et al. : Flail chest injuries as a marker for significant injuries. J Am Coll Surg 1994;178:466470.Google ScholarPubMed
35. Pretre, R, Chilcott, M: Blunt trauma to the heart and great vessels. N Engl J Med 1997;336:626632.CrossRefGoogle Scholar
36. Rosenkranz, KM, Sheridan, R: Management of the burned trauma patient: balancing conflicting priorities. Burns 2002;28:665669.CrossRefGoogle ScholarPubMed
37. Nakamori, Y, Tanaka, H, Oda, J, et al. : Burn injuries in the 1995 Hanshin-Awaji earthquake. Burns 1997;23:319322.CrossRefGoogle ScholarPubMed
38. Sheridan, R, Barillo, D, Herndon, D, et al. : Burn speciality teams. J Burn Care Rehabil 2005;26:170173.CrossRefGoogle Scholar
39. Wisner, DH, Chun, Y, Blaisdell, FW: Blunt intestinal injury. Keys to diagnosis and management. Arch Surg 1990;125:13191322.CrossRefGoogle ScholarPubMed
40. Renz, BM, Feliciano, DV: Unnecessary laparotomies for trauma: A prospective study for morbidity. J Trauma 1995;38:350356.CrossRefGoogle ScholarPubMed
41. Ahmad, W, Polk, HC: Blunt abdominal trauma: A prospective study with selective peritoneal lavage. Arch Surg 1976;111:489492.CrossRefGoogle ScholarPubMed
42. Matthews, LA, Spirnak, JP: The nonoperative approach to major blunt renal trauma. Semin Urol 1995;13:7782.Google ScholarPubMed
43. Carlin, BI, Resnick, MI: Indications and techniques for urologic evaluation of the trauma patient with suspected urologic injury. Semin Urol 1995;13:924.Google ScholarPubMed
44. Koraitim, MM: Pelvic fracture urethral injuries: Evaluation of various methods of management. J Urol 1996;156:12881291.CrossRefGoogle ScholarPubMed
45. Erek, E, Sever, MS, Serdengecti, K, et al. : An oview of morbidity and mortality in patients with acute renal failure due to crush syndrome: The Marmara earthquake experience. Nephrol Dial Transplant 2002;17:3340.CrossRefGoogle Scholar
46. Rock, P, Yao, Z: Ischemia reperfusion injury, preconditioning and critical illness. Curr Opin Anaesthesiol 2002;15:139146.CrossRefGoogle ScholarPubMed
47. Montazeri, A, Baradaran, H, Omidvari, S, et al. : Psychological distress among Bam earthquake survivors in Iran: A population-based study. BMC Public Health 2005;11:4.CrossRefGoogle Scholar
48. Feeny, NC, Zoellner, LA, Fitzgibbons, LA, et al. : Exploring the roles of emotional numbing, depression and dissociation in PTSD. JTrauma Stress 2000;13:489498.CrossRefGoogle ScholarPubMed
49. Brewin, CR, Andrews, B, Rose, S: Fear, helplessness and horror in posttraumatic stress disorder: Investigating DSM-IV criterion A2 in victims of violent crime. J Trauma Stress 2000;13:499509.CrossRefGoogle ScholarPubMed
50. Meltzer-Brody, S, Churchill, E, Davidson, JR: Derivation of the SPAN, a brief diagnostic screening test for post-traumatic stress disorder. Psychiatry Research 1999;88:6370.CrossRefGoogle Scholar
51. Goenjian, AK, Steinberg, AM, Najarian, LM, et al. : Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. Am J Psychiatry 2000;157:911916.CrossRefGoogle ScholarPubMed
52. Lonigan, CJ, Anthony, JL, Shannon, MP: Diagnostic efficacy of posttraumatic symptoms in children exposed to disaster. J Clin Child Psychol 1998;27:255267.CrossRefGoogle ScholarPubMed