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Prehospital Management of Earthquake Casualties Buried Under Rubble

Published online by Cambridge University Press:  28 June 2012

Itamar Ashkenazi ,
Boris Isakovich ,
Yoram Kluger ,
Ricardo Alfici ,
Boris Kessel  and
Ori S. Better
Itamar Ashkenazi*
Affiliation:
Surgery B/Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel
Boris Isakovich
Affiliation:
Intensive Care Unit, Hillel Yaffe Medical Center, Hadera, Israel
Yoram Kluger
Affiliation:
Surgery B, Rambam Medical Center, Haifa, Israel
Ricardo Alfici
Affiliation:
Surgery B/Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel
Boris Kessel
Affiliation:
Surgery B/Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel
Ori S. Better
Affiliation:
Supported by the Michael and Helen Schaffer Fund for research in Military Medicine
*
Department of Surgery B, Hillel Yaffe Medical Center, POB 169, Hadera 38100, Israel E-mail: i_ashkenazi@yahoo.com or trauma@hillel-yaffe.health.gov.il
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Abstract

Earthquakes continue to exact a heavy toll on life, injury, and loss of property. Survival of casualties extricated from under the rubble depends upon early medical interventions by emergency teams on site. The objective of this paper is to review the pertinent literature and to analyze the information as a practical guideline for the medical management of casualties accidentally buried alive.

Keywords

crush injuryearthquake casualtiessearch and rescuetreatment guidelines
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 20 , Issue 2 , April 2005 , pp. 122 - 133
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2005

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References

1.Ramenofsky, ML (ed): Advanced Trauma Life Support: Course for Physicians. American College of Surgeons. 1993.Google Scholar
2.Perez, E, Thompson, P: Earthquakes. In: Natural Hazards: Causes and Effects. Disaster Management Center, University of Wisconsin. 1986; pp 12–30.Google Scholar
3.Moede, JD: Medical aspects of urban heavy rescue. Prehosp Disast Med 1991;6(3):341–345.CrossRefGoogle Scholar
4.Noji, EK, Armenian, HK, Oganessian A: Issues of rescue and medical care following the 1988 Armenian earthquake. Int J Epidemiol 1993;22(6):1070–1076.CrossRefGoogle ScholarPubMed
5.Noji, EK, Kelen, GD, Armenian, HK, et al. : The 1988 earthquake in Soviet Armenia: A case study. Ann Emerg Med 1990;19(8):891–897.CrossRefGoogle ScholarPubMed
6.Osaki, Y, Minowa, M: Factors associated with earthquake deaths in the Great Hanshin-Awaji earthquake, 1995. Nippon Koshu Eisei Zasshi 1999;46(3):175–183.Google ScholarPubMed
7.Alexander, D: The health effects of earthquakes in the mid-1990's. Disasters 1996;20(3):231–247.CrossRefGoogle Scholar
8.Tanaka, K: The Kobe earthquake: The system response. A disaster report from Japan. Eur J Emer Med 1996;3(4):263–269.CrossRefGoogle ScholarPubMed
9.Roces, MC, White, ME, Dayrit, MM, Durkin, ME: Risk factors for injuries due to the 1990 earthquake in Luzon, Philippines. Bull World Health Organ 1992;70(4):509–514.Google Scholar
10.Peek-Asa, C, Kraus, JF, Bourque, LB, et al. : Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. Int J Epidemiol 1998;27(3):459–465.CrossRefGoogle ScholarPubMed
