Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Leonard Miller School of Medicine, Miami, FL 33136, USA.
Prehosp Disaster Med. 2010 Nov-Dec;25(6):487-93. doi: 10.1017/s1049023x00008645.
The 12 January 2010 earthquake that struck Port-au-Prince, Haiti caused >200,000 deaths, thousands of injuries requiring immediate surgical interventions, and 1.5 million internally displaced survivors. The earthquake destroyed or disabled most medical facilities in the city, seriously hampering the ability to deliver immediate life- and limb-saving surgical care. A Project Medishare/University of Miami Miller School of Medicine trauma team deployed to Haiti from Miami within 24 hours of the earthquake. The team began work at a pre-existing tent facility in the United Nations (UN) compound based at the airport, where they encountered 225 critically injured patients. However, non-sterile conditions, no means to administer oxygen, the lack of surgical equipment and supplies, and no anesthetics precluded the immediate delivery of general anesthesia. Despite these limitations, resuscitative care was administered, and during the first 72 hours following the event, some amputations were performed with local anesthesia. Because of these austere conditions, an anesthesiologist, experienced and equipped to administer regional block anesthesia, was dispatched three days later to perform anesthesia for limb amputations, debridements, and wound care using single shot block anesthesia until a better equipped tent facility was established. After four weeks, the relief effort evolved into a 250-bed, multi-specialty trauma/intensive care center staffed with >200 medical, nursing, and administrative staff. Within that timeframe, the facility and its staff completed 1,000 surgeries, including spine and pediatric neurological procedures, without major complications. This experience suggests that when local emergency medical resources are completely destroyed or seriously disabled, a surgical team staffed and equipped to provide regional nerve block anesthesia and acute pain management can be dispatched rapidly to serve as a bridge to more advanced field surgical and intensive care, which takes longer to deploy and set up.
2010 年 1 月 12 日海地太子港发生的地震造成超过 20 万人死亡，数千人需要立即进行外科干预，150 万人在国内流离失所。地震摧毁或使该市的大多数医疗设施瘫痪，严重影响了提供即时挽救生命和肢体的外科护理的能力。一个名为“医疗救助组织/迈阿密大学米勒医学院”的创伤小组在地震发生后 24 小时内从迈阿密部署到海地。该小组在机场联合国（UN）大院的一个预先存在的帐篷设施开始工作，在那里他们遇到了 225 名重伤患者。然而，非无菌条件、无法供氧、缺乏手术设备和用品以及没有麻醉剂，使得无法立即提供全身麻醉。尽管存在这些限制，但仍进行了复苏治疗，在事件发生后的头 72 小时内，一些截肢手术是在局部麻醉下进行的。由于这些艰苦的条件，三天后，一名有经验并配备有实施区域阻滞麻醉设备的麻醉师被派往那里，为肢体截肢、清创和伤口护理提供麻醉，使用单次阻滞麻醉，直到建立一个设备更好的帐篷设施。四周后，救援工作演变成一个拥有 250 张床位的多专业创伤/重症监护中心，配备了 200 多名医疗、护理和行政人员。在那段时间内，该设施及其工作人员完成了 1000 例手术，包括脊柱和儿科神经手术，没有出现重大并发症。这一经验表明，当地紧急医疗资源完全被摧毁或严重受损时，可以迅速派遣配备有实施区域神经阻滞麻醉和急性疼痛管理的外科小组作为桥梁，以提供更先进的现场外科和重症监护服务，后者需要更长的时间来部署和建立。
