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INJURY PATTERNS AND PROJECTED REHABILITATION NEEDS AS A RESULT OF THE JANUARY 12, 2010 EARTHQUAKE IN...
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Transcript of INJURY PATTERNS AND PROJECTED REHABILITATION NEEDS AS A RESULT OF THE JANUARY 12, 2010 EARTHQUAKE IN...
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INJURY PATTERNS AND PROJECTED REHABILITATION NEEDS AS A RESULT OF THE
JANUARY 12, 2010 EARTHQUAKE IN HAITI
Colleen O’Connell, MD FRCPC, Aleema Shivji, BSc PT, Thomas Calvot, MKDE
Handicap International, Haiti and France
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4:53pm Jan 12, 2010
7.0 magnitude earthquake occurred in Haiti
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• Epicentre (Léogâne) 25km west of Port au Prince (population approximate 3 million)
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Immediate Aftermath
Early estimates of communities 30-90% destroyed,
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Thousands of injured make way to hospitals, clinics
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Hospitals in affected areas destroyed, damaged, staff injuries/deaths
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Makeshift care sites, field hospitals and more distant centres accept injured
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• Telecommunications and electricity down
• Hospitals overwhelmed, supplies depleted
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Study Objective
• Provide a rapid assessment of the patterns and incidence of injuries to aid in planning the urgent and emergent rehabilitation needs and guide the development of longer term interventions
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MethodsIdentification and direct visits of Field and permanent hospitals
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Methods
• Collection of available data from the Governmental representatives, International NGOs, national NGOs, and Emergency coordination units (Clusters, etc.)
• Direct assessment of approximately 600 persons with injuries at both hospital and community level
• Interviews with doctors, administration staff, paramedical teams, physical rehabilitation teams
• Cross-reference for comparison with previous disasters
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Rapid Assessment Tool
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Rapid Assessent Tool
Nombre total de patients admis depuisle séismeNombre total de patients déjadéchargé?Nombre total de patients ce jourRaison d'admission la plus courante ence moment?
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Rapid Assessent Tool
Fracture - Membre InfFracture - Membre SupFracture - PelvisFracture - colonne vertebraleFracture - complexeAmputation - Membre InfAmputation - Membre Suptraumatisme médullairetraumatisme cranialbrûlureBlessure aux yeux
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Rapid Assessent Tool
Distribution d'aides de marche? Y a t'ilun stock? Besoin d'un stock? Commentfonctionne les distrib?
ChirurgiensInfirmiersPhysiosErgosTravailleur socialRessources additionnellesnécessaires?En ont t'il déjà déployé
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Individual Data Collection
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Assessment Teams
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Targeted Injuries – Mobility/Impairment
• Single, multiple or complex fractures• Polytrauma• Vertebral fractures• Spinal Cord Injuries• Amputations• Traumatic Brain Injuries• Burns
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MedishareData collection
from 17 hospitals from 15-29th of January
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Patient Data Collection
• 600 patient examined• 282 Hospital-based
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Gender and Age Distribution
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Patterns of Injury
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Fractures
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Amputations• 35% of Hospital based
high aquity admissions • Previous earthquakes
2.5-5%
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Spinal Cord Injury
• No in-country surgical capacity
• No immediate stable transport
• Early deaths tetraplegics
• 17 patients identified days 8-11 outdoors in tents/tarps
• Extrapolated to potential 100 survivors
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Discussion and Outcomes
• Extrapolations determined 1500-2000 persons with amputations, 100 potential SCI survivors, and 7500 risk permanent impairment/complications
• Determined need for 8-9 sites for Prosthetics• Determined need for urgent surgical access and
dedicated SCI rehab sites• Mobilization and rapid training of local staff and
implementation community access sites
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Urgent and Emergent
• Mobility aid distribution• Community access site with
hygiene/wound kits• Establish of coordination system for
referrals• Development of acute and longer term
rehabilitiation plan
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Conclusion
• Rapid identification of injury patterns and available resources, led by experts in rehabilitation, is an effective method to inform and direct urgent and emergent care needs.
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Conclusion
• The Haiti earthquake resulted in a high incidence of injuries causing potential or actual permanent impairment, which will require significant increase in the countries capacity to deliver short and long term rehabilitation services.
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Results
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Follow-Up
• 8 P&O Centres established – over 600 patients fit; estimated over half of persons newly amputated have been evaluated for limbs
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SCI
• 3 “centres” for SCI rehabilitation and 2 centres for SCI surgery; no deaths in last 2 months and first discharges have occurred
• Currently 45 patients in rehab centres