Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti
Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti
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DOI：
10.1007/s00268-016-3581-3
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发表时间：
2016-09-01
影响因子：
2.6
通讯作者：
Bader, Tarif
中科院分区：
文献类型：
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作者：
Bar-On, Elhanan;Blumberg, Nehemia;Bader, Tarif
以色列国防军医疗队在许多灾难事件中部署了野战医院。最近的两次部署是在2010年海地地震和2015年尼泊尔地震之后。尽管抵达时间相似，但运作模式不同-在海地独立运作，在尼泊尔与当地医院合作。在两家医院遇到的病理学和由此产生的治疗要求在两起事件之间存在显著差异。本研究的目的是分析这些差异及其对未来部署的准备和规划的影响。方法从IDF记录中获得数据，并使用SPSS（TM）软件进行分析。尼泊尔的案例中地震相关伤害明显较少（26%对66%），其中28%的人骨折，而海地为47%。在尼泊尔，股骨骨折占骨折的7.9%，而在海地占26.4%，足部骨折分别占23.8%和6.4%。开放性骨折的发生率在尼泊尔为29.4%，在海地为27.5%。18.1在尼泊尔，20%的受伤患者接受了手术，其中32.9%是骨骼，而在海地，32%的手术病例（58.8%是骨骼）。74.2尼泊尔和海地分别有%和34.3%的患者接受了与地震无关的病理治疗。结论两所医院活动差异的原因包括灾难的严重程度，当地医疗系统的功能在尼泊尔得到了相对的保留，而在海地却遭到了破坏，在海地，运作模式是独立的，与一家正常运作的当地医院合作在尼泊尔。紧急医疗队（EMT）可能会遇到不同的情况下，尽管类似的灾难场景。提前了解灾难的严重程度、当地医疗系统的功能以及合作的可能性，将有助于规划和准备EMT，使其发挥最佳和适当的作用。然而，由于这些信息通常不可用，EMT应该能够适应意外情况。
Background Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different-independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events. The purpose of this study was to analyze these differences and their implications for preparation and planning of future deployments.Methods Data were obtained from IDF records and analyzed using SPSS (TM) software.Results 1686 patients were treated in Nepal versus 1111 in Haiti. The caseload in Nepal included significantly less earthquake-related injuries (26 vs. 66 %) with 28 % of them sustaining fractures versus 47 % in Haiti. Femoral fractures accounted for 7.9 % of fractures in Nepal versus 26.4 % in Haiti with foot fractures accounting for 23.8 and 6.4 %, respectively. The rate of open fracture was similar at 29.4 % in Nepal and 27.5 % in Haiti. 18.1 % of injured patients in Nepal underwent surgery, and 32.9 % of which was skeletal compared to 32 % surgical cases (58.8 % skeletal) in Haiti. 74.2 % of patients in Nepal and 34.3 % in Haiti were treated for pathology unrelated to the earthquake.Conclusions The reasons for the variability in activities between the two hospitals include the magnitude of the disaster, the functionality of the local medical system which was relatively preserved in Nepal and destroyed in Haiti and the mode of operation which was independent in Haiti and collaborative with a functioning local hospital in Nepal. Emergency medical teams (EMTs) may encounter variable caseloads despite similar disaster scenarios. Advance knowledge of the magnitude of the disaster, the functionality of the local medical system, and the collaborative possibilities will help in planning and preparing EMTs to function optimally and appropriately. However, as this information will often be unavailable, EMTs should be capable to adapt to unexpected conditions.