Lessons learned from a landslide catastrophe in Rio de Janeiro, Brazil.
BACKGROUND
On January, 2011, a devastating tropical storm hit the mountain area of Rio de Janeiro State in Brazil, resulting in flooding and mudslides and leaving 30,000 individuals displaced.


OBJECTIVE
This article explores key lessons learned from this major mass casualty event, highlighting prehospital and hospital organization for receiving multiple victims in a short period of time, which may be applicable in similar future events worldwide.


METHODS
A retrospective review of local hospital medical/fire department records and data from the Health and Security Department of the State were analyzed. Medical examiner archives were analyzed to determine the causes of death.


RESULTS
The most common injuries were to the extremities, the majority requiring only wound cleaning, debridement, and suture. Orthopedic surgeries were the most common operative procedures. In the first 3 days, 191 victims underwent triage at the hospital with 50 requiring admission to the hospital. Two hundred fifty patients were triaged at the hospital by the end of the fifth day. The mortis cause for the majority of deaths was asphyxia, either by drowning or mud burial.


CONCLUSIONS
Natural disasters are able to generate a large number of victims and overwhelm the main channels of relief available. Main lessons learned are as follows: 1) prevention and training are key points, 2) key measures by the authorities should be taken as early as possible, and 3) the centralization of the deceased in one location demonstrated greater effectiveness identifying victims and releasing the bodies back to families.
Assistant Professor, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas, SP, Brazil.
Bruno Monteiro Tavares
BM
Pereira
Associate Professor, Department of Surgery, Teresópolis School of Medicine, Rio de Janeiro, Brazil; Chief, Clinics Hospital of Teresópolis Emergency Department, Rio de Janeiro, Brazil; Surgical Activities Coordinator of the Health and Security Rio de Janeiro's State Department, RJ, Brazil.
Wellington
W
Morales
G.R.A.U. Flight Doctor (HEMS), SP, Brazil.
Ricardo Galesso
RG
Cardoso
Faculty of the Department of Surgery, School of Medical Sciences, University of Rio de Janeiro, RJ, Brazil.
Rossano
R
Fiorelli
Chief, Professor of Surgery, Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas, SP, Brazil.
Gustavo Pereira
GP
Fraga
Associate Professor of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Susan M
SM
Briggs
D000328:Adult; D001938:Brazil; D002648:Child; D004189:Disaster Planning / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D055876:Landslides; D008297:Male; D054527:Mass Casualty Incidents; D008952:Mobile Health Units / Q000458:organization & administration; D020380:Needs Assessment / Q000458:organization & administration; D012189:Retrospective Studies; D014218:Triage / Q000458:organization & administration*