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Trapped, with how long to survive?

WASHINGTON — The medical relief teams racing to help victims of the Haiti earthquake are up against a grim biological fact: People trapped and injured are most likely to survive if rescued within 48 hours, and very few people are found alive more than six days after a disaster.

The rare people who are rescued much later often need treatment — kidney dialysis, intensive care nursing and cardiovascular support — that is hard to deliver in disaster zones.

On Thursday, Tarmo Joeveer, a U.N. security officer from Miami, walked out of the rubble of the flattened U.N. headquarters and raised a fist in triumph, nearly 40 hours after the earthquake.

A team labored five hours to free him and a dusty but beaming Joeveer emerged from the wreckage of the six-story building that now rises no higher than a single floor.

Joeveer's rescue, by the Fairfax County, Va., Urban Search and Research Team, was a moment to hang onto for a team that says the damage here is the worst they have ever seen — and they have been to quakes in Turkey, Taiwan and Iran.

Relieved co-workers rushed to hug Joeveer, their happiness tempered by the knowledge that dozens of U.N. employees — including the chief of mission, Hedi Annabi, whom Joeveer served as a body guard — remain missing and are feared dead.

Thousands of others are feared trapped in Haiti's rubble.

"The real issue is you have to know what is going to be needed at the time you can realistically arrive and be ready to operate your medical resource," said Joseph Barbera, an emergency physician and co-director of George Washington University's Institute for Crisis, Disaster and Risk Management.

He left Thursday as part of the Fairfax Urban Search and Rescue Task Force, one of the few relief organizations with experience treating victims of "crush syndrome" in disaster zones. People suffering from that problem can die within minutes of being rescued unless specific treatment — often begun before the debris is lifted — is performed.

Other search and rescue teams from Miami-Dade and Los Angeles counties also arrived Thursday and headed out on similar missions.

In a study of 34 earthquakes going back to the early 1980s that was published in 2006, researchers at George Washington University found no credible reports of people who survived 14 days after the event. There were five live rescues at least 10 days after collapse, and 42 between five and 10 days after. Fatalities in the individual earthquakes ranged from fewer than 100 in six events to five with more than 15,000. The largest in the study occurred on June 20, 1990, in Iran and killed between 40,000 and 50,000 people.

Barbera thinks there will be numerous late "saves" in Haiti.

"With devastation this wide, and the number of structures affected, one would expect there would be rescues for at least another three to five days. It's possible," he said.

Rescuers speak of a "Golden 48 hours" for saving earthquake victims analogous to the "Golden Hour" for starting treatment in people with penetrating trauma and shock. That time, however, has now passed.

Trapped, with how long to survive? 01/14/10 [Last modified: Friday, January 15, 2010 10:32am]
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