The Medical Activity of the IDF Field Hospital in the Earthquake Disaster in Adapazari
In the first 48 hrs the crew was busy in constructing the field
hospital and organizing the basic needs of the crew including toilets,
bathrooms sleeping quarter and the kitchen, concurrently treating
emergency medical situations. On the third day, work routine was
established in order to prevent wearing off of the staff.
The field hospital acted as a secondary referral center to the primary
care clinics in Adapazari, to several worldwide volunteering medical teams
and to the remaining of the 4 hospitals of Adapazari.
A total of 1025 patients were treated in the field hospital within 10 days
between day 4 and day 14 of the earthquake. The distribution of the
patients medical problems was: 32% internal medicine, 13% general surgery,
21% orthopedic surgery, 23% pediatric diseases, and 1% major psychiatric
disorders. A mean number of 35 patients were hospitalized in the field
hospital for a period between 24 hours to 1 week. The medical problems of
the hospitalized patients were distributed in the following manner: 41% of
the patients had diseases in the field of internal medicine (e.g.
infectious diseases, exacerbation of chronic diseases because of
inaccessible medications). 18% of the hospitalized patients were intensive
care or critically ill patients (e.g. acute coronary syndromes, pulmonary
edema, malignant arrhythmia, asthma, pre and post operative patients
etc.). 21% of the hospitalized patients had pediatric diseases (e.g.
infectious diseases, neonatal care etc.). 11% of the patients of the
hospitalized patients had gynecological and obstetric conditions (e.g.
cesarean sections, labors, dilatation and curettage etc.). The last 9% of
the hospitalized patients had orthopedic disorders (Limb fractures etc.).
Medical problems of the hospital staff: The intense heat in the first few
days after arrival was a major struggle for the hospital personnel causing
psychological as well as medical limitations. Several crew members
developed intertrigo, tinea cruris or cellulitis. One surgical nurse had
an accident during an operation and was cut with a used blade. She was
evacuated to Israel with the patients blood to be detected for HIV and
Hepatitis, because no laboratory facilities were available for these
tests. After the laboratory workup in Israel, she was flown back to IDF
Field Hospital in Adapazari.
The first 3 days of function: As the hospital settled down different types
of patients began to arrive, of whom, trauma, internal medicine and
pediatric patients were the main groups. Although a high number of
patients with internal complaints was not expected in these circumstances,
the intense heat, excessive stress and physical activity triggered the
development of food born infectious diseases, dehydration and various skin
disorders. Trauma patients who were not treated in the first 3 days
following the earthquake, especially orthopedic and plastic surgery
patients with limb fractures and minor infected soft tissue injuries. The
severe cases had either died or had been transferred to Istanbul by the
local authorities.
The fact that the city had lost all surgical
capabilities caused the operating room of the field hospital to be fully
occupied, especially by caesarian sections, gynecological, obstetric,
plastic and general surgery. In ten days a total of 40 major operations
were performed and many minor surgical interventions.
Between the sixth and the eighth day meteorological changes has changed
the patient mix. Most of the patients had diseases associated with cold
weather such as asthma, pneumonia and pulmonary edema. Patients who
sufferd from chronic disease and lost their regular medications or forgot
to use them because of the stressfull experience were admitted due to
excacerbation of their chronic illnesses. These illnesses included
myocardial infarction, diabetes, ketoacidosis, hypertension, and asthma.
The extreme stress of the population sometimes resulted in fights and even
gun shootings, which ended up in emergency laparotomy for damage control.
Hemothorax, liver lacerations and perforations were some of the cases
treated by the surgery.
On the nineth and the tenth days the local medical facilities started to
function again, either in tents or in buildings and a few operating rooms,
obstetrics units and inpatient services were opened. The local medical
units at this point started to be self-sufficient and the contribution of
the IDF Hospital became less crucial. At this stage, foreign ministries
officials have mutually decided that The IDF Field Hospital has fullfilled
its mission.
