Patients with thoracic trauma require rapid decision making and early intervention, especially during natural disasters when the influx of patients complicates hospitalization decisions. Identifying the characteristics of these patients can improve triage protocols, optimize resource allocation, and enhance outcomes in future disaster scenarios.

The aim of this study was to determine the characteristics of hospitalized patients after the February 2023 earthquakes in Türkiye and to contribute to Disaster Medicine.

This retrospective, cross-sectional study was conducted in a university hospital’s emergency department (ED) located in the earthquake area. All patients over 18 years old with earthquake-related thoracic trauma were included. Demographic information, mechanisms of injury, associated injuries, laboratory results, and treatments were recorded. Patients were divided into two groups: discharged and hospitalized.

The study included 179 patients, with a median age of 45 years. Overall, 80.4% were trapped under debris, and 43.8% were rescued on the first day. Hospitalization rates were higher in patients trapped under debris and those rescued after the first day. Blunt thoracic trauma was observed in 95.5% of patients. One hundred and three patients (57.5%) underwent Extended Focused Assessment with Sonography in Trauma (E-FAST) in the ED, 152 patients (84.9%) underwent x-ray, and 129 patients (72.1%) underwent computed tomography (CT). Imaging studies revealed rib fractures in 49.7% and lung parenchymal injuries in 48.6% of patients. Patients with lung parenchymal injury had higher hospitalizations rates. Hospitalized patients had higher levels of white blood cells (WBCs), potassium, blood urea nitrogen (BUN), creatinine, creatinine kinase (CK), creatine kinase-myocardial band (CKMB), and troponin I.

This study highlights the prevalence of blunt thoracic trauma and the importance of imaging in the assessment of thoracic injuries following earthquakes. While few patients needed surgery, many required hospitalizations and had abnormal laboratory results, emphasizing the need for careful monitoring for complications like muscle damage and infection.

Anaphylactic reactions can lead to life-threatening situations. Therefore, a rapid diagnosis and therapy are indicated. Various guidelines recommend immediate treatment with intramuscular adrenaline in severe anaphylaxis. Based on study data from different countries, it has been shown that therapy of anaphylaxis is often not carried out according to existing guidelines.

The aim of the study was an analysis of the emergency treatment and outcome of anaphylaxis in children and adults according to its severity. Focus was placed on the recommended first-line therapy with adrenaline in cases of severe reactions. Further demographic data, triggers, symptoms, and hospitalization rates of anaphylaxis were analyzed.

Data from Emergency Medical Services from Dresden/Germany in cases of anaphylaxis from the start of 2012 through the end of 2016 were retrospectively analyzed. The data of the air rescue were not considered. The severity of the anaphylaxis, the therapy, the further monitoring, and the outcome were analyzed.

A total of 1,131 adults and 223 children with anaphylactic reactions (Grade I-IV) were analyzed. Overall, 591 adults and 102 children showed a severe anaphylaxis. The most common trigger for severe anaphylactic reactions was food in children (61%) and medication in adults (33%). Seven percent of adults and eight percent of children with Grade II or higher anaphylactic reactions received adrenaline. There is a significant correlation between adrenaline therapy and improved condition/outcome in adults and children. Sixty-six percent of adults and 83% of children with severe anaphylaxis were hospitalized. Twenty-one percent of the adults and 13% of the children did not receive further medical observation despite a severe reaction.

The guideline-compliant first-line therapy with adrenaline was not carried out in the majority of the cases analyzed. However, the study shows that treatment with adrenaline for anaphylaxis leads to a significant improvement in the patients’ condition.

Mass-casualty incidents (MCIs) are overwhelming events which generate a surge in casualties, exceeding local capacity and stressing emergency services. Significant mortality, morbidity, and economic impact is often caused. They attract responses from both local and international governmental and non-governmental medical responders. To improve professional standards and accountability, there has been much recent focus on record-keeping by teams in these contexts. This paper seeks to further understand what data are gathered and shared as a result of MCIs to outline current practice and help move towards improved minimum standards of documentation.

A structured database search and abstract screening process was conducted utilizing PRISMA guidelines for scoping reviews. Data were then collected from all papers identified. To ensure all relevant data were gathered, authors of each included study were contacted to clarify their approach to data collection for their work.

From 154 included manuscripts, 64 data categories were found and recorded, capturing MCIs over a period of 32 years located in 42 countries from all World Health Organization (WHO) global regions. Retrospective and contemporaneous data collection was equally prevalent. In-hospital or research team data collection was most common. The ten most common data categories collected were: number of injuries (94.8%), number of deaths (89.6%), injury type (81.2%), cause of injury (79.9%), age (63.0%), sex (63.0%), treatment (62.3%), severity of injury (61.7%), outcome of injury (59.1%), and investigations/treatments given (55.8%). Of the contactable authors, only 29 responded. Sixteen reported reviewing notes retrospectively or using follow-up patient interviews.

There was significant variety in what data were collected, who collected it, and how it was done. The most common data categories were descriptive pieces of information or related to demographics. Only one-half of papers discussed treatments given. Information on both prehospital care and longer-term rehabilitation was much less prevalent.

Terrorism and shooting related MCIs were the largest by paper number. Predominantly made up of more recent MCIs in higher income countries, these findings potentially reflect more organized health care systems.

Overall, data collection in MCIs is challenging and heavily reliant on retrospective analysis. Current practice lacks standardization. If professionalism and accountability for health care delivery in MCIs is to be improved, so must the methods of data collection and minimum standards of documentation.

