Experience with mass casualties in a subcontinent earthquake

BACKGROUND
A massive earthquake struck North Pakistan on 8 October 2005. The objective of this study was to evaluate the types of injuries and the procedures carried out on the admitted casualties, and to present recommendations based on these experiences for improvement in disaster preparedness and management. This is a descriptive study conducted at the Military Hospital, Rawalpindi.
METHODS
Inclusion criteria included all patients who required admission for treatment. Patients who had minor injuries not requiring indoor treatment and those who were dead on arrival were excluded from this study. The files of admitted patients were analyzed for type of injuries, procedures performed, complications, and causes of death.
RESULTS
The total number of patients received was 1698, of which 862 (50.8%) were admitted. A total of 2289 operations were performed including 1046 (45.7%) major interventions. Sixteen (1.5%) amputations were necessary. Seventeen deaths (1.9%) occurred in hospital, while 76 dead bodies were received.
CONCLUSION
After the initial days of life- and limb saving, it is important to quickly divide the manpower into teams with a major emphasis on plastic, orthopedics and spinal surgery, to start shifts and to utilize the volunteer manpower early and judiciously. Prevention of tetanus is essential.

Bir kýta parçasý depremindeki kitlesel zayiat deneyimi

AMAÇ
8 Ekim 2005 tarihinde Kuzey Pakistan’ý büyük bir deprem vurdu. Bu çalýþmada, hastaneye yatýrýlan yaralýlarýn yaralanma tipleri ile uygulanan iþlemler deðerlendirildi ve bu deneyimlere dayanarak afetlere karþý hazýrlýklý olma ve afet yöntemi ile ilgili olarak öneriler sunuldu. Bu çalýþma, Rawalpindi’deki Asker Hastanesi’nde yürütülen tanýmlayýcý bir çalýþmadýr.
GEREÇ VE YÖNTEM
Çalýþmaya dahil edilme kriterleri, tedavi için hastaneye yatýrýlmayý gerektiren bütün hastalarý kapsadý. Ayaktan tedavi görebilecek küçük yaralanmalýlar ve hastaneye ulaþtýðýnda ölmüþ olan kiþiler çalýþma dýþýnda býrakýldý. Hastaneye yatýrýlan hastalarýn dosyalarý, yaralanma tipi, uygulanan prosedürler, komplikasyonlar ve ölüm nedenleri analiz edildi.
BULGULAR
Baþvuran toplam hasta sayýsý 1698 idi ve bunlarýn 862 tanesi (%50,8) hastaneye yatýrýldý; 1046 tane (%45,7) majör giriþimi içeren toplam 2289 ameliyat yapýldý. On altý adet (%1,5) amputasyon uygulanmasý gerekti. Hastanede 17 hasta yaþamýný yitirdi (%1,9); dýþarýdan 76 ceset getirildi.
SONUÇ
Hayat ve uzuv kurtarma ile ilgili ilk günlerden sonra, vardiyalarý baþlatmak, gönüllü insan gücünü erkenden ve mantýklý bir þekilde kullanmak ve plastik cerrahi, ortopedi ve spinal cerrahi konularýna özellikle önem vermek kaydýyla insan gücünü hýzlý bir þekilde ekiplere bölmek önemlidir. Tetanozun önlenmesi yaþamsal öneme sahiptir.