Three phases of disaster relief in Haiti--pediatric surgical care on board the United States Naval Ship Comfort.
BACKGROUND
On January 12, 2010, Haiti experienced the western hemisphere's worst-ever natural disaster. Within 24 hours, the United States Naval Ship Comfort received orders to respond, and a group of more than 500 physicians, nurses, and staff undertook the largest and most rapid triage and treatment since the inception of hospital ships.


METHODS
These data represent pediatric surgical patients treated aboard the United States Naval Ship Comfort between January 19 and February 27, 2010. Prospective databases managed by patient administration, radiology, blood bank, laboratory services, and surgical services were combined to create an overall patient care database that was retrospectively reviewed for this analysis.


RESULTS
Two hundred thirty-seven pediatric surgical patients were treated, representing 27% of the total patient population. These patients underwent a total of 213 operations composed of 243 unique procedures. Orthopedic procedures represented 71% of the total caseload. Patients returned to the operating room up to 11 times and required up to 28 days for completion of surgical management.


CONCLUSIONS
This represents the largest cohort of pediatric surgical patients in an earthquake response. Our analysis provides a model for anticipating surgical caseload, injury patterns, and duration of surgical course in preparing for future disaster response missions. Moreover, we propose a 3-phased response to disaster medicine that has not been previously described.
Department of Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA. ryanmwalk@gmail.com
Ryan M
RM
Walk
Timothy F
TF
Donahue
Richard P
RP
Sharpe
Shawn D
SD
Safford
D000293:Adolescent; D002056:Burns / Q000453:epidemiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D003953:Diagnosis-Related Groups; D054597:Disaster Medicine / Q000458:organization & administration*; D004189:Disaster Planning; D055866:Earthquakes; D005260:Female; D013502:General Surgery / Q000458:organization & administration*; D006205:Haiti; D006742:Hospital Bed Capacity; D006772:Hospitals, Military / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D008297:Male; D008493:Medical Missions / Q000458:organization & administration*; D008962:Models, Theoretical; D009326:Naval Medicine / Q000458:organization & administration*; D010372:Pediatrics / Q000458:organization & administration*; D012767:Ships; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014218:Triage; D014481:United States; D014947:Wounds and Injuries / Q000453:epidemiology / Q000601:surgery