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Published on: August 16, 2019
Massive pediatric neurosurgical injuries and lessons learned following a tornado disaster in Alabama
Joshua J Chern1, Joseph H Miller, R Shane Tubbs
1Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA. jc691586@gmail.com
Insights
Pediatric neurosurgical teams managed numerous patients with central and peripheral nervous system injuries following a tornado disaster. A well-organized team approach is crucial for reducing mortality and morbidity in mass casualty events.
Area of Science:
- Neurosurgery
- Disaster Medicine
- Pediatric Trauma
Background:
- Tornado disasters can cause significant mass casualties, including severe injuries to the central and peripheral nervous systems.
- Pediatric trauma centers face unique challenges in managing pediatric patients during mass casualty incidents.
Purpose of the Study:
- To review the neurosurgical management of pediatric patients following a tornado disaster.
- To identify key components for effective neurosurgical care during mass casualty events.
Main Methods:
- Retrospective review of pediatric patients with cranial, spinal, and peripheral nerve injuries due to a tornado.
- Analysis of neurosurgical team actions and procedures performed during and after the event.
Main Results:
- Twenty-four pediatric patients received neurosurgical care after the tornado.
- Eleven cranial, two spine, and two peripheral procedures were performed, with many within the first 24 hours.
- Peripheral nervous system injuries often presented with a delay.
Conclusions:
- Massive casualties from tornados are infrequent but require preparedness.
- A well-organized physician team collaborating with hospital administration can improve outcomes in mass casualty events.
Object:
A large volume of patients presented to a Level I pediatric trauma center during and after a recent tornado disaster. Injuries of the central and peripheral nervous systems and the medical responses of a pediatric neurosurgical team are reviewed.
Methods:
The clinical courses of patients who suffered cranial, spinal, and peripheral nerve injuries due to the tornado storm are reported. The clinical actions taken by the neurosurgical team during and after the event are reviewed and the lessons learned are discussed.
Results:
The tornado storm system moved through the Tuscaloosa and Birmingham metropolitan areas on the early evening hours of April 27, 2011. Twenty-four patients received care from the neurosurgical team. A total of 11 cranial (including placement of an external ventricular drain), 2 spine, and 2 peripheral procedures were performed for the victims. Nine procedures were performed within the first 12 hours of the event, and an additional 6 surgeries were performed in the following 24 hours. Injuries of the peripheral nervous system often presented in a delayed fashion. Several key components were identified that enabled adequate neurosurgical care for a large influx of acute patients.
Conclusions:
Massive casualties due to tornados are rare. A well-organized physician team working with the hospital administration may decrease the mortality and morbidity of such events.
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