Earthquake Injuries – the Haiti Experience – What to Prepare For

Last month’s JAMA (Journal of the American Medical Association) featured an article from the CDC (MMWR 2011;59:1673-1677) on post-earthquake injuries treated at a field hospital in 2010.

What did they see?  Or of more concern, what will we see when an earthquake strikes closer to home?

The statistics only included patients injured severely enough to be admitted to a field hospital.  Records were incomplete for the first 7-10 days, no doubt reflecting initial chaos.

From January 13 – May 28, 2010 a total of 1369 patients were admitted (a number that seems low in view of 222,570 deaths with 300,000 injuries, but this data is from a single facility).

Of these, 42% had injury-related diagnoses, of whom 60% required a surgical procedure.  Of these, about a fourth were directly related to the earthquake.

The most common injury diagnoses were:

  • fractures/dislocations
  • wound infections
  • head, face, and brain injuries

The most common surgical procedures were

  • wound debridement/skin grafting
  • treatment for orthopedic trauma
  • surgical amputation

The most common mechanisms of injuries for earthquake-related injuries were:

  • cut/pierce/struck by an object
  • crush injuries
  • falls
  • burns
  • vehicle injuries
  • assault/violence
  • unknown (49%)

Which of these are you prepared for?

The list of injuries is about what I would expect.  Assault will always be a factor when fear reigns and societal organization is disrupted.

A basic medical kit should contain plenty of gauze, tape, bacitracin, large band-aids, Kotex pads for covering large wounds, wound-closure strips for  superficial lacerations, alcohol or iodine for cleaning around wounds, burn cream, ice packs, elastic wraps, Coban, splints, and pain medications.  For those with advanced skills, lidocaine, syringes, needles, suture material, skin staplers, and electro-cautery would come in handy.  Preventing infection is as important as treating the immediate problem.

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About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
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