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Practical Strategies to Reduce Morbidity and Mortality of Natural Catastrophes: A Retrospective Study Based on Bam Earthquake Experience Pubmed



Najafi I1, 2 ; Safari S1, 2 ; Sharifi A1 ; Sanadgol H3 ; Hosseini M4 ; Rashidfarokhi F5 ; Seirafian S6 ; Mooraki A7 ; Samimagham H8 ; Osare S9 ; Pourfarziani V10 ; Atabak S11 ; Boroumand B9
Authors
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Authors Affiliations
  1. 1. Department of Nephrology, Shafa CAPD Research Center, Tehran University of Medical Sciences, Tehran 14155-6446, Poorsina Ave., Iran
  2. 2. Department of Nephrology, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14155-6446, Poorsina Ave., Iran
  3. 3. Department of Nephrology, Zahedan University of Medical Sciences, Zahedan, Iran
  4. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 14155-6446, Poorsina Ave., Iran
  5. 5. Department of Nephrology, Kerman University of Medical Sciences, Kerman, Iran
  6. 6. Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Department of Nephrology, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Nephrology, Bandarabbas University of Medical Sciences, Bandarabbas, Iran
  9. 9. Department of Nephrology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran
  10. 10. Department of Nephrology, Milad Hospital, Tehran, Iran
  11. 11. Department of Nephrology, Imam Hossein Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran

Source: Archives of Iranian Medicine Published:2009


Abstract

Background: Critical analysis of shortcomings of emergency medical management of earthquake casualties will provide an invaluable insight to improve outcomes for future events. Using a critical analysis methodology to evaluate the quality of emergency medical management after Bam earthquake, we suggest a practical strategic approach to decrease morbidity and mortality after such events. Methods: We designed a questioner to register the basic demographic data and the key biologic parameters of all rescued victims arriving in hospitals. Based on that questioner a data bank was created and used for different analyses. In addition, published official reports and on the scene observations of our nephrologist colleagues were other sources of our data. Results: Bam earthquake was publicly announced more than six hours after its occurrence. The earliest time when local and international rescue teams arrived at the scene was 12 hours after the disaster. Fifty-four percent of hospital inpatients had been admitted on the second or third day after the earthquake. The mean time of being under the rubble was 4.8±4.9 hours. The mean time between extrication and initiation of intravenous fluid infusion was 18.9 hours (min: 10 minutes, max: 96 hours). Conclusion: Problems encountered in the aftermath of the Bam earthquake were related to the lack of prepared action plan and data management system. Here, we present a specifically designed earthquake chart. By following the chart, rescue paramedic personnel and emergency medical teams will be able to recognize high-risk victims, in order to provide timely medical management.
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