A retrospective analysis of 374 casualties from the Nepal earthquake

Abstract

Objective To analyze the feature of victims transported from Nepal Pokhara' s earthquake, and summarized the rescuing experiences got by the Chinese government medical team. Methods A total of 374 casualties from the 2015 Nepal ' s earthquake magnitude 8.1 transported to the Field Hospital of the Chinese government medical team were classified into four groups according to different causes of injury, and then retrospectively analyzed the types of injury, vital signs, severity of injury and causes of injury. Results Of 374 casualties, the average age was (30.1 ±12.4) years, and were divided into group A (n =154) in which casualties trapped under ruined buildings, group B (n =123) in which the victims had crushed injury during escaping with their lives, group C (n =58) in which the wounded had injury resulted from fall on the ground during fleeing for their lives and group D (n =39) in which the injury of casualties was caused by fall from high level. Of them, 273 patients (296 parts of body injured) suffered from fracture including 34 patients with severe multiple trauma. The average age in the group D (22.3 ±7.4 years old) was significant younger compared with the others (all P <0.05). The average age in the group C (48.4 ±13.3 years old) was significant older compared to the others (all P <0.05). The injury probability was higher for male in the group D (14.2% vs. 7.1%, χ2 =5.077, P =0.024) and the injury probability was higher for female in the group C (19.7% vs 10.8%, χ2 =5.635, P =0.018). The incidence of limbs fracture was highest (66.6%) in all 296 parts of body injured. The incidence of skull fracture in the group B (31.6%) was higher compared to the others (all P <0.05), and the incidence of spinal fracture in the group D (40.0%) was higher compared to the others (all P <0.05). There was no significant difference in the severe multiple trauma incidence between the group A and the group D (16.9% vs. 12.8%, χ2=0.381, P =0.537), but both group A and group D had significant higher incidence of severe multiple trauma compared to the rest two groups (all P <0.05). The wound debridement was the leading rate of treatment among variety of treatments (57.5%) and the plaster fixation was the second high rate of treatment (30.9%), and the wound infection was found in 25 patients (17.4%) at the first dressing among 144 patients with soft tissue laceration. After active and regular debridement, 72% patients' wound smear tests were negative 3 days later, and 100% were negative 7 days later. Conclusions The casualties treated by Chinese government medical team had relatively young average age, not very severe critical illness, and quite high rate of wound infection. The treatment of all kinds of fractures and open wound was a matter of critical importance. Although facing the challenge of incomplete set of medical equipment, the lacking of medicine and many other unexpected problems, the Chinese government medical team successfully fulfilled the mission with the prior experience accumulated from several domestic earthquake disaster rescue actions. Key words: Earthquake; Trauma; Mountain; Injury reason; Injury mechanism; Rescue; Nepal; Case-analysis