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Published on: March 18, 2020
Pediatric otolaryngology in a field hospital in the Philippines
Tal Marom1, David Dagan2, Giora Weiser3
1Israel Defense Forces Medical Corps, Tel Hashomer, Israel; Department of Otolaryngology - Head & Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
Insights
Pediatric otolaryngology-head and neck surgery (OTO-HNS) services are crucial in disaster relief. This study characterized OTO-HNS conditions in children treated in a field hospital post-typhoon Haiyan, highlighting the need for otolaryngologists in subacute disaster phases.
Area of Science:
- Disaster medicine
- Pediatric otolaryngology
- Public health
Background:
- Typhoon Haiyan severely impacted healthcare in the Philippines.
- Field hospitals are essential for medical support during major natural disasters.
Purpose of the Study:
- To characterize pediatric otolaryngology-head and neck surgery (OTO-HNS) diseases and injuries treated at a field hospital.
- To evaluate the role of OTO-HNS services in a post-disaster "subacute" phase.
Main Methods:
- Retrospective chart review of pediatric patients (0-18 years) presenting with OTO-HNS conditions.
- Analysis of field hospital structure, capabilities, and patient demographics.
- Documentation of treatments and surgical interventions.
Main Results:
- 91 (11%) of 863 pediatric visits involved OTO-HNS conditions.
- Ear diseases (49%), primarily acute otitis media, and neck diseases (16%) were most common.
- Surgical interventions were performed on 8% of patients, including laceration repair and abscess drainage.
Conclusions:
- Otolaryngologists play a vital role in addressing pediatric healthcare needs in disaster areas.
- Subacute phase missions focus on routine medical and surgical care, distinct from acute phase trauma response.
- Recommendations for future disaster response missions are provided.
Background:
Major natural disasters adversely affect local medical services and resources. We sought to characterize pediatric patients presenting with otolaryngology-head and neck surgery (OTO-HNS)-related diseases/injuries to a field hospital over 11 days of operation, which was deployed to assist the healthcare facilities in Bogo, the Philippines, in the aftermath of typhoon Haiyan (Yolanda).
Methods:
We reviewed charts of pediatric patients aged 0-18 years visiting our field hospital, who presented with OTO-HNS-related diseases/injuries. We also describe the structure of the field hospital, equipment, facilities and capabilities of our service, discuss medical and ethical concerns, and propose several recommendations for future similar missions.
Results:
Of the 863 pediatric visits, 91 (11%) presented with OTO-HNS-related diseases/injuries, 3 of them were of recurring patients. Of the 88 included individual patients, 47 (53%) were boys, with an average age of 6.9±4.9 years. Ear-related diseases, mostly acute otitis media (AOM), and neck-related diseases were the most common pathologies (49% and 16% of the patients, respectively). Antibiotic therapy was administered to 36 (41%) patients, mostly to children with AOM. Despite limited resources, we were able to perform surgical interventions on 8 (9%) patients, which included laceration suturing, abscess drainage and neck surgery.
Conclusions:
Otolaryngologists have an important role in the treatment of children affected in a disaster area, at a time of an increased demand for healthcare. Unlike 'acute phase' missions, where traumatic injuries are the focus for treatment, 'subacute' phase missions provide more routine medical and surgical care.
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