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Gathen M, Welle K, Jaenisch M, Kasapovic A, Rommelspacher C, Novosel S, Roos J, Kabir K. Are orthopaedic surgeons prepared? An analysis of severe casualties from the 2021 flash flood and mudslide disaster in Germany. Eur J Trauma Emerg Surg 2022; 48:4233-4241. [PMID: 35426505 PMCID: PMC9532313 DOI: 10.1007/s00068-022-01967-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/24/2022] [Indexed: 11/25/2022]
Abstract
Abstract
Background
The purpose of this study was to describe and analyse the most severe casualties from the flash flood and mudslides occurring on 14 July 2021 in Germany, focusing on patients who were treated in the closest and largest level I trauma centre in the region the disaster occurred.
Methods
A single-centre retrospective study design was employed, and all patients treated because of the flooding and mudslides who needed inpatient treatment were documented. Data on each patient’s demographic characteristics, type of injury, number of surgeries, duration of hospitalisation, operation time, revision rate, injury severity score (ISS), and complications were collected. The primary outcome measure was status at discharge.
Results
Within the first week after the flood, a total of 63 patients were documented. Forty-one patients were treated on an outpatient basis in the emergency unit, and 22 patients were hospitalised. Of those hospitalised, 15 patients needed surgical treatment in the operation theatre. The most common injuries were fractures of the lower extremity (n = 7) and soft tissue wounds (n = 4). Overall, 20 surgeries were performed; the mean hospital stay was 7.2 ± 6.4 days, and the mean ISS was 5.7 ± 2.7.
Conclusion
The July 2021 flood disaster was one of the largest in German history. The included patients showed complex injuries of various types. Because of the effects of climate change, orthopaedic surgeons might face higher numbers of casualties affected by natural disasters. Learning more about the management and profile of these injuries can become a future challenge for orthopaedic and trauma surgeons.
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Affiliation(s)
- Martin Gathen
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Kristian Welle
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Max Jaenisch
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Adnan Kasapovic
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Charlotte Rommelspacher
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Suncana Novosel
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jonas Roos
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Koroush Kabir
- Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Missair A, Pretto EA, Visan A, Lobo L, Paula F, Castillo-Pedraza C, Cooper L, Gebhard RE. A Matter of Life or Limb? A Review of Traumatic Injury Patterns and Anesthesia Techniques for Disaster Relief After Major Earthquakes. Anesth Analg 2013; 117:934-941. [DOI: 10.1213/ane.0b013e3182a0d7a7] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bar-On E, Lebel E, Kreiss Y, Merin O, Benedict S, Gill A, Lee E, Pirotsky A, Shirov T, Blumberg N. Orthopaedic management in a mega mass casualty situation. The Israel Defence Forces Field Hospital in Haiti following the January 2010 earthquake. Injury 2011; 42:1053-9. [PMID: 21507401 DOI: 10.1016/j.injury.2011.03.054] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Revised: 03/19/2011] [Accepted: 03/25/2011] [Indexed: 02/02/2023]
Abstract
Following the January 2010 earthquake in Haiti, the Israel Defence Forces (IDF) established a field hospital in Port au Prince. The hospital started operating 89 h after the earthquake. We describe the experience of the orthopaedic department in a field hospital operating in an extreme mass casualty situation. The hospital contained 4 operating table and 72 hospitalization beds. The orthopaedic department included 8 orthopaedic surgeons and 3 residents. 1111 patients were treated in the hospital, 1041 of them had adequate records for inclusion. 684 patients were admitted due to trauma with a total of 841 injuries. 320 patients sustained 360 fractures, 18 had joint dislocations and 22 patients were admitted after amputations. 207 patients suffered 315 soft tissue injuries. 221 patients were operated on under general or regional anaesthesia. External fixation was used for stabilization of 48 adult femoral shaft fractures, 24 open tibial fractures and 1 open humeral fracture. All none femoral closed fractures were treated non-operatively. 18 joint reductions and 23 amputations were performed. Appropriate planning, training, operational versatility, and adjustment of therapeutic guidelines according to a constantly changing situation, enabled us to deliver optimal care to the maximal number of patients, in an overwhelming mass trauma situation.
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Affiliation(s)
- Elhanan Bar-On
- Pediatric Orthopedic Unit, Schneider Children's Medical Center, 14 Kaplan St, Petah Tikva 49202, Israel.
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The Needs of Children in Natural or Manmade Disasters. INTENSIVE AND CRITICAL CARE MEDICINE 2009. [PMCID: PMC7120869 DOI: 10.1007/978-88-470-1436-7_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Disasters have been described as “events of sufficient scale, asset depletion, or numbers of victims to overwhelm medical resources” [1] or as “a serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses that exceed the ability of the affected community or society to cope using its own resources” [2]. Importantly, that definition goes on to state: “A disaster is a function of the risk process. It results from the combination of hazards, conditions of vulnerability and insufficient capacity or measures to reduce the potential negative consequences of risk.”
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