11.Safar, P: Resuscitation potentials in mass disasters. Prehosp Disast Med 1986;2:34–47.CrossRefGoogle Scholar
12.Pretto, EA, Ricci, E, Klain, M, et al. : Disaster reanimatology potentials: A structured interview study in Armenia. III. Results, conclusions, and recommendations. Prehosp Disast Med 1992;7:327–337.CrossRefGoogle Scholar
13.Pretto, EA, Angus, DC, Abrams, JI, et al. : An analysis of prehospital mortality in an earthquake. Prehosp Disast Med 1994;9:107–124.CrossRefGoogle Scholar
14.Angus, DC, Pretto, EA, Abrams, JI, et al. : Epidemiologic assessment of mortality, building collapse pattern, and medical response after the 1992 earthquake in Turkey. Disaster Reanimatology Study Group (DRSG). Prehosp Disast Med 1997;12(3):222–231.CrossRefGoogle Scholar
15.Aoki, N, Nishimura, A, Pretto, EA, et al. : Survival and cost analysis of fatalities of the Kobe earthquake in Japan. Prehosp Emerg Care 2004;8(2):217–222.CrossRefGoogle ScholarPubMed
16.Barbera, JA, Cadoux, CG: Search, rescue and evacuation. Critical Care Clinics 1991;7(2):321–327.CrossRefGoogle ScholarPubMed
17.Barbera, JA, Lozano, M Jr, : Urban search and rescue medical teams: FEMA task force system. Prehosp Disast Med 1993;8(4):349–355.CrossRefGoogle ScholarPubMed
18.Yoshimura, N, Nakayama, S, Nakagiri, K, et al. : Profile of chest injuries arising from the 1995 southern Hyogo Prefecture earthquake. Chest 1996;110(3):759–761.CrossRefGoogle ScholarPubMed
19.Ozdogan, S, Hocaoglu, A, Caglayan, B, et al. : Thorax and lung injuries arising from the two earthquakes in Turkey in 1999. Chest 2001;120(4):1163–1166.CrossRefGoogle ScholarPubMed
20.Hogan, MD, Fuots, JR, McKinney, JD, Rall DP: Disease causing effects of environmental chemicals. Med Clin North Am 1990;74(2):461–473.CrossRefGoogle ScholarPubMed
21.Weill, H: Disaster at Bhopal: The accident, early findings and respiratory health outlook in those injured. Bull Eur Physiopathol Repir 1987;23(6);587–590.Google ScholarPubMed
22.Varma, DR, Guest, I: The Bhopal accident and methyl isocyanate toxicity. J Toxicol Environ Health 1993;40(4):513–529.CrossRefGoogle ScholarPubMed
23.Courteau, JP, Cushman, R, Bouchard, F, et al. : Survey of construction workers exposed to chlorine over a three to six month period in a pulpmill: Exposure and symptomatology. Occup Environ Med 1994;51(4):219–224.CrossRefGoogle Scholar
24.Nicolaou, D, Kelen, GD: Airway management for the trauma patient. In: Cameron, JL: Current Surgical Therapy (6th ed). St. Louis: Mosbi, Inc., 1998.Google Scholar
25.Schultz, CH, Koenig, KL, Noji, EK: A medical disaster response to reduce immediate mortality after an earthquake. N Engl J Med 1996;334(7):438–444.CrossRefGoogle ScholarPubMed
26.Grande, CM, Baskett, PFJ, Donchin, Y, et al. : Trauma anesthesia for disasters: Anything, anytime, anywhere. Critical Care Clinics 1991;7(2):339–361.CrossRefGoogle Scholar
27.Chudnofsky, CR, Wright, SW, Dronen, SC, et al. : The safety of fentanyl use in the emergency department. Ann Emerg Med 1989;18(6):635–639.CrossRefGoogle ScholarPubMed
28.Bedford, RF, Persing, JA, Pobereskin, L, Butler, A: Lidocaine or thiopental for rapid control of intracranial intubation? Anesth Analg 1980;59(6):435–437.CrossRefGoogle ScholarPubMed
