Improving Measures to Reduce Earthquake Casualties

Abstract

Current earthquake casualty reduction measures are examined and recommendations made for needed changes. Key new approaches are outlined and a new framework for understanding casualty reduction measures presented. The framework considers both issues of demand for medical services and supply within primary, secondary and tertiary prevention aspects of each. It is used to assess current measures against recent empirical data and to suggest changes that incorporate new data and methods. Issues include the management of emergency medical services, messages for individual protective actions and assumptions about the nature of injuries. Research has tended to consider primarily the demand side of earthquake injury prevention, focusing on the injured rather than the uninjured. Case series investigations have tended to be descriptive rather than analytical and be undertaken from a clinical rather than an epidemiological perspective, documenting medical aspects of earthquake injuries. Linking these injuries to the risk factors associated with them has not been as systematically studied. Proposed here is an approach for casualty reduction research to fill knowledge gaps. It includes steps to integrate future casualty data and assessment efforts into casualty modeling and into ongoing earthquake policy formation.

Building Collapse and Human Deaths Resulting from the Chi-Chi Earthquake in Taiwan, September 1999

“…Durkin et al 21 indicated that building codes and regulations, which have as their goal the prevention of structural collapse and the restraint of hazardous nonstructural elements, are the principal policy instruments for the primary prevention of injuries. Because earthquakes cannot be avoided, a better understanding of the structural characteristics of buildings, and their capability to withstand seismic forces, is essential in determin-ing relief needs and the appropriate public health response.…”

Development of the CanRisk earthquake injury model

“…In earthquakes of all magnitudes, there is generally enough time to react before peak motion (Lomnitz 1970;Armenian et al 1992;Roces et al 1992;Durkin and Thiel 1992). During North American earthquakes, one of the common reactions is to rapidly exit a building during shaking.…”

“…All three earthquakes representing light damage and high earthquake education were twentieth-century earthquakes from California (1989Loma Prieta, 1992Landers, and 1994. Researchers have noted that a significant number of minor injuries were likely treated but not reported (Durkin and Thiel 1992;McKevitt et al 1995;McArthur et al 2000). (2) Moderate damage is classified as primarily structural failures of moderate material (e.g., timber-frame) and/or low-rise buildings.…”

Effective Plans for Hospital System Response to Earthquake Emergencies

“…The second-and third-degree severity require specialized medical attention and hospitalization, however, unlike the second degree, the third one requires immediate rescue and treatment to avoid death. [58][59][60] We considered that 100% of the patients with third-degree injuries, for example, having punctured organs or crush syndrome with exposed wounds, plus 10% of patients with second-degree injuries, for example, having compound bone fractures, will require surgical treatment in operating rooms. We considered that patients arrive to the closest hospital during a period of 4 days after the earthquake in accordance to the evidence from previous earthquakes.…”