An analysis of prehospital mortality in an earthquake. Disaster Reanimatology Study Group.

Ernesto Pretto, D. C. Angus, J. I. Abrams, B. Shen, R. Bissell, V. M. Ruiz Castro, R. Sawyers, Y. Watoh, N. Ceciliano, E. Ricci

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

INTRODUCTION: Anecdotal observations about prehospital emergency medical care in major natural and human-made disasters, such as earthquakes, have suggested that some injured victims survive the initial impact, but eventually die because of a delay in the application of life-saving medical therapy. METHODS: A multidisciplinary, retrospective structured interview methodology to investigate injury risk factors, and causes and circumstances of prehospital death after major disasters was developed. In this study, a team of United States researchers and Costa Rican health officials conducted a survey of lay survivors and health care professionals who participated in the emergency medical response to the earthquake in Costa Rica on 22 April 1991. RESULTS: Fifty-four deaths occurred prior to hospitalization (crude death rate = 0.4/1,000 population). Seventeen percent of these deaths (9/54) were of casualties who survived the initial impact but died at the scene or during transport. Twenty-two percent (2/9) were judged preventable if earlier emergency medical care had been available. Most injuries and deaths occurred in victims who were inside wooden buildings (p < .01) as opposed to other building types or were pinned by rubble from building collapse. Autopsies performed on a sample of victims showed crush injury to be the predominant cause of death. CONCLUSIONS: A substantial proportion of earthquake mortality in Costa Rica was protracted. Crush injury was the principal mechanism of injury and cause of death. The rapid institution of enhanced prehospital emergency medical services may be associated with a significant life-saving potential in these events.

Original languageEnglish
Pages (from-to)107-117
Number of pages11
JournalPrehospital and disaster medicine : the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation
Volume9
Issue number2
StatePublished - Apr 1 1994
Externally publishedYes

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Earthquakes
Disasters
Emergency Medical Services
Costa Rica
Mortality
Cause of Death
Wounds and Injuries
Structure Collapse
Survivors
Autopsy
Hospitalization
Emergencies
Research Personnel
Interviews
Delivery of Health Care
Health
Population
Crush Injuries
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

An analysis of prehospital mortality in an earthquake. Disaster Reanimatology Study Group. / Pretto, Ernesto; Angus, D. C.; Abrams, J. I.; Shen, B.; Bissell, R.; Ruiz Castro, V. M.; Sawyers, R.; Watoh, Y.; Ceciliano, N.; Ricci, E.

In: Prehospital and disaster medicine : the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation, Vol. 9, No. 2, 01.04.1994, p. 107-117.

Research output: Contribution to journalArticle

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