ABSTRACT
BACKGROUND: On 8 October 2005, an earthquake measuring 7.6 on the Richter Scale struck the Himalayan region of Kashmir and Hazara divisions, killing an estimated 73,000 people. Soon after, a situation and response analysis of the emergency blood transfusion services was carried out in the affected areas to ascertain specific needs and suggest appropriate measures to assist in the disaster plan. METHOD: A semistructured questionnaire, complete with a checklist and participatory observation method, was used to collect data between 12 and 20 October 2005. Study sites were Abbotabad, Mansehra and Muzzafarabad in Pakistan, and interviewees were surgeons and blood bank personnel. RESULTS: Of the seven major hospitals in the area, 3 (43%) had a functional blood transfusion service. Although supply of voluntary blood was abundant, shortage of individual blood groups was noted at each centre. Quality assurance standards were either non-existent or inadequate. Only three blood banks had refrigerators, but with limited storage capacities. A complete breakdown of infrastructure coupled with frequent power failures posed a serious threat to safety of the blood. The continued aftershocks added to the problems. Although initial estimates of blood requirement were high, actual demand noted later was much lower. DISCUSSION: Timely establishment of blood banks in disaster areas, is a challenging task. Mobile blood banks can be advantageous in such situations. Organisation at a national level for blood transfusion services and development of a minimum standard of quality assurance in normal times should ensure safe emergency blood transfusion services when disaster strikes.
Subject(s)
Blood Transfusion/statistics & numerical data , Developing Countries , Disasters , Emergency Medical Services/statistics & numerical data , Blood Banks , Blood Donors , Emergencies , Humans , Needs Assessment , Pakistan , Quality ControlABSTRACT
The case report is presented of a patient with West Nile virus infection and ventilator dependent respiratory failure in whom bilateral diaphragmatic paralysis developed. If the prevalence of West Nile virus infection continues to rise, recognition of diaphragmatic paralysis and related respiratory complications will become increasingly important to the pulmonary/critical care physician.
