(P1-14) Incident Command and Rescue during a Building Collapse

On 11 December 2006, at 8:20h, five flats of a building containing 10 apartments collapsed due to a heater explosion. Four injured patients were transferred to a military hospital with the help of bystanders. Approximately 200 people gathered at the scene. People who were trapped in the building were rescued. The building was surrounded by safety tape. The first injured patient was discovered 4 hours after the collapse. The patinet was transferred by the National Medical Rescue Team. Rescue activities were terminated after 36 hours. A total of eight dead, including five children, and five injured people were recovered from the building. Six of the eight injured patients had superficial wounds. Two patients were monitored: one with head trauma and another with liver contusion and costa fracture.DiscussionThe explosion occurred during working hours, which contributed to the low number of injuries and deaths. The top floor of the building had the highest survival rate. Bystanders entered the scene through the safety tape, and complicated the rescue efforts.ConclusionsRescue efforts during disasters require a high level of education. Otherwise, it becomes impossible to control the crowd and prevent chaos. Also, considering the direction of the building collapse during the rescue activities might enable reaching more people in a shorter time period. Coordination by the departments taking part in the rescue efforts is just one of the key issues affecting a successful response.

Fenestrated Stent-Graft for Traumatic Juxtahepatic Inferior Vena Cava Injury

Purpose: To report the use of a fenestrated stent-graft to manage a traumatic rupture of the juxtahepatic inferior vena cava (IVC). Case Report: A 62-year-old man was involved in a traffic accident and hospitalized for severe right leg fractures. Computed tomography also uncovered liver contusion and retroperitoneal hematoma. The next day, he became hemodynamically unstable; a huge retroperitoneal hematoma had developed from a rupture of the juxtahepatic IVC. An emergent procedure to implant a self-expanding fenestrated stent-graft was successful in repairing the IVC injury and maintaining hepatic venous return. The patient recovered and continues in good health with a patent endograft 16 months after treatment. Conclusions: This experience supports the efficacy of fenestrated endograft implantation for emergent repair of IVC injuries, although proper facilities, an experienced interventional team, and an assortment of devices must be available.