Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 487-493 |
| Number of pages | 7 |
| Journal | Prehospital and Disaster Medicine |
| Volume | 25 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jan 1 2010 |
| Externally published | Yes |
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Keywords
- disaster
- disaster medicine
- earthquake
- regional anesthesia
- resuscitation
- surgery
- trauma
ASJC Scopus subject areas
- Emergency Medicine
- Emergency
Cite this
Surgery under extreme conditions in the aftermath of the 2010 haiti earthquake : The importance of regional anesthesia. / Missair, Andres; Gebhard, Ralf; Pierre, Edgar; Cooper, Lebron; Lubarsky, David; Frohock, Jeffery; Pretto, Ernesto A.
In: Prehospital and Disaster Medicine, Vol. 25, No. 6, 01.01.2010, p. 487-493.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgery under extreme conditions in the aftermath of the 2010 haiti earthquake
T2 - The importance of regional anesthesia
AU - Missair, Andres
AU - Gebhard, Ralf
AU - Pierre, Edgar
AU - Cooper, Lebron
AU - Lubarsky, David
AU - Frohock, Jeffery
AU - Pretto, Ernesto A.
PY - 2010/1/1
Y1 - 2010/1/1
N2 - 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.
AB - 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.
KW - disaster
KW - disaster medicine
KW - earthquake
KW - regional anesthesia
KW - resuscitation
KW - surgery
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=79952456331&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952456331&partnerID=8YFLogxK
U2 - 10.1017/S1049023X00008645
DO - 10.1017/S1049023X00008645
M3 - Article
C2 - 21181680
AN - SCOPUS:79952456331
VL - 25
SP - 487
EP - 493
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
SN - 1049-023X
IS - 6
ER -