29.Hedges, JR, Dronen, SC, Feero, S, et al. : Succinylcholine-assisted intubations in prehospital care. Ann Emerg Med 1988;17(5):469–472.CrossRefGoogle ScholarPubMed
30.Syverud, SA, Borron, SW, Storer, DL, et al. : Prehospital use of neuromuscular blocking agents in a helicopter ambulance program. Ann Emerg Med 1988;17(3):236–242.CrossRefGoogle Scholar
31.Vukmir, RB, Rinnert, KJ, Krugh, JW: Trauma airway management. In: Peitzman, AB, Rhodes, M, Schwab, CW, Yealy, DM (eds): The Trauma Manual. Philadelphia: Lippincott-Raven Publishers, 1998, pp 91–99.Google Scholar
32.Bickell, WH, Bruttig, SP, Millnamow, GA, et al. : The detrimental effects of intravenous crystalloid after aortotomy in swine. Surgery 1991;110(3):529–536.Google ScholarPubMed
33.Stern, SA, Dronen, SC, Wang, X: Multiple resuscitation regimens in nearfatal porcine aortic injury hemorrhage model. Acad Emerg Med 1995;2(2):89–97.CrossRefGoogle ScholarPubMed
34.Bickell, WH, Wall, MJ Jr, Pepe, PE, et al. : Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994;331(17):1105–1109.CrossRefGoogle ScholarPubMed
35.Better, OS: History of the crush syndrome: From the earthquakes of Messina, Sicily 1909 to Spitak, Armenia 1988. Am J Nephrol 1997;17:392–394.CrossRefGoogle ScholarPubMed
36.Howse, AJG, Seddon, H: Ischaemic contracture of muscle associated with carbon monoxide and barbiturate poisoning. Br Med J 1966;5481:192–195.CrossRefGoogle Scholar
37.Bywaters, EGL: 50 years of the crush syndrome. Br Med J 1990;301(6766):1412–1415.CrossRefGoogle ScholarPubMed
38.Bywaters, EGL, Beal, D: Crush injuries and renal function. Br Med J 1941;1:427–432.CrossRefGoogle Scholar
39.Bywaters, EGL: Ischemic muscle necrosis. JAMA 1944;124:1103–1109.CrossRefGoogle Scholar
40.Bywaters, EGL, Delroy, GE, Rimington, C, Smiles, J: Myoglobin in the urine of air raid casualties with crushing injury. Biochem J 1941;35:1164–1168.CrossRefGoogle Scholar
41.Bywaters, EGL, Stead, JK: The production of renal failure following the injection of solutions containing myoglobin. Q J Exp Physiol 1944;33:53–70.CrossRefGoogle Scholar
42.Better, OS, Abassi, Z, Rubinstein, I, et al. : The mechanism of muscle injury in the crush syndrome: ischemic versus pressure-stretch myopathy. Miner Electrolyte Metab 1990;16(4):181–184.Google ScholarPubMed
43.Better, OS, Rubinstein, I, Reis, DN: Muscle crush compartment syndrome: Fulminant local edema with threatening systemic effects. Kidney International 63:1155–1157, 2003.CrossRefGoogle ScholarPubMed
44.Better, OS, Stein, JH: Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Eng J Med 1990;322(12):825–829.Google ScholarPubMed
45.Allister, C: Cardiac arrest after crush injury. Br Med J Clin Res Ed 1983;287(6391):531–532.CrossRefGoogle ScholarPubMed
46.Collins, AJ, Burzstein, S: Renal failure in disasters. Critical Care Clinics 1991;7(2):421–435.CrossRefGoogle ScholarPubMed
47.Collins, AJ: Kidney dialysis treatment for victims of the Armenian earthquake. N Engl J Med 1989;320(19):1291–1292.CrossRefGoogle ScholarPubMed
48.Nadjafi, I, Atef, MR, Broumand, B, Rastegar, A: Suggested guidelines for treatment of acute renal failure in earthquake victims. Ren Fail 1997;19(5):655–664.CrossRefGoogle ScholarPubMed
