FED: Pass the pliers, surgeons at work!

AAP General News (Australia)
12-13-1998
FED: Pass the pliers, surgeons at work!

By Rada Rouse, National Medical Correspondent

BRISBANE, Dec 13 AAP - Surgeons used fruit juice bottles filled with sand as makeshift
traction weights and identified their patients with baggage tags in the traumatic aftermath of
the Papua New Guinea tsunami.

The resourcefulness of Australian civilian and defence medical personnel is revealed in
accounts of the Aitape disaster in the latest Medical Journal of Australia.

Paediatric orthopaedic surgeon Annette Holian, from Melbournes Monash Medical Centre,
reports that fruit juice bottles filled with sand were used as weights for a young girl
requiring traction for injuries to the pelvis.

Dr Holian was part of a team which performed 134 surgical procedures and treated 50 more
injuries in 15 days.

The shortage of equipment was a constant concern, and despite desperate attempts to get
more it was all "stalled in Customs, held up by transport companies, arrived incomplete or
just disappeared".

With limited orthopaedic tools, a local tradesman saved the day for patients needing pins
inserted in injured joints: the plumbers pliers and hammer were put to use, and the sharp
ends of the surgical pins were covered with rubber tubing from spearfishing slings.

Record keeping and accurate patient identification was a challenge with so many injuries.

"Before our arrival patients were identified by bed numbers....unfortunately, some beds now
had two numbers and other beds had two patients!" Dr Holian said.

"We identified our patients creatively using key tags, baggage labels and, later, arm
bands."

Many of the severely injured patients had spent days in salt water or mangrove swamps, some
with malaria, and wound infection and dying tissue was so bad that "surgical priority was
based largely on the intensity of odour".

In a separate account, Major Paul Taylor, officer in command of the Australian Defence
Force medical team, describes the frantic airlift from the disaster zone in which pilots, not
doctors, had to decide who to leave behind.

"In a desperate bid to maximise the evacuation airlift back to Vanimo, casualties had been
brought in piled on top of one another, with injured limbs lying at odd angles," he wrote.

"Placing the injured in splints and on stretchers would have greatly reduced the numbers
able to be evacuated."

On the first day after the ADF field hospital had been set up, 124 patients arrived,
requiring 39 operations.

"By days end we had 76 patients in a 20-bed facility," he recalls.

AAP rr/it

KEYWORD: TSUNAMI

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