Assessing Patient Demographics and Emergency Response Adaptation in a Primary-Level State Hospital Following the 6 February Türkiye Earthquakes

Yıl 2023, Cilt: 7 Sayı: 3, 238 - 248, 31.12.2023

Suat Batar , Mehmet Talha Aydın , Mehmet Berke Yuşan , Savaş Çamur , Mehmet Salih Soylemez

https://doi.org/10.30565/medalanya.1391661

Öz

Aim: On 6 February 2023, a series of earthquakes with magnitudes of 7.8, 6.6, and 7.6 struck the south-eastern region of Türkiye within a span of 10 hours, starting from 04:00 am. These earthquakes resulted in a devastating loss of life, with casualties exceeding 50,000 across 10 provinces. The destruction caused by these earthquakes was widespread with the collapse of many buildings, including hospitals. This study aimed to assess the patient demographics and emergency response adaptation in a primary-level state hospital following the 6 February Türkiye earthquakes.

Materials and Methods: The study was conducted at the Reyhanlı State Hospital, which remained largely unaffected by the earthquakes. The hospital faced challenges in providing medical care due to the loss of staff, damaged infrastructure, and limited resources. A volunteer orthopaedic surgery team, along with other medical professionals, provided treatment to the earthquake victims. The patient data was collected from the conventional record book of the operating room.

Results: From 6 to 12 February 2023, a total of 111 surgeries were performed at the hospital, with 92 (%83) being earthquake-related. Orthopaedic surgeons operated on most of the patients. The most common surgeries included fasciotomies, amputations, and fracture fixations. The surgeries were performed in a time-sensitive manner, with immediate life- and extremity-saving procedures prioritized. The hospital's infrastructure challenges and the lack of digital recording systems hampered the data collection process.

Conclusion: The study highlights challenges faced by a primary-level Hospital during the earthquakes. Our indings stress the importance of preparedness, infrastructure, and efficient patient records for effective emergency healthcare during natural disasters. Lessons learned can aid future plans for better emergency medical care in earthquake-prone regions.

Anahtar Kelimeler

Earthquake, patient demographics, infrastructure challenges, medical records, emergency adaptation

Etik Beyan

This study was conducted according to the Declaration of Helsinki and received Ethical approval from the Umraniye Training and Research Hospital Ethics Committee. (ID: B.10.1.TKH.4.34.H.GP.0.01/119).

6 Şubat Türkiye Depreminde Bir İkinci Basamak Devlet Hastanesindeki Hasta Demografisinin ve Acil Müdahale Uyumunun Değerlendirilmesi

Öz

Amaç: 6 Şubat 2023 tarihinde, 04:00'ten itibaren 7.8, 6.6 ve 7.6 büyüklüğünde bir dizi deprem, Türkiye'nin güneydoğu bölgesini 10 saat içerisinde etkiledi. Bu depremler, 10 ilde 50.000'i aşkın can kaybına neden olan yıkıcı bir tabloya yol açtı. Hastaneler de dahil olmak üzere birçok binanın çökmesiyle beraber bu depremlerin yol açtığı yıkım oldukça geniş kapsamlıydı. Bu çalışmada, 6 Şubat Türkiye depremi sonrasında ikinci basamak bir devlet hastanesinde hasta demografik özellikleri ve acil müdahale uyumunun değerlendirilmesi amaçlandı.

Gereç ve Yöntem: Çalışma depremden ağır düzeyde etkilenmeyen Reyhanlı Devlet Hastanesi'nde gerçekleştirildi. Hastane, personel kaybı, hasarlı altyapı ve sınırlı kaynaklar nedeniyle sağlık hizmeti sunumunda zorluklarla karşı karşıya kaldı. Gönüllü bir ortopedi ekibi, diğer branş hekimleriyle birlikte depremzedelerin tedavisinde görev aldı. Hasta verileri ameliyathanenin kayıt defterinden elde edildi.

Bulgular: 6-12 Şubat 2023 tarihleri arasında ilgili hastanede 92'si (%83) depremle ilgili olmak üzere toplam 111 ameliyat gerçekleştirildi. Hastaların çoğu ortopedistler tarafından ameliyat edildi. En sık uygulanan cerrahi işlemler fasyotomiler, amputasyonlar ve kırık tespitlerinden oluşmaktaydı. Ameliyatlar hızlı bir şekilde, acil hayat ve ekstremite kurtarma prosedürlerine öncelik verilerek gerçekleştirildi. Hastanenin altyapı zorlukları ve dijital kayıt sistemlerinin olmayışı veri toplama işlemlerini zorlaştırdı.

Sonuç: Çalışmamız, depremler sırasında birinci düzey bir hastanede karşılaşılan zorlukları ortaya koymuştur. Bulgularımız, doğal afetler sırasında etkili ve verimli acil sağlık hizmeti için hazırlıklı olmanın, altyapının ve tıbbi kayıtların önemini vurgulamaktadır. Elde edilen veriler, deprem riski taşıyan bölgelerdeki acil tıbbi hizmetlerin iyileştirilmesi için gelecekteki planlara yardımcı olabilir.

