Medical care following earthquakes: Clinical, organizational, and logistic challenges

Acta Orthop Traumatol Turc. 2023 Nov;57(6):296-300. doi: 10.5152/j.aott.2023.23184.ABSTRACTThe orthopedic load following earthquakes exceeds that caused by any other disaster. This is due to the large number of musculoskeletal injuries due to falling debris, coupled with the widespread damage to general and medical infrastructure, causing a huge imbalance between surgical needs and the ability to address these needs, necessitating a switch in mindset and operational mode. Clinically, the operational mode will be that of damage control surgery, considering "life before limb" with only lifesaving and limb-saving procedures being performed during the acute phase of the event. Open wounds are treated by thorough debridement, and fixation is performed using plaster casts or external fixation. Open reduction and internal fixation of closed fractures will be deferred until the surge subsides or the patient reaches a fully functional medical facility. Organizational and logistic needs will be addressed considering the "4 S's": space, staff, supplies and system. Geographical changes will be necessary in the hospital, shifting activities from damaged structures to safe ones or to open spaces. Field hospitals may be erected on the hospital grounds or on an independent site. Medical staff will be overloaded, especially traumatologists, orthopedic and plastic surgeons, anesthesiologists, and surgical nurses. This can be addressed by the recruitment of supplementary personnel, task shiftin...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Source Type: research