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Dialysis Discussion => Dialysis: News Articles => Topic started by: RightSide on January 17, 2010, 08:54:16 AM

Title: Dying without dialysis in Haiti after earthquake
Post by: RightSide on January 17, 2010, 08:54:16 AM
After an Earthquake: Management of Crush Injuries & Crush Syndrome
Background

Crush injury and crush syndrome may result from structural collapse during an earthquake. Crush injury is defined as compression of extremities or other parts of the body that causes muscle swelling and/or neurological disturbances in the affected areas of the body. Typically affected areas of the body include lower extremities, upper extremities, and trunk. Crush syndrome is localized crush injury with systemic manifestations. These systemic effects are caused by a traumatic rhabdomyolysis (muscle breakdown) and the release of potentially toxic muscle cell components and electrolytes into the circulatory system. Crush syndrome can cause local tissue injury, organ dysfunction, and metabolic abnormalities, including acidosis, hyperkalemia, and hypocalcemia.

Previous experience with earthquakes that caused major structural damage has demonstrated that the incidence of crush syndrome is 2-15% with approximately 50% of those with crush syndrome developing acute renal failure and over 50% needing fasciotomy. Of those with renal failure, 50% need dialysis.

http://tinyurl.com/y99zrgu
Title: Re: Dying without dialysis in Haiti after earthquake
Post by: willowtreewren on January 17, 2010, 12:09:54 PM
Add to the problem of these folks needing dialysis, all the people who were already on dialysis who cannot get treatments due to damage to their centers.

Sad, sad.
Title: Re: Dying without dialysis in Haiti after earthquake
Post by: Stacy Without An E on January 18, 2010, 12:19:17 PM
It is extremely sad, and I'm sorry these people are enduring all this pain and suffering.

But as someone who lives direclty over a major fault north of San Francisco, this is something that could happen here as well.  Although we're better prepared, if the water system shuts down and power is out, Dialysis will be unavailable here as well.  I asked my clinic about backup generators for major disasters and they respoinded, "What backup generators?  We don't have those."

Talk to your clinic about disaster preparation, especially if you live in tornado or earthquake country.  Its always good to be prepared.
Title: Re: Dying without dialysis in Haiti after earthquake
Post by: nursewratchet on January 18, 2010, 01:21:29 PM
I will speak for Texas, as that's what I am familiar with, but I think in the US, its the same.  All facilities are required EVERY month to have a disater plan in place, with a plan for backup generators in place.  The problem in Haiti, and with othere disaster areas would not be the generators, as those could be obtained, but with water.  If the water system goes out, and the power can't clean the water, no dialysios.  If the water is out, and there is power, they can't use HUNDREDS of gallons per week per patient for dialysis if no one has water.  Sad.  And Deadly...
Title: Re: Dying without dialysis in Haiti after earthquake
Post by: djgaryb11 on January 19, 2010, 09:44:29 PM
During an interview on CNN a person from Doctors without borders talks about the people that are dieing because of the lack of dialysis supplies and dialysis machines in Haiti now.....the subject comes on at about 5 minutes into the video


http://www.cnn.com/video/#/video/world/2010/01/19/amanpour.doctors.without.borders.cnn?hpt=C2