Anahtar Kelimeler

Deprem, hasta demografisi, altyapı sorunları, tıbbi kayıtlar, acil duruma uyum

Kaynakça

• 1. Akkar S, Azak T, Çan T, Çeken U, Demircioğlu Tümsa MB, Duman TY, et al. Evolution of seismic hazard maps in Turkey. Bulletin of Earthquake Engeenering. 2018;16:3197-228. doi: 10.1007/s10518-018-0349-1.
• 2. Jalali R. Civil society and the state: Turkey after the earthquake. Disasters. 2002;26:120-39. PMID: 12096846
• 3. Arroyo-Berezowsky C, Abonce-Zenteno J. The epidemiology of patients treated at a private hospital as a consequence of the September 19th 2017 earthquake in Mexico City. Acta Ortop Mex. 2020;34:215-21. PMID: 33535278
• 4. Nie H, Tang SY, Lau WB, Zang CJ, jiang YW, Lopez BL, et al. Triage during the week of the Sichuan earthquake: a review of utilized patient triage, care, and disposition procedures. Injury. 2011;42:515-20. PMID: 20153857
• 5. Lerner EB, Schwartz RB, Coule PL, Weinstein ES, Cone DC, Hunt RC, et al. Mass casualty triage: an evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep. 2008;2(Suppl. 1):S25-34. PMID: 18769263
• 6. ATLS Subcommittee; American College of Surgeons’ Committee on Trauma; International ATLS Working Group. Advanced Trauma Life Support (ATLS®): The Ninth Edition. J Trauma Acute Care Surg. 2013;74:1363-6. PMID: 23609291
• 7. Erdik M, Demircioglu M, Sesetyan K, Durukal E, Siyahi B. Earthquake hazard in Marmara region, Turkey. Soil Dynamics and Earthquake Engineering. 2004; 24: 605-631. doi: 10.1016/j.soildyn.2004.04.003
• 8. Aslan A, Balta O, Coşkun HS. Evaluation of the Orthopedic Traumas in the Earliest Days of the 2023 Kahramanmaraş Earthquakes In Türkiye. Acta Med. Alanya 2023;7(1): 1-4 doi: 10.30565/medalanya.1303749
• 9. Cartwright C, Hall M, Lee ACK. The changing health priorities of earthquake response and implications for preparedness: a scoping review. Public Health. 2017;150:60-70. PMID: 28645042
• 10. Savage PEA. Disaster planning: a review. Injury. 1972;3:49-55. PMID: 5115153
• 11. Arboleya-Casanova H, Zavala-Sánchez HM, Gómez-Peña EG, López-Jacinto EA, Flores-Soto JA, Méndez-Hernández EM, et al. Earthquakes and healthcare: the organization of the services of medical attention. Salud Pública de México. 2018;60(Suppl. 1):59-64. doi: 10.21149/9328.
• 12. Kilic E, Bingol O, Durgal A, Karlidag T, Keskin OH, Ozdemir G. Hyperbaric oxygen therapy does not change the amputation level in patients with fasciotomy after an earthquake: Our single-center experience after 2023 Kahramanmaras earthquake. Jt Dis Relat Surg. 2023;34(2):480-7. PMID: 37462661
• 13. Moore L, Clark DE. The value of trauma registries. Injury. 2008;39: 686-95. PMID: 18511052
• 14. Basu M, Ghosh S, Jana A, Bandyopadhyay S, Singh R. Medical requirements during a natural disaster: a case study on WhatsApp chats among medical personnel during the 2015 Nepal earthquake. Disaster Med Public Health Prep. 2017;11:652-55. PMID: 28606208
• 15. Bar-On E, Lebel E, Kreiss Y, Merin O, Benedict S, Gill A, et al. 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
• 16. Haverkort JJ, de Jong MB, Foco M, Gui D, Barhoum M, Bahouth H, et al. Dedicated mass-casualty incident hospitals: an overview. Injury. 2017;48:322-6. PMID: 28024651
• 17. Kurt N, Küçük HF, Celik G, Demirhan R, Gül O, Altaca G. Evaluation of patients wounded in the 17 August 1999 Marmara earthquake. Ulus Travma Derg. 2001;7:49-51. PMID: 11705174
• 18. Igarashi Y, Matsumoto N, Kubo T, Yamaguchi M, Nakae R, Onda H, et al. Prevalence and characteristics of earthquake-related head injuries: a systematic review. Disaster Med Public Health Prep. 2022;16:1253-8. PMID: 33947499
• 19. Sugawara J, Hoshiai T, Sato K, Tokunaga H, Nishigori H, Arai T, et al. Impact of the Great East Japan Earthquake on regional obstetrical care in Miyagi Prefecture. Prehosp Disaster Med. 2016;31:255-8. PMID: 27005003
• 20. Görmeli G, Görmeli CA, Güner S, Ceylan MF, Dursun R. The clinical profile of musculoskeletal injuries associated with the 2011 Van earthquake in Turkey. Eklem Hastalik Cerrahisi. 2012;23(2):68-71. PMID: 22765483
• 21. Rice MJ, Gwertzman A, Finley T, Morey TE. Anesthetic practice in Haiti after the 2010 earthquake. Anesth Analg. 2010;111:1445-9. PMID: 20889938
• 22. Wasay M, Mushtaq K. Health issues of internally displaced persons in Pakistan: preparation for disasters in future. Am J Disaster Med. 2010;5:126-8. PMID: 20496645