Management of an Earthquake in a Pediatric Intensive Care Unit

Objective: The 2023 Kahramanmaraş earthquake (7.8 magnitude) devastated Turkey, impacting approximately 14 million people and causing over 50,000 fatalities. This study suggests a pediatric protocol for managing earthquake victims in pediatric intensive care units (PICUs). Materials and Methods: A r...

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Main Authors: Murat Tanyıldız, Ömer Özden, Lasin Özbek, Karya Şenköylü, Aysu Çakar, İlker Eren, Aslıcan Çakkalkurt, Mehmet Emin Menentoğlu, Ilmay Bilge
Format: Article
Language:English
Published: Istanbul University Press 2023-09-01
Series:Çocuk Dergisi
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Online Access:https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/1B8D2D229B6D4695A6961120AD08E694
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author Murat Tanyıldız
Ömer Özden
Lasin Özbek
Karya Şenköylü
Aysu Çakar
İlker Eren
Aslıcan Çakkalkurt
Mehmet Emin Menentoğlu
Ilmay Bilge
author_facet Murat Tanyıldız
Ömer Özden
Lasin Özbek
Karya Şenköylü
Aysu Çakar
İlker Eren
Aslıcan Çakkalkurt
Mehmet Emin Menentoğlu
Ilmay Bilge
author_sort Murat Tanyıldız
collection DOAJ
description Objective: The 2023 Kahramanmaraş earthquake (7.8 magnitude) devastated Turkey, impacting approximately 14 million people and causing over 50,000 fatalities. This study suggests a pediatric protocol for managing earthquake victims in pediatric intensive care units (PICUs). Materials and Methods: A retrospective, observational study was conducted. Within a week, 72 patients were followed and initially treated post-stabilization, per the treatment protocol and PICU organization. Of these, 58 were referred to tertiary PICUs in other cities. Thirteen patients treated at our regional PICU were reviewed. Results: Thirteen patients were studied. Eight had severe crush injuries, including four extremities in one patient and both legs in another. The average time under debris was 14.8±13.8 h. Fasciotomy was performed on 46.1% (n=6) of patients. Debridement was needed in 61.5% (n=8), averaging 3.6±3.8 procedures per patient. Vacuum-assisted closure (VAC) was applied to 53.8% (n=7). Continuous renal replacement therapy (CRRT) was given to two of the three patients with acute kidney injury, while one received intermittent hemodialysis. Four patients underwent an average of 5.2±9.5 therapeutic plasma exchange (TPE) sessions. Hyperbaric oxygen therapy (HBOT) was administered for an average of 15.0±17.5 sessions to eight patients. No patient deaths occurred at our center. Conclusion: Implementing a treatment protocol was crucial for disaster management. Specialized treatments, including daily TPE, frequent HBOT, anticoagulant and vasodilator therapies, and VAC, contributed to favorable outcomes for patients with severe crush syndrome.
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series Çocuk Dergisi
spelling doaj-art-7a5310bf4aab4d6bbde8fee33a2853ac2025-08-20T03:53:18ZengIstanbul University PressÇocuk Dergisi1308-84912023-09-0123322323210.26650/jchild.2023.1341364123456Management of an Earthquake in a Pediatric Intensive Care UnitMurat Tanyıldız0https://orcid.org/0000-0001-8804-032XÖmer Özden1https://orcid.org/0000-0003-0297-5250Lasin Özbek2https://orcid.org/0000-0002-2828-555XKarya Şenköylü3https://orcid.org/0009-0009-0243-5925Aysu Çakar4https://orcid.org/0009-0004-0510-4295İlker Eren5https://orcid.org/0000-0003-2965-7690Aslıcan Çakkalkurt6https://orcid.org/0000-0002-9520-6225Mehmet Emin Menentoğlu7https://orcid.org/0000-0003-3839-4722Ilmay Bilge8Koç Üniversitesi, Istanbul, TurkiyeKoç Üniversitesi, Istanbul, TurkiyeKoç Üniversitesi, Istanbul, TurkiyeKoç Üniversitesi, Istanbul, TurkiyeKoç Üniversitesi, Istanbul, TurkiyeKoç Üniversitesi, Istanbul, TurkiyeKoç Üniversitesi, Istanbul, TurkiyeBakırköy Dr. Sadi Konuk Eğitim Araştırma Hastanesi, İstanbul, TürkiyeKoç Üniversitesi, Istanbul, TurkiyeObjective: The 2023 Kahramanmaraş earthquake (7.8 magnitude) devastated Turkey, impacting approximately 14 million people and causing over 50,000 fatalities. This study suggests a pediatric protocol for managing earthquake victims in pediatric intensive care units (PICUs). Materials and Methods: A retrospective, observational study was conducted. Within a week, 72 patients were followed and initially treated post-stabilization, per the treatment protocol and PICU organization. Of these, 58 were referred to tertiary PICUs in other cities. Thirteen patients treated at our regional PICU were reviewed. Results: Thirteen patients were studied. Eight had severe crush injuries, including four extremities in one patient and both legs in another. The average time under debris was 14.8±13.8 h. Fasciotomy was performed on 46.1% (n=6) of patients. Debridement was needed in 61.5% (n=8), averaging 3.6±3.8 procedures per patient. Vacuum-assisted closure (VAC) was applied to 53.8% (n=7). Continuous renal replacement therapy (CRRT) was given to two of the three patients with acute kidney injury, while one received intermittent hemodialysis. Four patients underwent an average of 5.2±9.5 therapeutic plasma exchange (TPE) sessions. Hyperbaric oxygen therapy (HBOT) was administered for an average of 15.0±17.5 sessions to eight patients. No patient deaths occurred at our center. Conclusion: Implementing a treatment protocol was crucial for disaster management. Specialized treatments, including daily TPE, frequent HBOT, anticoagulant and vasodilator therapies, and VAC, contributed to favorable outcomes for patients with severe crush syndrome.https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/1B8D2D229B6D4695A6961120AD08E694disasterearthquakepediatric intensive care managementprotocol
spellingShingle Murat Tanyıldız
Ömer Özden
Lasin Özbek
Karya Şenköylü
Aysu Çakar
İlker Eren
Aslıcan Çakkalkurt
Mehmet Emin Menentoğlu
Ilmay Bilge
Management of an Earthquake in a Pediatric Intensive Care Unit
Çocuk Dergisi
disaster
earthquake
pediatric intensive care management
protocol
title Management of an Earthquake in a Pediatric Intensive Care Unit
title_full Management of an Earthquake in a Pediatric Intensive Care Unit
title_fullStr Management of an Earthquake in a Pediatric Intensive Care Unit
title_full_unstemmed Management of an Earthquake in a Pediatric Intensive Care Unit
title_short Management of an Earthquake in a Pediatric Intensive Care Unit
title_sort management of an earthquake in a pediatric intensive care unit
topic disaster
earthquake
pediatric intensive care management
protocol
url https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/1B8D2D229B6D4695A6961120AD08E694
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AT aysucakar managementofanearthquakeinapediatricintensivecareunit
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