49.Ukai, T: The Great Hanshin-Awaji earthquake and the problems with emergency medical care. Ren Fail 1997;19(5):633–645.CrossRefGoogle ScholarPubMed
50.Oda, J, Tanaka, H, Yoshioka, T, et al. : Analysis of 372 patients with crush syndrome cuased by the Hanshin-Awaji earthquake. J Trauma 1997;42(3):470–476.CrossRefGoogle Scholar
51.Erek, E, Sever, MS, Serdengecti, K, et al. : An overview of morbidity and mortality in patients with acute renal failure due to crush syndrome: The Marmara earthquake experience. Nephrol Dial Transplant 2002;17(1):33–40.CrossRefGoogle ScholarPubMed
52.Shimazu, T, Yoshioka, T, Nakata, Y, et al. : Fluid resuscitation and systemic complications in crush syndrome: 14 Hanshin-Awaji earthquake patients. J Trauma 1997;42(4):641–646.CrossRefGoogle ScholarPubMed
53.Sever, MS, Erek, E, Vanholder, R, et al. : The Marmara earthquake: epidemiological analysis of the victims with nephrological problems. Kidney Int 2001;60(3):1114–1123.CrossRefGoogle ScholarPubMed
54.Sarisozen, B, Durak, K: Extremity injuries in children resulting from the 1999 Marmar earthquake: An epidemiologic study. J Pediatr Orthop B 2003:12(4):288–291.CrossRefGoogle Scholar
55.Kikta, MJ, Meyer, JP, Bishara, RA, et al. : Crush syndrome due to limb compression. Arch Surg 1987;122(9):1078–1081.CrossRefGoogle ScholarPubMed
56.Ron, D, Taitelman, U, Michaelson, M, et al. : Prevention of acute renal failure in traumatic rhabdomyolysis. Arch Intern Med 1984;144(2):277–280.CrossRefGoogle ScholarPubMed
57.Rubinstein, I, Abassi, Z, Milman, F, et al. : Selective induction of nitric oxide synthase (NOS) isoforms contributes to vasodilatation in crush syndrome. J Am Soc Nephrol 1996;7(9):1833. (Abstract)Google Scholar
58.Smith, J, Greaves, I: Crush injury and crush syndrome: A review. J Trauma 2003;54:s226–s230.Google ScholarPubMed
59.Zager, RA: Studies of mechanisms and protective maneuvers in myoglobinuric acute renal injury. Lab Invest 1989;60(5):619–629.Google ScholarPubMed
60.Levinsky, NG: Hyperkalemia: treatment. In: Wilson: Harrison's Principles of Internal Medicine, (12th ed). New York: McGraw Hill, 1991, p 288.Google Scholar
61.Zager, RA: Rhabdomyolysis and myohemoglobinuric acute renal failure. Kidney Int 1996;49:314–326.CrossRefGoogle ScholarPubMed
62.Better, OS, Rubinstein, I, Winaver, JM, Knockel, JP: Mannitol therapy revisted (1940–1997). Kidney Int 1997;52(4):886–894.CrossRefGoogle Scholar
63.Better, OS, Zinman, C, Reis, DN, et al. : Hypertonic mannitol ameliorates intracompartmental tamponade in model compartment syndrome in the dog. Nephron 1991;58:344–346.CrossRefGoogle ScholarPubMed
64.Daniels, M, Reichman, J, Brezis, M: Mannitol treatment for acute compartment syndrome. Nephron 1998;79(4):492–493.CrossRefGoogle ScholarPubMed
65.Oredsson, S, Plate, G, Qvarfordt, P: The effect of mannitol on reperfusion injury and postischaemic compartment pressure in skeletal muscle. Eur J Vasc Surg 1994;8(3):261–231.CrossRefGoogle ScholarPubMed
66.Ben-Haim, SA, Edoute, Y, Hayam, G, Better, OS: Sodium modulates inotropic response to hyperosmolarity in isolated working rat heart. Am J Physiol 1992;263(32):H1154–H1160.Google ScholarPubMed
67.Marion, DW, Penrod, LE, Kelsey, SF, et al. : Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 1997;336(8):540–546.CrossRefGoogle ScholarPubMed
