Earthquakes are the second most frequent natural disaster after floods and caused the most significant economic losses in the world during 2007-2016. Indonesia is at the confluence of three active world plates: India-Australia, Eurasia, and Pacific plates, making it vulnerable to earthquakes. Losses caused by earthquakes depend on the magnitude, the distance from the epicenter, the population density, earthquake preparedness, and mitigation efforts. From January to April 2017, there were 1426 earthquake events in Indonesia with a magnitude of 1-9.5 on the Richter scale. Usually, a large-magnitude earthquake only occurs once, followed by small-magnitude earthquakes. However, in Lombok in July 2018, a large-magnitude earthquake occurred three times: once on Jul 29th, 2018, Aug 5th, 2018, and Aug 19th, 2018.
West Nusa Tenggara (NTB) Province is an archipelagic province consisting of 2 (two) large islands, namely Lombok and Sumbawa, with at least 332 small islands consisting of 7 regencies/cities. Its total population is 3,798,297, with a population density of 246 inhabitants/km2. However, only Mataram City has the number of health facilities that meet the minimum standard of availability of health facilities, while other regencies/cities still require additional health facilities. Furthermore, although all regencies/cities affected by the earthquake have not met the minimum standard for the availability of general practitioners and specialist doctors, only Mataram City has met the minimum standard availability of specialists.
The main cause of death and injuries is building collapse. Most of these buildings are not designed to withstand earthquakes or were poorly constructed. The mode of injury when a building buries victims, the severity of the injury, and the length of time needed to evacuate victims affect the mortality and morbidity rates. The roles of physicians, general practitioners, specialist doctors, and nurses are also vital in the first hour after the earthquake to prevent the conditions of victims from worsening. In such situations, anesthesia techniques can be applied in earthquake victims include general and regional anesthesia. Regional anesthesia techniques were widely used because of several advantages, such as safety in the context of unknown patient history, a shorter period of anesthesia recovery and ICU use, minimized use of oxygen and other postoperative treatments, and the ability to reduce postoperative pain.
This research was conducted to describe the conditions of Lombok earthquake victims managed by the RSUD NTB, especially to describe the anesthetic techniques used to treat the earthquake victims. The current study was a descriptive cross-sectional study. The data were collected from the anesthesia record of all earthquake victims treated at the emergency room (ER) of the RSUD NTB on August 6th and 7th, 2018. In addition, the samples took from all victims who underwent Surgery from August 5th – 25th, 2018. Therefore, the study used total sampling, and the anesthesiologists on duty validated the data during the surgery.
The study concluded that the majority used regional anesthesia drugs were hyperbaric lidocaine and Clonidine. The management of earthquake victims on Lombok Island found that the role of anesthesiologists during a disaster is essential in achieving safe and optimal surgical conditions. However, the limited number of anesthesiologists in developing countries should be considered for optimal anesthesia techniques so that disaster preparation and disaster management can proceed well.
Authors: Moses Glorino Rumambo Pandin
Link: The Anesthetic Techniques for Earthquake Victims in Indonesia
