earthquake, organization of medical care

From Big Medical Encyclopedia

EARTHQUAKE, organization of medical care — the tremors which are followed by fluctuations of crust, caused by the natural reasons, hl. obr. tectonic activity. Intensity 3. it is measured in points and on the international seismic scale of MSK-64 it is estimated on 12-mark system. 3. intensity in 1 point are registered only seismic devices, and catastrophic, in 11 — 12 points, are followed by education in the soil of numerous cracks, collapses, landslides, destruction of constructions and constructions of all types. 3. in 6 — 7 points and give to disturbance of normal living conditions of people above and are connected with danger to their health. Human losses and material damage from 3. are caused by intensity 3. and related rate of decay of buildings. At catastrophic 3. mass human losses arise within minutes and even seconds. So, e.g., as a result of catastrophic 3. on the island of Honshu (Japan) on September 1, 1923 died and was missing apprx. 137 thousand and more than 103 thousand people, and are wounded in Skoplje (Yugoslavia) from 3. in 9 — 10 points on July 26, 1963 for 20 sec. 80% of buildings were destroyed, more than 2 thousand persons died.

The center of mass losses arising at 3. catastrophic character, and also a condition which at the same time are created are in many respects similar to the situation taking place at nuclear explosion.

A death toll and received injuries at 3. it is subject to considerable fluctuations and can exceed a half of number of inhabitants of the settlement. It is noted that among victims women and children prevail. So, at 3. in Tashkent on April 25, 1966 in the districts which underwent the greatest destruction, wounded women were 1,5 times more, than men.

At victims at 3. the closed injuries of a skull, extremities, a thorax and a basin, the bruises of soft tissues with extensive hemorrhages smashed, contaminated by the earth of a wound prevail; at a considerable part of victims the syndrome of long crush is noted (see. Traumatic toxicosis ). At 3., followed by the fires, can be a lot of burned. So, at Tokyo 3. in 1923 died from the fires apprx. 38 thousand people and very large number of people got burns.

At the persons which appeared in a zone 3., psychological reactions which weight and duration considerably depends on intensity 3 are observed. At catastrophic 3. reactive states are shown in the form of a twilight state with psychomotor excitement and in the form of a psychogenic stupor. According to the Yugoslavian authors Petrovich and Popovic (D. Petrovic, M. of Popovic, 1963), in Skoplje acute reactive states were observed at the vast majority of residents. Approximately in 20% of cases this state passed during the first hours, in 70% it proceeded of several hours to 2 — 3 days, and in 10% the serious mental disorders which demanded hospitalization were observed. Persons with reactive states can induce among people around, especially at the persons unstable in the emotsionalnovolevy relation, mass panic reactions. In prevention well thought over system of information responding situations to the specific requests calming and disseminating negative rumors reducing influence of imagination and the frightening imagination, and also carrying out in short terms of rescue operations and rendering medical aid to victims is of their great importance.

Serious influence 3 is revealed. on emergence and a current of a number of somatopathies, and first of all cardiovascular. The hypertensive crises proceeding with a coronary and cerebral syndrome are made heavier and become frequent, the lethality among patients with a myocardial infarction raises, the current of a diabetes mellitus is burdened. A number of authors with action of adverse factors 3.svyazyvayut disturbance of a normal course of pregnancy (premature births, abortions and so forth).

Disturbance of water supply and the sewerage, deterioration in conditions of placement and food, the decrease in immune responsiveness connected with 3., can promote developing of infectious diseases and create threat epid, flashes.

Mitigation of consequences 3. has nation-wide character in the USSR and it will be organized by party and Soviet bodies. For the organization of assistance to affected population, rescue and urgent emergency vosstano vitelny works, rescue of the state material values and personal property of citizens are usually created the extraordinary commissions with large powers.

For carrying out rescue and emergency recovery operations the troops of GO and not paramilitary forces created at the expense of the civilian population (rescue emergency and recovery and other teams), which kept working capacity inhabitants of the victim from 3 are attracted. point, and if necessary and formations of GO from the nearby cities. These works include: search and extraction from under blockages of victims, withdrawal of people from the dilapidated and burning buildings; the device of drives and passes for formations of GO and evacuation of the population; localization and accident elimination on utility and power networks, life-threatening people or capable to cause extensive material damage; destruction or strengthening of structures of the buildings and constructions menacing with a collapse; equipment of collection points for affected and first-aid posts. Works on extraction of people from under ruins shall be performed by special teams in perhaps short terms with use of various technical means.

For rendering medical aid to the population which was injured at 3., bodies of health care, and also formation of medical service GO are attracted: dignity. teams (see. Druzhina sanitary ), OPM (see. Group of first aid ). Staff dignity. teams renders first aid (see) directly in the center 3. Besides, the first medical aid shall appear as it should be self-care and mutual assistance (see). After rendering victims to the first medical aid direct on transport, and lightly wounded and on foot in the next developed OPM or which remained to lay down. institutions where render to them first medical assistance (see), and at an opportunity and the qualified medical care (see). Here medical sorting and preparation for evacuation in local is carried out to lay down. institutions, in-tsy a country zone or other cities for rendering medical aid in full and further treatment. Responsibility for the organization of this evacuation is born by commanders of summary groups of GO, heads of objects of the national economy, and also persons designated by local executive committees of Councils of deputies of workers.

In the prevention epid, flashes the crucial role belongs effective protivoepid, and a dignity. - a gigabyte. to actions, including active identification and urgent hospitalization of infectious patients, implementation of close medical check behind water supply, providing the population with food stuffs, the organization of cooking in places of resettlement (tent towns), and also to control for a dignity. condition of the territory, burial of corpses and active purposeful dignity. - a gleam. to work. Organization and carrying out complex dignity. - a gigabyte. and protivoepid, actions are assigned to local bodies of health care.

During the calculations on rescue operations, holding anti-epidemic actions it must be kept in mind possible destructions of healthcare institutions and failure of a certain part of staff of formations of GO, including and medics.

To prevent 3. it is impossible. However implementation in seismodangerous districts of aseismic construction, maintenance of constant readiness for holding the relevant activities, including and actions for rendering medical aid to affected population, creation in the cities located near seismodangerous districts, necessary stocks of medical property can significantly lower serious consequences 3.

Bibliography: Altunin A. T. Formations of civil protection in disaster management, M., 1976, bibliogr.; And with with and r M. The guide to sanitary measures at natural disasters, the lane with English, M., WHO, 1972; Brusilovsky L. Ya., Brukhansky N. P. isegalovt. E. Zemletryaseniye in the Crimea and nevropsikhichesky traumatism, L., 1928; Egorov P. T., Shlyakhov I. A. and Alabin N. I. Civil protection, M., 1977, bibliogr.; Earthquakes in the USSR, under the editorship of E. F. Savarensky, etc., M., 1961, bibliogr.

O. S. Lobastov