In the bowels of our planet, continuous internal processes occur, as a result of which the face of the Earth changes. Most frequently, these changes are slow and gradual, and their effect is not noticed immediately. Detailed analyses reveal that some parts of the earth’s surface rise and even distances between continents do not remain constant. Sometimes, internal processes are stormy, and the terrible element of earthquakes turns whole cities into ruins and devastates entire areas (Chopra, 2017).
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Maryland belongs to the U.S. states that are under the threat of an earthquake (Pulinets, Morozova, & Yudin, 2014). The greatest danger of such a natural disaster lies in its poor predictability and detrimental effect. However, the scientific achievements of recent years offer real opportunities not only to predict earthquakes but also to influence their progress. To arrange the successful emergency management in case of an earthquake, it is necessary to take into consideration the principles of incident management, public health issues, the problems of triaging victims, and the collaboration of agencies at different levels.
Fundamental Principles of Healthcare Incident Management
Emergencies demand immediate reaction to mitigate the outcomes. Fundamental principles of healthcare incident management involve the protection of people’s lives, the stabilization of the disaster spot, and the preservation of property. Comprehensive emergency management involves four stages: mitigation, preparedness, response, and recovery (Boatright-Royster & Brewster, 2016). An earthquake fits into this classification since its occurrence demands the fulfillment of all the mentioned principles and stages.
The principle of protecting the lives of citizens is the most important one since, in large earthquakes, people may find themselves in blockages. In conditions of prolonged soft tissue compression of individual body parts, lower or upper extremities, a severe lesion can develop, called the syndrome of prolonged squeezing of limbs or traumatic toxicosis (Haddow, Bullock, & Coppola, 2017). Such an occurrence is possible due to the absorption of toxic substances into the bloodstream, which are the products of the decomposition of proliferated soft tissues (Haddow et al., 2017).
Individuals affected by traumatic toxicosis complain of pain in the damaged part of the body, nausea, headache, and thirst. There usually are visible abrasions and dents on the injured part, repeating the outline of the protruding portions of the objects pressing. The possibility of these and other injuries justifies the necessity to employ the principle of protecting people’s lives.
The other two principles also bear much significance since they are aimed at arranging convenient living conditions for those who have suffered during an earthquake. To provide the stabilization of disaster area protect people’s property, the following programs have been introduced by the Centers for Disease Control and Prevention (CDC): planning and readiness assessment, surveillance and epidemiology capacity, education and training, health alert network, communication of health risks and dissemination of health information, and others (Boatright-Royster & Brewster, 2016).
The implementation of the fundamental principles of healthcare incident management involves the cooperation between various organizations and citizens. The outcomes of earthquakes allow considering this type of natural disaster eligible for this classification.
Triaging of Victims as a Challenge
Medical sorting is the method of distributing the victims to groups according to the need for similar therapeutic, preventive, and evacuation measures, depending on medical indications and the specific situation. The primary goal of triage is to ensure the timely delivery of medical care and rational evacuation to the affected (Waugh, 2015). This measure becomes particularly important in situations where the number of people requiring medical care exceeds the capacity of local health services. Medical assistance is considered timely only when it saves the life of the affected person and prevents the development of dangerous complications.
Medical sorting is a concrete, continuous, repetitive, and successive process of providing victims with all types of medical care. Triaging is carried out from the moment of rendering first medical aid on the site of the accident and in the pre-hospital period outside the zone of earthquake defeat, as well as when entering the national, regional and other medical institutions to receive full medical assistance and treatment until the outcome (Waugh, 2015).
Sorting the victims of an earthquake may be a challenging task since the number of affected individuals is great, and there may be a lack of competent healthcare specialists. Frequently, help is provided by the survivors whose injuries are not very serious, and these people may not have sufficient medical education. Another challenge is that the victims may have internal damages that are impossible to feel or notice at a glance.
In the hearth of the earthquake lesion, the simplest measures of medical sorting are performed in the place of the injury, in the interest of providing first aid. When the medical personnel arrives in the disaster area (ambulance brigades, disaster medicine teams), the sorting continues, and deepens (Waugh, 2015). The medical staff of any level of training and professional competence should first perform the selective sorting and identify the individuals most severely affected.
Then, it is essential to determine the predominant group of people that require medical care. These are children and individuals with external bleeding, asphyxia, or convulsions. Triaging of earthquake victims is a challenging task, but its appropriate fulfillment can mitigate the adverse outcomes to a considerable extent.
Injuries Most Likely to Occur
Since in the event of massive destruction of buildings, landslides, rockfalls, and landslides, various injuries may occur, medical aid for earthquakes is exceptionally diverse. The victims of an earthquake may have fractures, contusions, brain, and spinal cord injuries, dislocations, bruises, concussions, electric shock, and other damages. Earthquakes are considered to be the leading reason for mortality and morbidity associated with natural disasters (Clover, Jemec, & Redmond, 2014).
