ISSUES OF RESCUE AND MEDICAL-CARE FOLLOWING THE 1988 ARMENIAN EARTHQUAKE

On-site emergency care and rescue efforts may be critical in preventin g disability and other serious consequences of disasters. In this repo rt we compare efforts used in the rescue and emergency medical care of 189 people (case subjects) from Kumairy (Leninakan), Armenia, who wer e hospitalized with serious injuries following the Armenian earthquake of 7 December 1988, with efforts used in helping 68 people (controls) from Kumairy with mild injuries who were not hospitalized. We used a standardized interview questionnaire to ascertain the circumstances of entrapment, the rescue process used, the injuries the victims sustain ed, and the medical care they received. Case and control subjects shar ed similar social and demographic characteristics; however, case subje cts waited longer to be rescued and to receive medical care than did c ontrol subjects. Of the people who said they were trapped, 66.2% of th e case subjects and 41.2% of the control subjects said that they were trapped for >1 hour (odds ratio [OR] = 2.79, 95% confidence interval [ CI] : 1.52-5.13) whilst the OR for >6 hours of entrapment was 3.88 (95 % CI : 1.69-9.10). Of those requiring medical care, 28.6% of people wh o were hospitalized waited >1 hour after rescue to receive medical car e, compared with only 14.7% of the control subjects (OR = 2.32, 95% CI : 1.05-5.23). In addition to the case-control study, we collected dat a on general characteristics of the rescue and emergency medical care process. We found that most of the trapped people were rescued by untr ained local inhabitants who most often used their hands or simple tool s. Only 2.5% of the trapped survivors were rescued by Soviet specialis ts in urban search and rescue, and fewer than 1% were rescued by speci alized foreign rescue groups. Many of the surviving injured victims (4 3.5%) did not receive their first medical care until they arrived at a hospital. Of the people with serious injuries, 37% walked to hospital s or were transported by private cars, and 24% were transported by pla ne or helicopter. Of those who received some sort of medical treatment , more than 60% underwent an orthopaedic procedure and 56.7% required only minor procedures. Only 1.6% required surgery. The results of this study highlight, once more, the importance of local disaster prepared ness and proper on-site emergency care.