Document Detail

Pediatric orthopedic injuries following an earthquake: experience in an acute-phase field hospital.
MedLine Citation:
PMID:  23147182     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Following the 2010 earthquake in Haiti, the Israel Defense Forces Medical Corps deployed a field hospital in Port au Prince. The purpose of this study was to characterize the injuries sustained by the pediatric population treated in the hospital and examine the implications for planning deployment in future similar disasters.
METHODS: Medical records of children treated in the hospital were reviewed and compared with medical records of the adult population.
RESULTS: A total of 1,111 patients were treated in the hospital. Thirty-seven percent were aged 0 to 18 years. Earthquake-related injuries were the cause of admission in 47% of children and 66% of adults. Forty-seven percent of children with traumatic injuries sustained fractures. Seventy-two percent were in the lower limbs, 19% were in the upper limbs, and 9% were in the axial skeleton, with the femur being the most common long bone fractured compared with the tibia in adults.There were four functional operating theaters, and treatment guidelines were adjusted to the rapidly changing situation. Soft tissue injuries were treated by aggressive debridement. Fractures were stabilized by external fixation or casting. Amputation was performed only for nonviable limbs or life-threatening sepsis. Children were more likely than adults to undergo surgery (44% vs. 29% of trauma patients). To maximize hospital surge capacity, minor procedures were performed in the wards under sedation, and patients were discharged after an average of 1.4 days, with subsequent follow-up in the clinic.
CONCLUSION: Children constitute a high percentage of patients in a developing country. The epidemiology of pediatric injuries following an earthquake differs significantly from that encountered in everyday practice and compared with that in adults. Children sustain a significantly higher percentage of femoral fractures and are more likely to require surgery. The shift to nontraumatic reasons for admission occurred earlier in the pediatric population than in adults. Organizations providing post-earthquake relief are usually geared toward adult populations and will require supplementation of both manpower and equipment specifically suited for treatment of pediatric patients. Early deployment teams should be adequately staffed with adult and pediatric orthopedists.
LEVEL OF EVIDENCE: Epidemiologic study, level IV.
Elhanan Bar-On; Ehud Lebel; Nehemia Blumberg; Rami Sagi; Yitshak Kreiss;
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  74     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  2013-04-05     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  617-21     Citation Subset:  AIM; IM    
Pediatric Orthopedic Unit, Schneider Children's Medical Center, Petah Tikva, Israel.
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MeSH Terms
Age Factors
Child, Preschool
Femoral Fractures / epidemiology,  etiology,  surgery
Fracture Fixation / statistics & numerical data
Fractures, Bone / epidemiology*,  etiology,  surgery
Haiti / epidemiology
Infant, Newborn
Mass Casualty Incidents / statistics & numerical data
Tibial Fractures / epidemiology,  etiology,  surgery

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