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Chest injuries transferred to trauma centers after the 1999 Taiwan earthquake☆,☆☆,★

https://doi.org/10.1053/ajem.2000.18132Get rights and content

Abstract

To better understand the effects of delayed medical care and long transportation times when emergency medical services (EMS) failed after the 1999 Chi-Chi, Taiwan earthquake, we analyzed the patterns and outcomes of patients with chest injuries who were transferred to an unaffected back-up hospital. The medical records of 164 trauma patients who were transferred to Taichung Veterans General Hospital from September 21 to September 24, 1999 were reviewed. Of the 164 patients, 26 (15.9%) had chest injuries. Chest injuries were caused by blunt trauma in all cases. Minor chest injury was noted in 16 patients (61.5%). Mortality developed in two patients, who were transferred after first aid in the field hospital and were in shock status on arrival to emergency department of the back-up hospital. Inadequate resuscitation attributable to insufficient manpower in field hospitals and long transportation times to back-up hospitals are the major problems to be solved in developing disaster plans. For evacuation of overwhelming casualties and for support of medical resources, transportation by helicopter is suggested in aftermath of a large earthquake. (Am J Emerg Med 2000;18:825-827. Copyright © 2000 by W.B. Saunders Company)

Section snippets

Patients and methods

In this study, we analyzed the traumatized patients who arrived at Taichung Veterans General Hospital from Nantou County during the first 3 days after the earthquake. This hospital, located about 50 kilometers away from Nantou County, serves as a level I trauma center in the central part of Taiwan island, and is the only hospital in this region with a helicopter landing area. This hospital was not affected by the earthquake, and served as a back-up hospital. The medical records of 164 trauma

Results

In all of the 26 patients with chest injuries resulted from blunt trauma. Of the 26 patients, 19 were transferred on the first day, 5 on the second day, and 2 on the third day (Table 1).

. Signs and Associated Injuries of 26 Consecutive Patients With Chest Injuries

PatientSex/AgeRib FractureHemothoraxPneumothoraxAssociated Injuries
1*F/73†−++Undetermined‡
2*F/25†−−−Intra-abdominal bleeding, head injury
3M/22−−−Nil
4F/27−−−Nil
5F/55−−−Nil
6F/42−−−Nil
7*F/29−−−Kidney injury, burn, leg crush injury
8M/48−−−

Discussion

In this study, most of the chest injuries were minor or superficial (61.5%), compatible with reports by Yoshimura from the 1995 southern Hyogo Perfecture earthquake.5 All of the patients with hemopneumothorax in this study had associated injuries other than chest injuries. Priority in the treatment of these patients is maintenance of airway, breathing, and circulation (ABCs). Hemopneumothorax can be relieved simply by insertion of chest tube, and severe flail chest can be managed by

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Address reprint requests to Wen Yi-Szu, MD, Department of Emergency, Taichung Veterans General Hospital, #160, Sec. 3, Taichung Kan Rd, Taichung 40705, Taiwan, R.O.C. E-mail: [email protected]

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Am J Emerg Med 2000;18:825-827

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