Gamulin Axel, Armenter-Duran Júlia, Assal Mathieu, Hagon Olivier, Dayer Romain
Department of Surgery, Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland.
J Pediatr Orthop. 2012 Jun;32(4):327-33. doi: 10.1097/BPO.0b013e31825197ec.
Major natural disasters may provoke a mass casualty situation, and children tend to represent an important proportion of the victims. The purpose of this study was to prospectively record medical conditions presented by pediatric survivors of a major natural disaster to determine the type of medical specialists most needed during the acute phase of relief response.
After the 2010 Haiti earthquake, age, sex, date of presentation, diagnosis, and treatment provided were prospectively recorded for all patients less than 18 years old treated by a medical relief team. Patients were then allocated to 1 of the 2 groups: surgical (traumatism or surgical disorder) and medical (medical disorder). Medical activity lasted for 43 days.
Four hundred seventy-one of the 796 treated patients were less than 18 years old. Two hundred forty-four (52%) were assigned to the surgical group and 227 (48%) to the medical group. As there was a substantial decrease in the number of new surgical patients registered on day 11 of activity, we arbitrarily defined an early period (until day 10 of activity) and a late period (beginning on day 11 of activity). Data obtained from the 147 new patients registered during the early period revealed 134 (91%) surgical patients and 13 (9%) medical patients. Eighty-eight percent of patients needed specialized care for traumatic orthopaedic lesions, and procedures under anesthesia or sedation were mainly (98%) performed for traumatic conditions. Data obtained for the 324 new patients registered during the late period revealed 110 (34%) surgical patients and 214 (66%) medical patients. There was a switch from high surgical needs to more routine medical and surgical care, with less procedures (88%) for the treatment of traumatic lesions.
Pediatric orthopaedic surgeons have a major role to play in the acute phase of relief response to potentially minimize long-term physical and psychosocial disability associated with these complex injuries in growing patients.
Economic or decision analyses, level II.
重大自然灾害可能引发大规模伤亡情况，儿童往往占受害者的很大比例。本研究的目的是前瞻性记录重大自然灾害中儿科幸存者所呈现的医疗状况，以确定救援响应急性期最需要的医学专科类型。
2010年海地地震后，对医疗救援团队治疗的所有18岁以下患者的年龄、性别、就诊日期、诊断和治疗情况进行前瞻性记录。然后将患者分为两组之一：外科（创伤或外科疾病）和内科（内科疾病）。医疗活动持续了43天。
796名接受治疗的患者中有471名年龄小于18岁。244名（52%）被分配到外科组，227名（48%）被分配到内科组。由于活动第11天登记的新外科患者数量大幅下降，我们任意定义了一个早期（直到活动第10天）和一个晚期（从活动第11天开始）。从早期登记的147名新患者获得的数据显示，有134名（91%）外科患者和13名（9%）内科患者。88%的患者需要针对创伤性骨科损伤的专科护理，麻醉或镇静下的手术主要（98%）针对创伤情况进行。从晚期登记的324名新患者获得的数据显示，有110名（34%）外科患者和214名（66%）内科患者。需求从高外科需求转向更多的常规内科和外科护理，用于治疗创伤性损伤的手术减少（88%）。
儿科骨科医生在救援响应急性期可发挥重要作用，以尽量减少与这些成长中患者的复杂损伤相关的长期身体和心理社会残疾。
经济或决策分析，二级。
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