Surgical Management of Musculoskeletal Injuries after 2015 Nepal Earthquake: Our Experience

Vaishya, Raju; Agarwal, Amit Kumar; Vijay, Vipul; Hussaini, M.; Singh, Harsh

doi:10.7759/cureus.306

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…Similar results from Iran (25,31), Turkey (26,29), Haiti (32, 33), Nepal (34,35), China (27,36), and Pakistan (18, 37) were reported, demonstrating high prevalence of the lower limb fractures, followed by upper limbs, and pelvis. The proximal bone involvement is greater if the earthquake happens early in the morning (as most people are asleep) and it is assumed that proximal bones are more involved generally (25).…”

Section: Anatomic Distributionsupporting

confidence: 69%

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Mortazavi¹,

Ebrahiminasab²,

Farhoud³

et al. 2017

J Orthop Spine Trauma

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Objectives: This study aims to investigate the pattern of Musculoskeletal and soft tissue injuries in a series of referred patients in a tertiary medical center and review previous reports in the literature. Methods: In this study, we recorded musculoskeletal injuries of the victims, following the Kermanshah earthquake on November 12, 2017, with a total number of 38. All patients were admitted to the Imam Khomeini Hospital. Injury type, site of injury, gender, age, complications, mortality, and treatment modality were recorded for each case.Results: Among 38 patients, 18 were male (47%) and 20 were female (53%). The mean age was 37 ± 21.6 years. Most of them were aged between 18 and 65 (71.1%). Lower extremities were involved more than the upper (37% versus 24%) and distal limb involvement was more than the proximal (57.3% versus 43.7%). One patient died due to necrotizing fasciitis and septic shock after femoral shaft open fracture. Two patients developed compartment syndrome and underwent fasciotomy complications by skin necrosis and infection. Conclusions: Soft tissue injuries and fractures are the most common injuries following the earthquakes, hence orthopedic surgeries play a vital role in disasters. Despite patients overload and emergency situation in natural disasters like earthquakes, it is crucial to have a stepwise and evidence based approach for each patient. For the patients with open fractures referred to a tertiary center, careful contamination assessment even in the previously managed wounds is highly recommended, especially for those with early wound closure. Early fasciotomy in the crush syndrome is not beneficial as it has adverse effects such as skin necrosis and infection.

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Section: Anatomic Distributionsupporting

confidence: 69%

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Mortazavi¹,

Ebrahiminasab²,

Farhoud³

et al. 2017

J Orthop Spine Trauma

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“…The mountainous terrain further complicated transport and search and rescue operations, contributing to a delay in emergency response before international teams arrived. While the primary burden of earthquake-related trauma was orthopaedic [20, 21], all medical fields were involved in managing patients in the aftermath of the earthquake [22–24]. Ophthalmology services in the acute setting following a natural disaster are particularly important, as even minor ocular injuries that are sustained may become sight threatening if not managed promptly.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, 50–70% of patients presented within 1 day of injury in comparable series of ocular trauma patients in Nepal [9, 13]. Late presentations could have occurred as patients first presented to closer institutions which could not provide specialized eye care, with other serious injuries such as orthopedic injuries which had to be managed first [20]. Another reason could be a lack of awareness or education about the potentially sight-threatening nature of eye injuries.…”

Section: Discussionmentioning

confidence: 99%

The impact of ocular trauma during the Nepal earthquake in 2015

et al. 2017

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BackgroundNepal was struck by a massive earthquake on the 25th April 2015 and major aftershock on the 12th of May 2015, resulting in widespread devastation with a death toll in the thousands. The burden of ocular trauma resulting from the recent earthquakes in Nepal has not been described thus far. The aim of this study was to determine the types of ocular injuries sustained in the earthquake in Nepal and its management in Tilganga Institute of Ophthalmology (TIO) in Gaushala, Kathmandu.MethodsThis is a hospital-based retrospective study of patients presenting to TIO following repeated earthquake. Variables that were recorded included patients’ presenting symptoms and time to presentation, visual acuities at presentation and at follow-up, diagnosis of ocular injury and surgery performed.ResultsThere were 59 cases of earthquake victims visiting TIO, Gaushala, Kathmandu from April 2015 to July 2015, with 64 affected eyes due to 5 cases of bilateral involvement. The majority of patients were from the district Sindhupalchowk (14 cases, 23.7%), which was the epicenter of the main earthquake. The average duration between the earthquake and presentation was 13 · 9 days (range 1–120 days). Closed globe injury was most frequent (23 cases), followed by open globe injuries (8 cases). While 24 patients (38%) initially presented with a visual acuity <3/60 in their affected eye, 15 patients (23%) had a visual acuity of <3/60 on follow-up. A variety of surgical treatments were required including anterior and posterior segment repair.ConclusionsImmediate management of ocular trauma is critical in order to prevent blindness. Characterizing the burden of earthquake-related ocular trauma will facilitate planning for service provision in the event of a future earthquake in Nepal, or in countries, which are similarly at risk of having natural disasters.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-017-0429-z) contains supplementary material, which is available to authorized users.

