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Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results

Published online by Cambridge University Press:  28 June 2012

Miroslav Klain ,
Edmund Ricci ,
Peter Safar ,
Victor Semenov ,
Ernesto Pretto ,
Samuel Tisherman ,
Joel Abrams  and
Louise Comfort
Miroslav Klain
Affiliation:
International Resuscitation Research Center (IRRC), Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh
Edmund Ricci
Affiliation:
Graduate School of Public Health, University of Pittsburgh
Peter Safar*
Affiliation:
International Resuscitation Research Center (IRRC), Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh
Victor Semenov
Affiliation:
Institute of Reanimatology of the USSR Academy of Medical Sciences, Moscow, USSR
Ernesto Pretto
Affiliation:
International Resuscitation Research Center (IRRC), Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh
Samuel Tisherman
Affiliation:
International Resuscitation Research Center (IRRC), Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh
Joel Abrams
Affiliation:
School of Engineering, University of Pittsburgh
Louise Comfort
Affiliation:
Graduate School of Public and International Affairs, University of Pittsburgh
*
University of Pittsburgh, 3434 Fifth Avenue, Pittsburgh, PA 15260, USA; 412/624–6735; fax 412/624–0943
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Abstract

In general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

Keywords

EarthquakeAdvanced Life SupportEmergency Medical ServicesEvaluationFirst AidHealth Care RescueResuscitation
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 4 , Issue 2 , December 1989 , pp. 135 - 152
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1989

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