Original Article | Preliminary Reports After the 2023 Türkiye Earthquakes · Open access
Systematic triage and treatment of earthquake victims: Our experience in a tertiary hospital after the 2023 Kahramanmaras earthquake
Abstract
Objectives: The aim of this study was to evaluate the benefits of our triage system in acceleration of intervention for the musculoskeletal injuries and clinical follow-ups of trauma patients admitted to our center after the Kahramanmaras earthquake.
Patients and methods: Between February 6th, 2023 and February 20th, 2023, a total of 439 patients (207 males, 232 females; mean age: 37.1±19.1 years; range, 1 to 94 years) with earthquake-related musculoskeletal injuries after the Kahramanmaras earthquake were retrospectively analyzed. Data including age, sex, referral city information, removal time from the rubbles, physical examination findings, clinical photos, fasciotomy and amputation stumps and levels, and X-ray images and computed tomography images of all patients were shared and archived in the WhatsApp (Meta Platforms, Inc.® ATTN/CA, USA) group called ‘Earthquake’ created by orthopedic surgeons. To complete the patient interventions as soon as possible and to ensure order, the patients were distributed with the teams in order through this group by the consultant orthopedic surgeon. The treatments were applied and recorded according to the skin and soft tissue conditions, and fractures of the patients. All treatments were carried out with a multi-disciplinary approach.
Results: Of the patients, 16.2% were children. Lower limb injuries constituted 59.07% of musculoskeletal injuries. Upper limb, pelvic, and spinal cord injuries were observed in 21.9%, 12.7%, and 6.25%, respectively. Conservative treatment was applied to 183 (41.68%) patients. The most common surgical intervention was debridement (n=136, 53.1%). External fixation was applied in the first stage to 21 (8.2%) patients with open fractures. The mean removal time from the rubbles was 32.1±29.38 h. A total of 118 limb fasciotomy operations were applied to the patients. Fifty limb amputations were performed in 40 patients at the last follow-up due to vascular insufficiency and infection.
Conclusion: Based on our study results, we believe that a triage system using a good communication and organization strategy is beneficial to prevent treatment delay and possible adverse events in future disasters.
Declarations
Ethics Committee Approval
The study protocol was approved by the Ankara Bilkent City Hospital Ethics Committee (date: 08.03.2023, no: E1-23-3333). The study was conducted in accordance with the principles of the Declaration of Helsinki.
Author Contributions
Idea/consept, design, supervision, data collection and processing, analysis and interpretation, literature review, writing the article, critical review, references: G.Ö., T.K., O.B., B.S.; Supervision, data collection and processing, analysis and interpretation, literature review, critical review, references: C.Ç., İ.B., M.O.A., N.M., B.G., V.B., Ş.Ç., C.C.K., Ö.D., F.İ., E.C., İ.A.Y., M.G., H.A., S.T., K.K., M.D., B.Ö., O.T., A.Ş.S., E.U., H.İ.Ö., M.B., Ş.G., E.E., N.K.Ü., T.A., A.M.G., Ö.H.K.
Conflict of Interest
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
Financial Disclosure
The authors received no financial support for the research and/or authorship of this article.
Patient Consent for Publication
A written informed consent was obtained from each patient and/or parents or legal guardians of the patient.
Data Sharing Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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