Mountain Rescue Services (MRS) are a vital link in the chain of survival when it comes to emergencies at high altitudes. Cognitive impairment in hypobaric hypoxic conditions is known, and previous studies have shown suboptimal performance of MRS members after a steep ascent. These impairments may be linked to regional cerebral oxygenation (rSO2). Therefore, this study aimed to investigate whether there are dynamics in rSO2 between “baseline” and “working” altitudes after climbing up to a potential patient.

In this alpine proof-of-concept field study, experienced mountaineers of the Austrian MRS had to perform an active rapid ascent of 1,200 meters on foot to 3,454 meters above sea level. Near-infrared spectroscopy (NIRS) was used to measure rSO2 before and after the climb. Continuous data were compared among subgroups using Mann-Whitney-U tests, and categorical data were compared with χ2-square tests. Statistical significance was defined by two-tailed P values of <.05.

Twenty MRS members were assessed. Their rSO2 values at baseline altitude were significantly higher than at working altitude (70 [SD = 1]% versus 60 [SD = 1]%; absolute difference 10 [95% CI, 6-15]; P <.001). When assessing the single dynamics of each mountain rescuer, there was a wide variability in delta rSO2, ranging from a minimum of 0% to a maximum of 32% (mean 10 [SD = 8]%).

Overall, low rSO2 values were found in mountain rescuers at high altitudes, and there were considerable interpersonal differences of changes in cerebral oxygenation after an ascent. Using rSO2 to assess performance-readiness in mountain rescuers and individual proneness to potential cognitive dysfunction or acute mountain sickness (AMS) could be further research goals.

The escalation of the armed Ukrainian conflict forced millions of refugees to cross borders into neighboring countries, such as Poland, Czech Republic, Republic of Moldova, and Romania. The objective of this manuscript is to report the mission of an Italian Emergency Medical Team (EMT), named CUAMM EMT, deployed to assist Ukrainian refugees sheltered in the Republic of Moldova.

A total of 1,173 patients were admitted to the CUAMM EMT during the period of observation covered in this report (June - December 2022). The majority of patients (88.7%; n = 1,040) had health problems not directly related to the conflicts, while only 3.2% (n = 38) of patients presented diseases directly related to the event. With reference to the World Health Organization (WHO) Minimum Data Set (MDS), the most prevalent diagnosis (66.8%; n = 783) referred to “other diseases, not specified above” (Code 29). Among this group, the majority of diagnosis were attributable to non-communicable diseases (NCDs) such as cardiovascular diseases (23.4%; n = 177), gastrointestinal diseases (7.4%; n = 56), chronic musculoskeletal diseases (6.1%; n = 46), and cancer (4.7%; n = 36).

The most prevalent diagnoses faced by CUAMM EMT during its deployment referred to health problems not directly related to the conflict. Among them, the majority of cases registered were attributable to NCDs, raising interesting points of discussion concerning the management of these conditions during EMTs disaster deployment.

The aim of this study was to describe the demographic characteristics, injury characteristics, and outcomes of individuals sustaining injuries during a hailstorm in Istanbul, Turkey.

In this study, the medical records of 76 patients who presented to the emergency department (ED) of a tertiary hospital after incurring injuries due to hailstorms were retrospectively reviewed. Analyses were performed to identify hailstorm-associated injury profiles, injury mechanisms, patient demographics, and ED resource use.

Of the 76 patients, 42 (55.3%) were male and 34 (44.7%) were female, with the ages of the patients ranging from five to 79 years. Of the patients, 93.4% presented to the ED within the first eight hours after a hailstorm. The most common injury mechanisms were the direct impact of hailstones on the body surface (36.8%) and slips and falls during escape (35.6%). The most frequently injured anatomical areas were skin (60.5%), head (44.7%), and extremities (16.7%). Significant injuries occurred in only 11.8% of the patients, of whom three were treated surgically and one died. The most common injuries were soft tissue and minor head injuries.

Severe hailstorms often strike suddenly and can be difficult to predict. In response, EDs must handle a large number of injured patients in the aftermath of a hailstorm. It is important to remember that hailstorms, like other natural disasters, can cause serious injuries.

Handheld ultrasound (US) devices have become increasingly popular since the early 2000s due to their portability and affordability compared to conventional devices. The Rapid Ultrasonography for Shock and Hypotension (RUSH) protocol, introduced in 2009, has shown promising accuracy rates when performed with handheld devices. However, there are limited data on the accuracy of such examinations performed in a moving ambulance. This study aimed to assess the feasibility and accuracy of the RUSH protocol performed by paramedics using handheld US devices in a moving ambulance.

The study aimed to examine the performability of the RUSH protocol with handheld US devices in a moving ambulance and to evaluate the accuracy of diagnostic views obtained within an appropriate time frame.

A prospective study was conducted with paramedics who underwent theoretical and practical training in the RUSH protocol. The participants performed the protocol using a handheld US device in both stationary and moving ambulances. Various cardiac and abdominal views were obtained and evaluated for accuracy. The duration of the protocol performance was recorded for each participant.

Nine paramedics completed the study, with 18 performances each in both stationary and moving ambulance groups. The accuracy of diagnostic views obtained during the RUSH protocol did not significantly differ between the stationary and moving groups. However, the duration of protocol performance was significantly shorter in the moving group compared to the stationary group.

Paramedics demonstrated the ability to perform the RUSH protocol effectively using handheld US devices in both stationary and moving ambulances following standard theoretical and practical training. The findings suggest that ambulance movement does not significantly affect the accuracy of diagnostic views obtained during the protocol. Further studies with larger sample sizes are warranted to validate these findings and explore the potential benefits of prehospital US in dynamic environments.