The most common damages after a quake are the injuries of the musculoskeletal system and soft tissues. The predominant injuries are those of limbs: 60% of all cases (Clover et al., 2014). Over 50% of people have fractures, 8-13% of which are open (Clover et al., 2014). Thus, the specialists most commonly needed by earthquake victims are surgeons.
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Apart from tissue and musculoskeletal damage, survivors may also suffer from pneumonia or infectious diseases. Researchers studying the 2011 Great East Japan Earthquake remark that 43% of survivors had pneumonia, and 12% of people had skin and subcutaneous tissue infections (Aoyagi et al., 2013). Moreover, 20.5% of hospitalized individuals were positively tested for urinary pneumococcal antigen (Aoyagi et al., 2013). Since these diseases are related to climatic and weather factors of the earthquake spot, it is possible to conclude that survivors of a similar event in Maryland are also prone to such infections.
Another common injury that can be observed in earthquake victims is brain concussion. This condition is characterized by consciousness disorder, stunning, headaches of varying intensity, dizziness, or vomiting (Haddow et al., 2017). Frequently, the concussion is accompanied by focal symptoms: the violation of eye convergence, nystagmus, changes in pupillary reflexes, the deviation of the tongue from the midline, smoothness of the nasolabial fold, or the shift in tendon reflexes (weakening or strengthening) (Haddow et al., 2017). Characteristic features of a concussion include the change in body temperature, pallor or redness of the skin, increased sweating, and changes in heart rate or blood pressure. Thus, concussions complete the list of injuries most likely to occur after earthquakes, following musculoskeletal damages and infectious diseases.
Issues Affecting Vulnerable Populations
Although any person suffering from an earthquake may experience much physical pain or spiritual suffering, there are groups of individuals that are at specific risk. Such vulnerable populations include children, elderly citizens, disabled people, and pregnant women (Armaş, Toma-Danila, Ionescu, & Gavriş, 2017). Also, scholars identify individuals with low education as vulnerable in conditions of an earthquake (Armaş et al., 2017). The main problems affecting these populations’ likelihood to survive the outcomes of a natural disaster are concerned with their low emotional stability, poor physical abilities, and insufficient knowledge of how to behave.
Public Health Issues That May Ensue and Their Mitigation
Apart from immediate physical damages that earthquake victims undergo, there is a danger of public health issues developing as a result of the natural disaster. Due to the lack of proper hygienic conditions in the aftermath of an earthquake, there is a high risk of the spread of infectious diseases among the survivors. Such illnesses are commonly caused by various microorganisms such as viruses, fungi, or bacteria (Gamage, Kravolic, & Roselle, 2016). To mitigate this public health issue, it is crucial to provide the victims with drinking water and access to hygienic conditions as soon as possible.
Utilizing Interagency Cooperation and Local Collaboration
A highly significant issue that can improve the outcomes of an earthquake is the arrangement of collaboration between various organizations whose combined efforts can help the victims. The institution responsible for Maryland in case of an emergency is the National Naval Medical Center that is located in Bethesda, MD (Boatright-Royster & Brewster, 2016).
However, the efforts of only one agency cannot be enough, thus, Maryland relies not only on local but also on state organizations and programs, such as the National Disaster Medical System, the Office of Assistant Secretary for Preparedness and Response, the Food and Drug Administration, the Strategic National Stockpile, and others (Boatright-Royster & Brewster, 2016). The collaboration at all levels promotes prompt reaction to natural disasters and can save the lives of many people injured during an earthquake.
Considerations Unique to the Disaster
All-natural disasters have some things in common, such as a large number of victims or damages. However, when managing the outcomes of an earthquake, one should take into account some specific considerations. Probably the most crucial of such aspects is the possibility of earthquake-induced landslides (Carlton, Kaynia, & Farrokh, 2016). Disaster managers should not neglect this hazard since they can lead to the severe aftermath.
Earthquakes, which bring great harm to humankind, are the object of profound research and study. Maryland belongs to the states that are vulnerable to these natural disasters. The arrangement of the successful emergency management in case of an earthquake should involve the principles of incident management, public health issues, the problems of triaging victims, and the collaboration of agencies at different levels.
Thorough investigations of seismic zones are needed to predict earthquakes and inform people about the approaching disaster. Currently, scientists are doing everything possible to notify the state and citizens, which leads to building defensive structures and arranging safety methods. By taking into consideration the aspects discussed in the paper, it will be easier to mitigate the devastating outcomes of earthquakes.
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