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PubMed2001

[Chemical disaster].

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Accidents, Occupational↗
PubMed2001

[Evaluation of patients wounded in the 17 August 1999 Marmara earthquake].

This study describes the experience of Kartal Research and Training Hospital in the Marmara Earthquake. We reviewed medical records of 698 patients admitted to our hospital in a 30 days' period after the earthquake and analysed the types of injuries, treatment, morbidity and mortality rates. The hospitalized 273 patients were grouped according to the major injury; patients with crush syndrome were analysed separately. The most frequent injuries were crush injury (23.1%), extremity fractures (16.8%) and pelvis and spine injuries (16.1%). More than two system injuries were seen most frequently in the abdominal injury (45.5%), crush injury (24.4%), and pelvis and spine injury (27.3%) groups (p < 0.05). Overall mortality rate was 7.3%. The highest mortality rates were seen in the abdominal injury (27.3%) and crush injury (20%) groups (p < 0.05). 61.9% of the patients with crush syndrome underwent fasciotomy due to the compartment syndrome; hemodialysis was performed in 31 patients. The most serious problem with earthquake is organization in the earthquake area, between hospitals and in hospitals. Crush injury is the major injury seen earthquakes. Early diagnosis and proper treatment should be done to improve survival.

Adult↗
PubMed2001

[Hurricane-related orthopedic surgical admissions to an emergency department in December 1999].

INTRODUCTION: On 3 December, 1999, at 15.00 pm, hurricane Adam struck Esbjerg (Denmark). Wind velocity exceeded 33 m/s, the strongest hurricane ever recorded in Denmark during the last century. This article describes and analyses the orthopaedic impact of the hurricane on a local hospital in Esbjerg. MATERIALS AND METHODS: We examined retrospectively all the patients treated at the Emergency Department from 3 pm on 3 December and for the following 24 hours. For comparison, we used the records of all patients treated at the Emergency Department in the same time interval on the first three Fridays in December from 1994 to 1998. RESULTS: No hurricane-associated deaths were recorded, but the number of patients treated on 3 December was significantly higher than that recorded in the period 1994-1998 (159 versus 74, p < 0.001). The main diagnosis was similar to that of the previous years, but more people sought treatment at the Emergency Department. Sixty-eight percent of the recorded injuries were injuries to the upper and lower extremities and 22% to the head and neck. DISCUSSION: Hurricanes can lead to substantial morbidity and mortality. Early warning is the most effective way of reducing death and injury. People should seek cover and follow the instructions given by the news media. Educational programmes for the medical staff of the Emergency Department should be made available.

Adult↗
PubMed2001

Dealing with the continuing challenges of natural disasters.

Tropical Storm Allison--which struck the Texas and Louisiana coasts in June 2000--killed 22 people, flooded more than 27,000 homes, and caused an estimated $2 billion in property damage in the Houston area alone. Among the hardest hit were some 12 hospitals in the Texas Medical Center, south of downtown Houston, the world's largest medical facility, which all experienced flooding and reduction of services to various degrees. (The medical complex of 42 member institutions also includes numerous academic buildings and research laboratories where nearly 35,000 lab animals drowned.) Two of the hospitals were forced to evacuate all patients and close after losing emergency power. Sixteen patients died at medical center facilities during the storm, but a team from the JCAHO reportedly found that the deaths were caused by the critical nature of their illnesses rather than the severe flooding that inundated basements and other areas of the medical center.

Disaster Planning↗
PubMed2002

Hurricanes as teachers.

Hurricane Floyd came ashore and raced through eastern North Carolina on September 16, 1999. Even though Floyd's effects were devastating, some home care agencies in the affected area were up and running as soon as agency employees saw daylight. This article describes one agency's experience.

Case Management↗