Competing interests:
No competing interests
06 September 1999
Y Bar-Dayan
IDF Field Hospital Mission Team
P Beard, D Mankuta, A Eldad, C Gruzman, P Benedek, G Martinovitz
Rapid Response:
The Medical Activity of the IDF Field Hospital in the Earthquake Disaster in Adapazari
In the first 48 hrs the crew was busy in constructing the field
hospital and organizing the basic needs of the crew including toilets,
bathrooms sleeping quarter and the kitchen, concurrently treating
emergency medical situations. On the third day, work routine was
established in order to prevent wearing off of the staff.
The field hospital acted as a secondary referral center to the primary
care clinics in Adapazari, to several worldwide volunteering medical teams
and to the remaining of the 4 hospitals of Adapazari.
A total of 1025 patients were treated in the field hospital within 10 days
between day 4 and day 14 of the earthquake. The distribution of the
patients medical problems was: 32% internal medicine, 13% general surgery,
21% orthopedic surgery, 23% pediatric diseases, and 1% major psychiatric
disorders. A mean number of 35 patients were hospitalized in the field
hospital for a period between 24 hours to 1 week. The medical problems of
the hospitalized patients were distributed in the following manner: 41% of
the patients had diseases in the field of internal medicine (e.g.
infectious diseases, exacerbation of chronic diseases because of
inaccessible medications). 18% of the hospitalized patients were intensive
care or critically ill patients (e.g. acute coronary syndromes, pulmonary
edema, malignant arrhythmia, asthma, pre and post operative patients
etc.). 21% of the hospitalized patients had pediatric diseases (e.g.
infectious diseases, neonatal care etc.). 11% of the patients of the
hospitalized patients had gynecological and obstetric conditions (e.g.
cesarean sections, labors, dilatation and curettage etc.). The last 9% of
the hospitalized patients had orthopedic disorders (Limb fractures etc.).
Medical problems of the hospital staff: The intense heat in the first few
days after arrival was a major struggle for the hospital personnel causing
psychological as well as medical limitations. Several crew members
developed intertrigo, tinea cruris or cellulitis. One surgical nurse had
an accident during an operation and was cut with a used blade. She was
evacuated to Israel with the patients blood to be detected for HIV and
Hepatitis, because no laboratory facilities were available for these
tests. After the laboratory workup in Israel, she was flown back to IDF
Field Hospital in Adapazari.
The first 3 days of function: As the hospital settled down different types
of patients began to arrive, of whom, trauma, internal medicine and
pediatric patients were the main groups. Although a high number of
patients with internal complaints was not expected in these circumstances,
the intense heat, excessive stress and physical activity triggered the
development of food born infectious diseases, dehydration and various skin
disorders. Trauma patients who were not treated in the first 3 days
following the earthquake, especially orthopedic and plastic surgery
patients with limb fractures and minor infected soft tissue injuries. The
severe cases had either died or had been transferred to Istanbul by the
local authorities.
The fact that the city had lost all surgical
capabilities caused the operating room of the field hospital to be fully
occupied, especially by caesarian sections, gynecological, obstetric,
plastic and general surgery. In ten days a total of 40 major operations
were performed and many minor surgical interventions.
Between the sixth and the eighth day meteorological changes has changed
the patient mix. Most of the patients had diseases associated with cold
weather such as asthma, pneumonia and pulmonary edema. Patients who
sufferd from chronic disease and lost their regular medications or forgot
to use them because of the stressfull experience were admitted due to
excacerbation of their chronic illnesses. These illnesses included
myocardial infarction, diabetes, ketoacidosis, hypertension, and asthma.
The extreme stress of the population sometimes resulted in fights and even
gun shootings, which ended up in emergency laparotomy for damage control.
Hemothorax, liver lacerations and perforations were some of the cases
treated by the surgery.
On the nineth and the tenth days the local medical facilities started to
function again, either in tents or in buildings and a few operating rooms,
obstetrics units and inpatient services were opened. The local medical
units at this point started to be self-sufficient and the contribution of
the IDF Hospital became less crucial. At this stage, foreign ministries
officials have mutually decided that The IDF Field Hospital has fullfilled
its mission.
Competing interests: No competing interests