Profile of injuries arising from the 2005 Kashmir earthquake: the first 72 h.

BACKGROUND: The Kashmir Earthquake of October 8, 2005 had widespread destructive effects with in excess of 86,000 people killed and over 80,000 severely injured. Most hospitals were destroyed and limited facilities were available for medical service in the immediate aftermath. A small military hospital in Forward Kahuta, Pakistan, remained functional and was inundated with severely injured patients over 72h.
METHODS: A retrospective review of medical records to document the injury patterns, subsequent treatment, infections and logistical requirements that occurred following this earthquake.
RESULTS: One thousand five hundred and two patients were triaged over 72h. Four hundred and sixty eight (31.1%) patients required admission. Three hundred and nineteen (68.2%) patients were managed non-operatively and 149 (31.8%) required a procedure under general anaesthesia. The most common type of injuries were: superficial lacerations (64.9%); fractures (22.2%); and soft tissue contusions/sprains (5.9%). There were 266 major injuries to the extremities (40.1% upper limb; 59.9% lower limb). Six patients had significant abdominal injuries, 66.6% of these required urgent laparotomy. 14.8% had clinically relevant infections at follow-up requiring surgical debridement or antibiotic therapy.
CONCLUSIONS: Disaster response in the early phase of earthquake relief is complex, with local facilities often overwhelmed and damaged. Limb injuries are most likely; however facilities should have clear plans to deal with severe trauma including head injuries and penetrating abdominal trauma. Coordinated effort is required for success, with lessons learnt to improve future disaster management.