68.Gentilello, LM: Advances in the management of hypothermia. Surg Clin North Am 1995;75(2):243–256.CrossRefGoogle ScholarPubMed
69.Michelson, AD, MacGregor, H, Barnard, MR, et al. : Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thromb Haemost 1994;71(5):633–640.Google ScholarPubMed
70.Staab, DB, Sorensen, VJ, Fath, JJ, et al. : Coagulation defects resulting from ambient temperature-induced hypothermia. J Trauma 1994;36(5):634–638.CrossRefGoogle ScholarPubMed
71.Watts, DD, Trask, A, Soeken, K, et al. : Hypothermic coagulopathy in trauma: Effect of varying levels of hypothermia on enzyme speed, platelet function, and fibrinolytic activity. J Trauma 1998;44(5):846–854.CrossRefGoogle ScholarPubMed
72.Gentilello, LM, Jurkovich, GJ, Stark, MS, et al. : Is hypothermia in the victim of major trauma protective or harmful? A randomized, prospective study. Ann Surg 1997;226(4):439–447.CrossRefGoogle ScholarPubMed
73.Tighe, SQ, Rudland, SV, Loxdale, PH: Resuscitation in northern Iraq. Injury 1992;23(7):448–450.CrossRefGoogle ScholarPubMed
74.Helm, M, Lampl, L, Hauke, J, Bock, KH: Accidental hypothermia in trauma patients. Is it relevant to preclinical emergency treatment? Anaesthesist 1995;44(2):101–107.Google ScholarPubMed
75.Peng, RY, Bongard, FS: Hypothermia in trauma patients. J Am Coll Surg 1999;188(6):685–696.CrossRefGoogle ScholarPubMed
76.Watts, DD, Roche, M, Tricarico, R, et al. : The utility of traditional prehospital interventions in maintaining thermostasis. Prehosp Emerg Care 1999;3(2):115–122.CrossRefGoogle ScholarPubMed
77.Nakamori, Y, Tanaka, H, Oda, J, et al. : Burn injuries in the 1995 Hanshin-Awaji earthquake. Burns 1997;23(4):319–322.CrossRefGoogle ScholarPubMed
78.Sever, MS, Erek, E, Vanholder, R, et al. : The Marmara earthquake: Admission laboratory features of patients with nephrological problems. Nephrol Dial Transplant 2002;17(6):1025–1031.CrossRefGoogle ScholarPubMed
79.Sever, MS, Erek, E, Vanholder, R, et al. : Serum potassium in the crush syndrome victims of the Marmara disaster. Clin Nephrol 2003;59(5):326–333.CrossRefGoogle ScholarPubMed
80.Iskit, SH, Alpay, H, Tugtepe, H, et al. : Analysis of 33 pediatric trauma victims in the 1999 Marmar, Turkey earthquake. J Pediatr Surg 2001;36(2):368–372.CrossRefGoogle Scholar
81.Scheinin, M, Koulu, M, Laurikainen, E, Allonen, H: Hyperkalemia and other nonbronchial effects of inhaled fenoterol and salbutamol: A placebo-controlled dose-response study in healthy volunteers. Br J Clin Pharmacol 1987;24(5):645–653.CrossRefGoogle Scholar
82.Knochel, JP: Serum calcium derangements in rhabdomyolysis. N Engl J Med 1981;305(3):161–163.CrossRefGoogle ScholarPubMed
83.Cheung, JY, Bonventre, JV, Mallis, CD, Leaf, A: Calcium and ischemic injury. N Engl J Med 1986;314(26):1670–1676.Google ScholarPubMed
84.Kuwagata, Y, Oda, J, Tanaka, H, et al. : Analysis of 2702 traumatized patients in the 1995 Hanshin-Awaji earthquake. J Trauma 1997;43(3):427–432.CrossRefGoogle Scholar
85.Hooft, PJ, Noji, EK, Van-de-Voorde, HP: Fatality management in mass casualty incidents. Forensic Sci Int 1989;40(1):3–14.CrossRefGoogle ScholarPubMed
86.Marmar, CR, Weiss, DS, Metzler, TJ, et al. : Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel. J Nerv Ment Dis 1999;187(1):15–22.CrossRefGoogle ScholarPubMed