1376. Collegiate Neurosurgery in disaster and mass medical emergencies: lessons learned from Mexico

Authors: Ivan Segura Duran; Rodrigo Ramos-Zuñiga, MD, PhD; José Rodrigo Arellano-Contreras, MD; Jorge Alejandro Rochin-Mozqueda, MD; José Alberto Plascencia-Jiménez, MD (Guadalajara Jalisco, Mexico)

Introduction: In the morning of September 19th, 2017 a 7.1 earthquake stroke Mexico City an four other cities, leaving around 19 million people affected and 331 deaths. Although the medical response was timely, most of the efforts fell short because demand exceeded responsiveness. About neurosurgical lesions, previous reports from the Van earthquake on 2011 showed that the most common injuries were spinal fractures and spinal cord injuries, scalp injuries like depressed skull fractures, and cerebral hemorrhages. The aim of this study is to make an analysis of how we respond to these medical emergencies and which new strategies have been proposed. Methods: We searched all the information in both official institutional and social media with a public sanitary scope. We submitted this information to a descriptive qualitative analysis and compared with official information and management. Results: The more used means to communicate general information, regarding guidelines, strategies, advice and instructions to attend the emergency on a greater scale was twitter, where the civil population had the initiative to use the key word #earthquakemexico; in comparison personal emergency communication was conducted mainly via WhatsApp. Collegiate medical institutions, specifically Neurosurgeons, which did not participate actively on their official media or any other social media, ended having an almost inexistent on site direct actions during the emergency. Conclusion: The participation of social leaders and qualified personnel providing support and advice in massive medical emergencies and disasters is feasible if done in an organized manner, meeting basic criteria of organization, guidelines and algorithms of management . Their early intervention in the classification, triage and initial management will result in a more expeditious and efficient medical care and reducing the time taken in the referral of the patient to hospitals with space and capacity to provide the definitive specialized treatment required.