title: Conditions found among pediatric survivors during the early response to natural disaster:  a prospective case study.
abstract: BACKGROUND
  Major natural disasters may provoke a mass casualty situation, and children tend to represent an important proportion of the victims. The purpose of this study was to prospectively record medical conditions presented by pediatric survivors of a major natural disaster to determine the type of medical specialists most needed during the acute phase of relief response.
  
  
  METHODS
  After the 2010 Haiti earthquake, age, sex, date of presentation, diagnosis, and treatment provided were prospectively recorded for all patients less than 18 years old treated by a medical relief team. Patients were then allocated to 1 of the 2 groups: surgical (traumatism or surgical disorder) and medical (medical disorder). Medical activity lasted for 43 days.
  
  
  RESULTS
  Four hundred seventy-one of the 796 treated patients were less than 18 years old. Two hundred forty-four (52%) were assigned to the surgical group and 227 (48%) to the medical group. As there was a substantial decrease in the number of new surgical patients registered on day 11 of activity, we arbitrarily defined an early period (until day 10 of activity) and a late period (beginning on day 11 of activity). Data obtained from the 147 new patients registered during the early period revealed 134 (91%) surgical patients and 13 (9%) medical patients. Eighty-eight percent of patients needed specialized care for traumatic orthopaedic lesions, and procedures under anesthesia or sedation were mainly (98%) performed for traumatic conditions. Data obtained for the 324 new patients registered during the late period revealed 110 (34%) surgical patients and 214 (66%) medical patients. There was a switch from high surgical needs to more routine medical and surgical care, with less procedures (88%) for the treatment of traumatic lesions.
  
  
  CONCLUSIONS
  Pediatric orthopaedic surgeons have a major role to play in the acute phase of relief response to potentially minimize long-term physical and psychosocial disability associated with these complex injuries in growing patients.
  
  
  METHODS
  Economic or decision analyses, level II.
authors.affiliation: Department of Surgery, Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland. axel.gamulin@hcuge.ch
authors.forename: Axel
authors.initials: A
authors.lastname: Gamulin
authors.forename: Júlia
authors.initials: J
authors.lastname: Armenter-Duran
authors.forename: Mathieu
authors.initials: M
authors.lastname: Assal
authors.forename: Olivier
authors.initials: O
authors.lastname: Hagon
authors.forename: Romain
authors.initials: R
authors.lastname: Dayer
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000379:methods; D002648:Child; D002675:Child, Preschool; D055866:Earthquakes; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006205:Haiti; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D054527:Mass Casualty Incidents / Q000706:statistics & numerical data; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D011446:Prospective Studies; D013038:Specialization / Q000706:statistics & numerical data; D017741:Survivors