Europe South Asia Asia Pacific Americas Middle East Africa BBC Homepage World Service Education



Front Page

World

UK

UK Politics

Business

Sci/Tech

Health

Education

Sport

Entertainment

Talking Point

In Depth

On Air

Archive
Feedback
Low Graphics
Help

Friday, September 24, 1999 Published at 08:41 GMT 09:41 UK


Health

Surviving against the odds

Chances of a successful rescue decrease rapidly as time passes

The small boy found in the rubble more than three days after the Taiwan earthquake is the kind of miracle that every rescue team dreams about.

But time moves very fast for anyone caught in debris after an earthquake.

The survival time of people who are trapped under collapsed buildings varies greatly on the time of year, the terrain and the physical injuries they have suffered.

A basic rule of thumb is that if they are not rescued within 48 hours, there is a 90% chance that they will not live.

There are exceptions, like the little boy found on Friday morning in Tali.

Most people, however, succumb to dehydration, whether or not they are suffering from physical injuries.

Dr Michel Thieren, medical officer for the WHO's humanitarian assistance programme, said: "You don't need to be in a critical condition to be at risk of dying after three days without drinking anything."

Lack of oxygen can also be a problem.

Speed is vital

Those who are rescued often need rapid medical attention.

The first thing that doctors need to do is to assess the patient for head injuries, and damage to organs.

This can be done by testing reflexes, measuring blood pressure and assessing level of awareness by asking simple questions.

At this stage it is also important to dress minor wounds, which if left untreated may become infected.

Most people who have been trapped under rubble also need treatment to bring their body fluids up to more normal levels.

This can be done by administering rehydration salts, water, and in serious cases a glucose drip.

Crush syndrome


[ image: Rescue teams have to work fast to find victims in time]
Rescue teams have to work fast to find victims in time
One of the most common problems is a condition known as crush syndrome. This must be treated with 48 hours otherwise it can be fatal.

When the muscles are crushed they release a protein which in normal circumstances is entirely harmless.

However, once the protein is released into the blood stream it finds its way to the kidney, where it can block the function of the organ and lead to total kidney failure and death.

People with crush syndrome need to receive kidney dialysis as soon as possible so that their blood can be purged of the toxic protein.

The relief organisation Medicins Sans Frontieres (MSF) has sent one kidney specialist and five specialist nurses to the earthquake disaster zone to tend survivors.

Psychological care

Once a patient has been stabilised, it is important that they also receive psychological care as quickly as possible.

MSF aims to provide psychotherapeutic care to victims within a week

MSF spokesman Nathan Ford said: "Psychological care is something that comes after more immediate medical care, but it is something that nevertheless has to be done pretty quickly.

"The longer you wait the more complex the problems can become. Stress can quickly turn into post traumatic stress disorder, and we try to nip the problem in the bud as quickly as possible."

MSF runs a programme of psycho-social care which is designed to help victims accept that they have suffered a traumatic experience, and then to achieve a rational perspective about what they have gone through.

These programmes take the form of 10-15 counselling sessions in the days after the disaster.

Other organisations use different techniques. For instance, Unicef provided art therapy for children caught up in the Kosovo conflict.

Long term psychological care, however, is inevitably the responsibility of the domestic authorities.



Advanced options | Search tips




Back to top | BBC News Home | BBC Homepage | ©


Health Contents

Background Briefings
Medical notes

Relevant Stories

18 Aug 99 | Health
Turkish earthquake: The health impact





Internet Links


Medicins Sans Frontieres

Unicef


The BBC is not responsible for the content of external internet sites.




In this section

Disability in depth

Spotlight: Bristol inquiry

Antibiotics: A fading wonder

Mental health: An overview

Alternative medicine: A growth industry

The meningitis files

Long-term care: A special report

Aids up close

From cradle to grave

NHS reforms: A guide

NHS Performance 1999

From Special Report
NHS in crisis: Special report

British Medical Association conference '99

Royal College of Nursing conference '99