Earthquakes and Ingenuity

At 1:55 p.m. EDT, just before I went out the door, my secretary asked, “Did you feel that?” At 1:57 I heard Rush Limbaugh’s stand-in say they’d felt an earthquake...

At 1:55 p.m. EDT, just before I went out the door, my secretary asked, “Did you feel that?”

At 1:57 I heard Rush Limbaugh’s stand-in say they’d felt an earthquake in New York, with reports soon following of a quake centered near Washington, D.C. Apparently sensitive individuals as far northwest as Akron, Ohio felt it as well.

The Pentagon, the Capitol, the city of D.C. – all evacuated.

Usually these “minor” events take on a bit of a holiday atmosphere. The danger appears minimal, and a little time off work is always welcome. And fortunately, most earthquakes do not cause widespread injury.

However, today’s quake can serve as a wake-up call for those of us less familiar with the aftermath of serious earthquakes.

The CDC offers a starting point for earthquake preparedness at: http://www.bt.cdc.gov/disasters/earthquakes/. The site offers good advice for citizens on what I would call a “controlled disaster,” one in which neither mass panic nor significant injury occurs. Today is a good day to print it out, read it, follow it, and store it. (Will your computer be working when things go bad?)

Readers of Armageddon Medicine may want to investigate further regarding severe injuries that often occur with a serious earthquake.  The CDC’s bioterrorist site on Crush Injuries and Crush Syndrome (see http://www.bt.cdc.gov/masscasualties/blastinjury-crush.asp) estimates the incidence of crush syndrome as 2-15% of quake-related injuries, with half the affected individuals developing acute renal failure, and half of them requiring dialysis. Clearly, this is ICU-level care involving an entire medical team. Professionals may want to think through how to handle such a situation without back-up care. The death rate of patients suffering crush syndrome could easily approach 50%.

After the Haiti quake, of those treated at a hospital, the CDC reports:

The most common injury-related diagnoses were fractures/dislocations, wound infections, and head, face, and brain injuries. The most common surgical procedures were wound debridement/skin grafting, treatment for orthopedic trauma, and surgical amputation. Among patients with earthquake-related injuries, the most common mechanisms recorded were cut/pierce/struck by an object and crush.

(See http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5951a1.htm)

Blast injuries are further enumerated and described at: http://www.bt.cdc.gov/masscasualties/blastinjuryfacts.asp.

Some of our professionals have visited Haiti after the 2010 earthquake. Would any of you care to comment (anonymously, or otherwise) on what you saw or experienced while there?

Or how about this question: what is the most complex medical situation that you have successfully handled without benefit of X-rays, labs, nursing, supplies, or back-up – a real end-of-the-world-as-we-know-it-scenario?

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