Medical

Acute medical care and longer-term health concern with this earthquake.

This section contains articles and information about the issues relating to acute medical management and potential health concerns after the acute stage.

Acute concerns: 

World Health Organization (WHO) has a good profile of needs during earthquake (http://www.who.int/hac/techguidance/ems/earthquakes/en/). Here is a summary:

–       Immediate deaths are mostly from trauma, asphyxia, dust inhalation

–       Surgical needs are paramount in the first week.

o   Majority are minor cuts and bruises

o   Smaller groups simple fractures

o   Minority multiple or complex fractures, internal injuries and crush s syndrome requiring surgeries and intensive management

–       Burns and electric shock are of concerns

–       Disruption of health services, water and sewer, energy lines, roads, communication delaying health delivery

–       Things to remember:

o   Survival after 48 hrs of entrapment is rare

o   Highest demand for health services is in first 24 hrs; returns almost to normal in 3-5 days

o   Local personnel and health facilities are therefore most important: rescue workers and field hospitals arrive too late

–       Some inappropriate responses:

o   Don’t send blood/ blood products: this is generally filled in locally

o   Don’t send medical/paramedical teams: they are too late

o   Don’t send field hospitals or modular medical units: too late

o   Decide on resources based on needs

Long-term health concerns (epidemics): 

Summary generated from a Centers for Disease Control and Prevention (CDC) article (http://wwwnc.cdc.gov/eid/article/13/1/pdfs/06-0779.pdf):

–       Size and characteristics of displacement (Do they have access to clean water, latrines? Are they immunized? Are they malnourished? Are they living in crowded conditions) are the primary determinants of epidemic risks.

–       Associated communicable diseases:

o   Water-borne: diarrheal diseases, Hepatitis, Leptospirosis

o   Crowding-associated: Measles, meningitis, acute respiratory infections

o   Vector-borne: Malaria, dengue

o   Others: Tetanus, locally endemic/ epidemic diseases

–       Disaster-related interruption of services