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“…All titles and abstracts were screened and only 11 articles met the inclusion criteria. [10][11][12][13][14][15][16][17][18][19][20] The Google search returned over 300,000 hits for each word combination entered, and the first 200 hits for each search were examined; data were extracted from 20 sources (mainly official EMT webpages with limited information). More data were obtained from key web sites, especially from the web Humanitarian Response, including 10 WHO-MoHP coordination meeting…”

Section: Methodsmentioning

confidence: 99%

“…Several papers have presented I-EMT individual experiences of deployment after the Nepal earthquake. [10][11][12][13][14][15][16][17][18][19][20] Additionally, a report by the Nepal Health Research Council (NHRC; Kathmandu, Nepal) reviews the effectiveness of I-EMTs' deployment following the earthquake. 8 Building on the information already available, the aim of this study was to describe the characteristics, timing, and activities performed by I-EMTs deployed to Nepal after the 2015 earthquake, and to assess their adherence to WHO-EMT registration and minimum standards.…”

Section: Introductionmentioning

confidence: 99%

International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake

Camacho

Karki

Subedi³

et al. 2019

Prehosp. Disaster med.

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Introduction:International Emergency Medical Teams’ (I-EMTs) response to disasters has been characterized by a late arrival, an over-focus on trauma care, and a lack of coordination and accountability mechanisms. Analysis of I-EMT performance in past and upcoming disasters is deemed necessary to improve future response.Objective:This study aimed to describe the characteristics, timing, and activities of I-EMTs deployed to the 2015 Nepal earthquake, and to assess their registration and adherence to the World Health Organization Emergency Medical Teams’ (WHO-EMT; Geneva, Switzerland) minimum standards compared to past disasters.Methods:An online literature search was performed and key web sites related to I-EMT deployments were purposively examined. The methodology used is reported following the STARLITE principles. All articles and documents in English containing information about characteristics, timing, and activities of I-EMTs during Nepal 2015 were included in the study. Data were retrieved from selected sources to compile the results following a systematic approach. The findings were validated by the Nepalese focal point for the coordination of I-EMTs after the earthquake.Results:Overall, 137 I-EMTs deployed from 36 countries. They were classified as Type I (65%), Type II (15%), Type III (1%), and specialized cells (19%). Although national teams remained the first responders, two regional I-EMTs arrived within the first 24 hours post-earthquake. According to daily reporting, the activities performed by I-EMTs included 28,372 out-patient consultations (comprising 6,073 trauma cases); 1,499 in-patient admissions; and 440 major surgeries. The activities reported by I-EMTs during their deployment were significantly lower than the capacities they offered at arrival. Over 80% of I-EMTs registered through WHO or national registration mechanisms, but daily reporting of activities by I-EMTs was low. The adherence of I-EMTs to WHO-EMT standards could not be assessed due to lack of data.Conclusion:The I-EMT response to the Nepal earthquake was quicker than in previous disasters, and registration and follow-up of I-EMTs was better. Still, there is need to improve I-EMT coordination, reporting, and quality assurance while strengthening national EMT capacity.Amat Camacho N, Karki K, Subedi S, von Schreeb J. International Emergency Medical Teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260–264.

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Surgical Management of Musculoskeletal Injuries after 2015 Nepal Earthquake: Our Experience

Cited by 11 publications

References 12 publications

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

Muskuloskeletal Related Injuries After 2017 Kermanshah Earthquak: A Literature Review

The impact of ocular trauma during the Nepal earthquake in 2015

International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake

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