Management of an Earthquake in a Pediatric Intensive Care Unit

Authors : Murat Tanyildiz, Ömer Özden, Lasin Ozbek, Karya Senkoylu, Aysu Cakar, Ilker Eren, Aslıcan Cakkalkurt, Mehmet Emin Menentoglu, Ilmay Bilge

Pages : 21-30

Doi:10.26650/jchild.2023.1341364

View : 145 | Download : 107

Publication Date : 2023-10-24

Article Type : Research Paper

Abstract :Objective: The 2023 Kahramanmaraş earthquake (7.8 magnitude) devastated Turkey, impacting approximately 14 million people and causing over 50,000 fatalities. This study suggests a pediatric protocol for managing earthquake victims in pediatric intensive care units (PICUs). Materials and Methods: A retrospective, observational study was conducted. Within a week, 72 patients were followed and initially treated post-stabilization, per the treatment protocol and PICU organization. Of these, 58 were referred to tertiary PICUs in other cities. Thirteen patients treated at our regional PICU were reviewed. Results: Thirteen patients were studied. Eight had severe crush injuries, including four extremities in one patient and both legs in another. The average time under debris was 14.8±13.8 h. Fasciotomy was performed on 46.1% (n=6) of patients. Debridement was needed in 61.5% (n=8), averaging 3.6±3.8 procedures per patient. Vacuum-assisted closure (VAC) was applied to 53.8% (n=7). Continuous renal replacement therapy (CRRT) was given to two of the three patients with acute kidney injury, while one received intermittent hemodialysis. Four patients underwent an average of 5.2±9.5 therapeutic plasma exchange (TPE) sessions. Hyperbaric oxygen therapy (HBOT) was administered for an average of 15.0±17.5 sessions to eight patients. No patient deaths occurred at our center. Conclusion: Implementing a treatment protocol was crucial for disaster management. Specialized treatments, including daily TPE, frequent HBOT, anticoagulant and vasodilator therapies, and VAC, contributed to favorable outcomes for patients with severe crush syndrome.
Keywords : afet, çocuk yoğun bakım yönetimi, deprem, protokol

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