Management of critically ill patients following earthquake disasters

Abstract

The devastating earthquakes that struck southeastern Türkiye on February 6, 2023, underscored the profound social and healthcare challenges of large-scale natural disasters. These events highlighted the need for healthcare professionals to be well-prepared and equipped with the expertise to manage such crises effectively. Earthquake-induced trauma presents a wide array of medical and surgical complications, frequently requiring urgent hospitalization and specialized management for critically ill patients. However, the limited availability of comprehensive data and evidence-based guidelines complicates optimal care delivery in these scenarios. This review outlines current recommendations for the multidisciplinary management of critically ill patients with earthquake-related trauma. It underscores the significance of promptly identifying and addressing acute complications, including crush syndrome, acute kidney injury, infections, and sepsis. Key strategies such as individualized fluid and electrolyte management, nutritional interventions, and rigorous infection control measures are discussed. Additionally, this review highlights the critical roles of physiotherapy and psychological support in the rehabilitation process, as well as the importance of long-term follow-up for survivors at risk of postintensive care syndrome and posttraumatic stress disorder. To enhance future disaster response and patient outcomes, the review calls for strengthened collaboration, preparedness, and research efforts. This comprehensive examination provides a framework for managing critically ill patients hospitalized due to earthquake-related trauma, offering valuable insights for healthcare providers across multiple disciplines.

Keywords: Earthquake; critically ill; crush syndrome; disaster; intensive care; trauma.

Figure 1

The cycle of critically ill patients affected by the earthquake.

Figure 2

Schematic approach to the monitoring, management, and long-term follow-up of critically ill patients following earthquake disasters. VBG: venous blood gas, CBC: complete blood count, BUN: blood urea nitrogen, CK: creatinine kinase, AST: aspartate aminotransferase, RRT: renal replacement therapy, PTSD: posttraumatic stress disorder, PICS: postintensive care syndrome, QoL: quality of life This illustration was generated by ChatGPT 4.o and Canva.