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Conditions found among pediatric survivors during the early response to natural disaster: a prospective case study
Axel Gamulin1, Júlia Armenter-Duran, Mathieu Assal
1Department of Surgery, Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland. axel.gamulin@hcuge.ch
Insights
Pediatric survivors of the 2010 Haiti earthquake required significant surgical care, especially for orthopedic trauma, in the early phase of disaster relief. Medical needs increased later, highlighting the need for pediatric orthopedic surgeons during mass casualty events.
Area of Science:
- Disaster medicine
- Pediatric emergency medicine
- Public health response
Background:
- Major natural disasters can lead to mass casualty incidents, with children often comprising a significant portion of victims.
- Understanding the medical needs of pediatric survivors is crucial for effective disaster response.
Purpose of the Study:
- To prospectively record medical conditions of pediatric survivors after a major natural disaster.
- To determine the most needed medical specialists during the acute phase of relief efforts.
Main Methods:
- Prospective data collection on patients under 18 years old after the 2010 Haiti earthquake.
- Categorization into surgical (traumatism/surgical disorder) and medical (medical disorder) groups.
- Analysis of patient needs during early (days 1-10) and late (day 11 onwards) periods of medical activity.
Main Results:
- Of 471 pediatric patients, 52% were in the surgical group and 48% in the medical group.
- Early period: 91% surgical patients, predominantly for orthopedic trauma (88%).
- Late period: Shift to 66% medical patients, indicating a decrease in acute surgical needs.
Conclusions:
- Pediatric orthopaedic surgeons play a critical role in the acute phase of disaster relief.
- Addressing complex injuries in children promptly can mitigate long-term physical and psychosocial disabilities.
Background:
Major natural disasters may provoke a mass casualty situation, and children tend to represent an important proportion of the victims. The purpose of this study was to prospectively record medical conditions presented by pediatric survivors of a major natural disaster to determine the type of medical specialists most needed during the acute phase of relief response.
Methods:
After the 2010 Haiti earthquake, age, sex, date of presentation, diagnosis, and treatment provided were prospectively recorded for all patients less than 18 years old treated by a medical relief team. Patients were then allocated to 1 of the 2 groups: surgical (traumatism or surgical disorder) and medical (medical disorder). Medical activity lasted for 43 days.
Results:
Four hundred seventy-one of the 796 treated patients were less than 18 years old. Two hundred forty-four (52%) were assigned to the surgical group and 227 (48%) to the medical group. As there was a substantial decrease in the number of new surgical patients registered on day 11 of activity, we arbitrarily defined an early period (until day 10 of activity) and a late period (beginning on day 11 of activity). Data obtained from the 147 new patients registered during the early period revealed 134 (91%) surgical patients and 13 (9%) medical patients. Eighty-eight percent of patients needed specialized care for traumatic orthopaedic lesions, and procedures under anesthesia or sedation were mainly (98%) performed for traumatic conditions. Data obtained for the 324 new patients registered during the late period revealed 110 (34%) surgical patients and 214 (66%) medical patients. There was a switch from high surgical needs to more routine medical and surgical care, with less procedures (88%) for the treatment of traumatic lesions.
Conclusions:
Pediatric orthopaedic surgeons have a major role to play in the acute phase of relief response to potentially minimize long-term physical and psychosocial disability associated with these complex injuries in growing patients.
Level Of Evidence:
Economic or decision analyses, level II.
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