Destructive disasters, trauma, crush syndrome, and beyond

Area of Science:

• Disaster Medicine
• Trauma Surgery
• Nephrology

Background:

• Orthopedic injuries, including fractures and traumatic rhabdomyolysis, are common in mass casualty incidents.
• Crush syndrome, a consequence of rhabdomyolysis, is a significant cause of mortality, particularly following earthquakes.
• Effective management requires interventions before and after victim extrication.

Purpose of the Study:

• To outline critical interventions for orthopedic injuries and crush syndrome in disaster settings.
• To discuss the controversies and indications for procedures like amputation and fasciotomy.
• To emphasize the importance of early management, hospital care, and continuous training in disaster medicine.

Main Methods:

• Review of established protocols for disaster victim care.
• Discussion of on-site and hospital-based management strategies.
• Analysis of the pathophysiology and treatment of crush syndrome and acute kidney injury.

Main Results:

• Early interventions such as airway management, hemorrhage control, and fluid resuscitation are vital.
• Systematic surveys, triage, wound care, and decontamination are essential post-rescue.
• Crush syndrome management focuses on fluid-electrolyte balance, dialysis, and complication prevention.

Conclusions:

• Prompt and appropriate medical care, from pre-hospital to hospital settings, significantly impacts outcomes for disaster victims.
• Standardized training in disaster medicine principles is crucial for healthcare providers.
• Defining clear indications for surgical interventions like amputation and fasciotomy is necessary to balance benefits and risks.