One-month recovery experience of a disaster relief team functioning as an outpatient clinic following Super Typhoon Haiyan: Changes in distribution of trauma patients and required medical components

Abstract

As the distribution of trauma and non-trauma patients changes with time following a large-scale disaster, the required medical resources change commensurately. An understanding of these changes is necessary to provide effective medical support. Super Typhoon Yolanda, one of the strongest recorded tropical cyclones, struck the central area of the Republic of the Philippines on November 8, 2013. The current authors worked together on one of the disaster relief medical teams from the Republic of Korea. The authors investigated differences in medical components provided to trauma and non-trauma patients and analyzed changes in the distribution of trauma patients over time in the Tacloban area affected by Super Typhoon Yolanda.

The authors retrospectively reviewed patients admitted to an outpatient clinic established by our Korean Disaster Relief Team (KDRT) located in Tacloban City, Republic of the Philippines, between November 16 and December 13, 2013. Medical records were reviewed to collect patient information, including date of admission, sex, age, patient categorization as trauma or non-trauma, types of medical resource provided to patients, and times at which patients were transferred to other hospitals or clinics.

During the study period, 5,827 patients were admitted to the KDRT clinic. Of these, 1,378 (23.6 percent) were trauma patients and 4,449 (76.4 percent) were non-trauma patients. The total patient number per week increased from the second to third weeks (1,553 to 2,426) and rapidly decreased from the third to fifth weeks (2,426 to 757) following the disaster. Trauma patients were consistently present, and the proportion of trauma patients rapidly increased from the third to fifth weeks (18 to 39 percent) following the disaster.

Certain patient factors were significantly related to trauma, including patient age [OR (95% CI): 1.01 (1.01-1.01)], male sex [OR (95% CI): 2.12 (11.88-2.40)], frequency of laboratory tests [OR (95% CI): 0.19 (0.12- 0.29)], required electrocardiography [OR (95% CI): 0.28 (0.14-0.50)], required ultrasound [OR (95% CI): 0.32 (0.21-0.47)], required invasive procedures [OR (95% CI): 53.50 (44.17-65.18)], required short-term monitoring [OR (95% CI): 1.25 (1.05-1.50)], and required prescriptions for medication [OR (95% CI): 0.33 (0.29-0.38)]. Other factors (eg, X-ray radiography and transfer from the clinic) were not associated with trauma.

The proportions of trauma patients increased over time after disaster. The medical requirements for effective patient care were different between non-trauma and trauma patients.