Radiologists in Türkiye describe the consequences of the earthquakes that occurred in 2023

Radiologists in Turkey describe the events of the first 24 hours in the radiology unit after two major earthquakes devastated the country on February 6, 2023, and provide details of the imaging tests performed.

The first quake struck at 4:17 a.m., according to Dr. Mehtap Ilgar of Ankara Etlik City Hospital in Ankara and Dr. Nurullah Dag of Malatya Training and Research Hospital, a major trauma center 50 miles from the epicenter. There was only one radiologist and seven radiology technicians on duty at the time.

“Within half an hour, the number of patients increased, and all available radiology staff were called to perform emergency duties,” the authors wrote in an article published Aug. 22 in the journal Computed Tomography.

The epicenter of the second quake was about 80 miles away and occurred at 1:24 p.m. local time. The authors wrote that radiology staff who were home during the first quake were worried about their families. Meanwhile, aftershocks continued, increasing anxiety and fear that the building might collapse.

“The second earthquake shows that worst-case scenarios should always be taken into account when planning for disasters,” the authors wrote.

More than 50,000 people were killed and more than 100,000 were injured in the earthquakes. Over the course of 24 hours, the unit in Malatya scanned 596 patients. Five X-ray units, two 128-detector CT units, one 16-detector CT unit and portable ultrasound machines were available.

Despite the power outage, generators remained running and imaging equipment was working, the authors wrote. They had the advantage that X-ray and CT scanners were located on the ground floor, where some of the elevators were damaged. In addition, large aftershocks made using the elevators risky, they wrote.

Number of affected patients by region. Images are available for republishing under a Creative Commons license (CC BY 4.0 DEED, Attribution 4.0 International) and with permission from Tomography.

Ultrasound and CT reports were handwritten on paper or verbally transmitted by radiologists to face-to-face physicians in the emergency department. Within the first six hours, ultrasound was the most useful and accessible medium, yet there were no suitable computers nearby where radiologists could enter these reports, they noted.

Overall, 437 (73.3%) of the 596 patients underwent CT scans, the vast majority of which were whole-body CT scans without contrast unless clinically indicated. The most commonly affected areas were the chest, vertebrae, and extremities.

Bruising was more common in patients with chest symptoms. Bruising was seen in 35 patients (67.3%), rib fractures in 21 (40.4%), pneumothorax in 20 (38.5%), hematoma in 18 (34.6%), and laceration in three (5.8%). Multiple chest symptoms were seen together in 26 patients (50%).

Fractures were the most common finding. Of the 160 patients with satisfactory findings, 139 (86.9%) had evidence of fracture. Fractures were observed in a single bone in 84 (60.4%) and in more than one bone in 55 (39.6%). The fibula, femur, and tibia were the most commonly fractured bones.

“When developing disaster preparedness plans, radiology departments should be actively involved to ensure their rapid and effective operation,” the authors concluded.

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