DISASTER MANAGEMENT AT TEACHING HOSPITAL BATTICALOA DURING THE EASTER SUNDAY ATTACK
21st of April 2019 was an unfortunate day for all Sri Lankans and Batticaloa once again received the mass casualties following a brutal terrorist attack. During the 30 year war which ended in 2009 such events were very common. 2004 Tsunami was another tragedy which bought mass casualties. Although we rehearsed several times at the Emergency Department in the recent past, the real emergency of a mass casualty broke in yesterday ( 21/ 04/2019 )
The explosion at the Zion church happened around 8.50 am. Since this place is less than a kilometer away from the Hospital, Dead bodies and injured patients were bought immediately. The time for the preparation at the Accident and Emergency was very minimal. It took some time for us to realize that it is a bomb blast. Initial stories were Gas explosions or Transformer explosion because the first admission came with a burn.
The triage at the A and E was led by Dr.T.R.Nimalaranjan (Consultant Surgeon) who was on call along with the two Consultant Anaestetists namely Dr.S.Mathanalagan and Dr.Yogananth. Although it was a Sunday following a long weekend holiday the hospital authorities were able to brought enough doctors, nurses and other health staff within an hour. When I arrived at the A and E , I was surprised to see that each patient is attended by at least one doctor and two nurses.
There were a total of 69 admissions. Majority was having penetrating shrapnel injuries and some had flash burn in addition. 04 patients died in the R room due to inevitable injuries to head, chest and abdomen in spite of resuscitation. Out of this four, three were children which was very heartbreaking. Another 26 dead bodies were also bought but they were triaged out. All 03 operating theatres at the A and E, the ENT theatre and a routine theatre were opened immediately for operating (5 tables). 02 Emergency Laparotomies, One Thoracotomy, Few Neck explorations, Fasciotomies, and many compound fracture cleaning were some of the immediate procedures we did. One child needed a clavicle division to ligate a laceration on subclavian vein. Two patients were transferred to TH Kandy and TH Anuradhapura for Neurosurgical care. Two children had evisceration of eyes due to penetrating injuries.
Existing patients in the Intensive Care Units were transferred out to ICUs at DGH Ampara to clear Emergency beds. Dr.V.Jeevathas (Consultant ENT surgeon), Dr.N.Jayaratne (Consultant Orthopaedic surgeon), Dr.A.Madushanka(Consultant OMF surgeon), Dr.W.Wijayasiriwardana (Consultant eye surgeon) and Dr.R.Ramesh (Consultant Physician) did their maximum to safeguard the lives of this unfortunate. I was surprised to see Dr.Salakianathan, who is a Senior Consultant Surgeon at United Kingdom and a member of the CSSL came in to do a Neck exploration.
I should not forget the services by Dr.Anton Swarnan (Senior Registrar, NHSL ) , Surgical Registrars Dr.Harikrishanth, Dr.Kokulan, Dr.Kovoor, Dr.Pakeerathan, Dr.Arulprasanth, Dr.Sivakaran and Dr.Kalaventhan. Some of them are not working at the TH Batticaloa but were on holiday with their families and quickly responded to the emergency call. Dr.Kalaranjini, Director TH Batticaloa coordinated all the activities with no time for preparation.
Although it’s an unfortunate event and should never happen in this country again, it gives a feedback for our performances. The importance of continuous updates on ATLS and NTMC courses for all surgeons in this country became very obvious on this day.
Thank you
Dr.S.Branavan
Consultant General Surgeon
Council Member ( Eastern Chapter)
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