Study of the severity of musculoskeletal injuries and triage during the 2005 Pakistan earthquake

Awais, Syed Muhammad; Saeed, Ayesha

doi:10.1007/s00264-013-2013-3

Cited by 57 publications

(13 citation statements)

References 17 publications

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“…External fixators are time-tested best tools for DCO [21]. For the same reason, many external fixations were done at Mansehra and Muzaffarabad medical treatment camps, as evident by the retrospective computerised data analysis of their 19,700 patients [4]. The greatest number of external fixators were applied to the tibia and forearm bones.…”

Section: Discussionmentioning

confidence: 99%

“…The tremors and constant landslides multiplied the shock and trauma, while the onslaught of a harsh winter jeopardised the lives of survivors. This was without argument the most fatal natural catastrophe in Pakistan's history; recuperating from it has already cost billions, and the process of healing continues to this day [1,4]. The earthquake created a massive managerial task to aid the injured, from triage to rehabilitation [5].…”

Section: Introductionmentioning

confidence: 99%

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Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Awais

Saeed

2014

International Orthopaedics (SICOT)

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Purpose In the 2005 Pakistan earthquake, the great many injured with multiple fractures and open wounds provided a unique opportunity to practice damage-control orthopaedics. External fixators remain a time-tested tools for operating surgeons on such occasions. The locally manufactured, readily available Naseer-Awais (NA) external fixator filled such needs of this disaster with good outcome. Methods This is a retrospective descriptive study of 19,700 patients that presented over seven months to the two centres established by the lead author (SMA) in Muzaffarabad and Mansehra just one night after the 2005 earthquake. A series of local and foreign orthopaedic surgeon teams operated in succession. The computerised patient data collection of 1,145 operations was retrospectively analysed. Results Of the 19,700 patients presenting to the SMA centres, 50 % had limb injuries. Total fracture fixations were 1,145, of which 295 were external fixations: 185 were applied on the lower limb and 90 on upper limb, the majority were applied on tibia. Conclusion External fixators are valuable damage-control tools in natural disasters and warfare injuries. The locally manufactured NA external fixator served the needs of the many limb injuries during the 2005 Pakistan earthquake.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Awais

Saeed

2014

International Orthopaedics (SICOT)

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“…Of the 101 patients evaluated, only 9 were categorised as ready to be transferred to a step-down facility funded by the MoHP in the community; 83 required immediate rehabilitation (including mobilisation), with the remainder categorised as able to be discharged home upon recovery from their wounds and/or depending on their post-discharge living circumstances. The team also applied the reverse triage process [14] where possible by providing more attention to the most seriously injured patients, in order to utilise staff and scarce resources more appropriately.…”

Section: Clinical Triage Tool Auditmentioning

confidence: 99%

Rehabilitation Needs Assessment in Persons Following Spinal Cord Injury in Disaster Settings: Lessons Learnt in 2015 Nepal Earthquakes

Khan¹,

Amatya²,

Dhakal³

2015

Int J Phys Med Rehabil

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Objective: To report on the use of a 'triage' clinical tool for rehabilitation decision-making process and outcomes in an acute disaster setting-the Nepal earthquake (EQ); and the lessons learnt. Participants and Setting:Consecutive EQ victims with a spinal cord injury (SCI) (n=101) admitted to a Nepalese sub-acute medical facility.Intervention: An accredited WHO Foreign Medical Team (FMT) from the Royal Melbourne Hospital was deployed to assist with priorities identified by the host institution: develop triage processes for clinical outcomes, identify barriers and train local healthcare professionals. Results:The triage tool was clinically useful in identifying patients requiring immediate and urgent rehabilitation intervention for a range of disabilities. Mean age was 34.4 ± 15.1 years and female (53.5%) admitted 2-10 days following injury. Over two-thirds had SCI (78%) with common clinical issues: pain (74%), bladder (73%) and bowel dysfunction (58%), and pressure ulcers (33.3%). Participants reported symptoms consistent with post-traumatic stress. The 'triaging' and disability management plans were well received by staff, as patients were stream-lined for step-down facilities; during this process barriers were identified for future action. Conclusion:A collaborative interdisciplinary approach using the triage tool improved clinical outcomes in the disaster-setting. Long-term planning should include early rehabilitation, community-based programs, accreditation, partnerships, and inclusion of persons with disability.

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“…Médecins Sans Frontières (MSF) introduced internal osteosynthesis in a level-3 hospital several years ago and again following recent natural disasters. Under any circumstance, osteosynthesis is challenging, and controlling for results and complications is essential to define the limits of complication acceptance [1].…”

Section: Introductionmentioning

confidence: 99%

External fixators and sudden-onset disasters: Médecins Sans Frontières experience

Boillot

Hérard

2014

International Orthopaedics (SICOT)

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Purpose Carrying out osteosynthesis is challenging, and controlling for results and complications is necessary to define the limits of acceptable complications. Within the context of sudden-onset disasters, comparing internal with external osteosynthesis remains controversial. Methods The most recent and significant Médecins Sans Frontières (MSF) experience with osteosynthesis was following the earthquake in Haiti in 2010: 353 external fixators were used in the 12 months following the catastrophe, 62 of which were used in the first month. Carrying out internal osteosynthesis was possible two weeks following the earthquake. Results The most common indication for open tibial fracture was Gustillo grade 2 or 3. Conversion rate from external to internal osteosynthesis remains anecdotal for several practical reasons. Advantages and drawbacks of external fixators are discussed in the context of precarious situations frequently encountered by MSF. Conclusions External osteosynthesis as a primary and definitive treatment for open fractures, especially of the leg, remains the most frequently used and best-adapted procedure in the context of sudden-onset disasters, even though not ideal.

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Study of the severity of musculoskeletal injuries and triage during the 2005 Pakistan earthquake

Cited by 57 publications

References 17 publications

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Rehabilitation Needs Assessment in Persons Following Spinal Cord Injury in Disaster Settings: Lessons Learnt in 2015 Nepal Earthquakes

External fixators and sudden-onset disasters: Médecins Sans Frontières experience

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