Surgical Care of Victims in Aeroplane and Airport Disasters

Extract

We must be prepared for a survivorship of about 600 to 700 injured passengers in case of an accident involving two jumbo jets as these planes are able to absorb more impact forces than earlier types, and 40%-50% of the passengers may survive.

A triage post, an anteroom for resuscitation and anesthesia, and an operating room with 3 tables must be installed within the airport. Mobile operation units are necessary in addition for urgent surgical care on the spot. The optimum time of the operational readiness is approximately half an hour, if “on the spot surgical care” is to be effective.

At the triage post several tables are available, each with an experienced surgeon for the rapid medical examination. The time of examination and triage for each victim of the earthquake disaster in El Asnam was three minutes.

In an airport disaster, about 10% of survivors might belong to the first category of triage, i.e., have life-threatening injuries. They will require resuscitation and urgent surgical care. Twenty percent might be seriously wounded passengers of the second category, who should be conveyed to hospital as soon as possible. Seventy percent might have minor injuries of the third category and can wait for care and transportation.

Many victims may require neurosurgical operations, but this should be carried out by trained experts and not at the airport. Open depressed skull fractures should be treated at the airport by shaving the scalp, irrigating the wound, applying a sterile dressing and instituting antibiotic therapy. Foreign bodies should be left in place until definitive surgery can be undertaken.