Prehospital and Disaster Medicine http://pdm.medicine.wisc.edu Vol. 21, No. 5 ORIGINAL RESEARCH 1. Baqiyatallah Military Health Research Center, Mollasardra, Vanak, Tehran, Iran 2. Iranian Blood Transfusion Organization 3. Iranian Pediatrics Hematology and Oncology Sosciety, Tehran, Iran 4. Johns Hopkins Medical Institutions and John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii USA Correspondence: Mohammad Hadi Radfar Iranian Pediatrics Hematology and Oncology Society No. 32 Shahed Alley Vesal Street Kesharvarz Boulevard Tehran, Iran E-mail: mhadirad@yahoo.com Keywords: earthquake; fasciotomy; injury; pediatrics; tertiary care Abbreviations: None. Received: 19 October 2005 Accepted: 27 January 2006 Web publication: 12 October 2006 Pediatric Trauma at Tertiary-Level Hospitals in the Aftermath of the Bam, Iran Earthquake Marzieh Sabzehchian, MD; 1 Hassan Abolghasemi, MD; 2 Mohammad Hadi Radfar, MD; 3 Nematollah Jonaidi-Jafari, MD; 1 Houman Ghasemzadeh, MD; 3 Frederick M. Burkle, Jr., MD, MPH, FAAP, FACEP 4 Introduction On the morning of 26 December 2003, a major earthquake measuring 6.5 on the Richter scale struck the city of Bam in the Province of Kerman, Iran. 1 The earthquake left >40,000 dead, 30,000 injured, and left approximately 75,000 per- sons homeless. 1,2 Within 48 hours of the Earthquake, >12,000 injured patients were airlifted to several hospitals throughout Iran. 1 Few studies specifically addressed the clinical features of traumatized chil- dren during disasters caused by natural hazards. 3 Recognizing that children are one of the most vulnerable age groups during disasters, this event provid- ed an opportunity to investigate the characteristics of earthquake-induced physical and psychological injuries among children. This study reviews clini- cal features and laboratory data of children admitted to three tertiary-level hospi- tals in Tehran, and assesses their capacity and capability to manage such injuries. Methods This research was conducted in three tertiary-level referral hospitals in Tehran (Imam Hossein, Milad, and Baqiyatallah hospitals). A total of 119 injured children (<16 years of age) were hospitalized within one week of the Bam Earthquake. Primary care physicians were recruited to conduct physical examinations and review medical records. Questionnaire data were collected on: (1) age; (2) sex; (3) location at the time of injury; (4) type of injury; (5) on- scene treatment; (6) initial hospital care (operative/non-operative); (7) fascioto- my performed; and (8) blood transfusion. Patients were disaggregated for age: (1) <6 years; (2) 6–10 years of age; and (3) 11–16 years of age. Injuries were clas- sified as: (1) extremity injuries; (2) chest and/or abdomen injuries; and (3) head and/or spinal column injuries. Extremity injuries were categorized further as soft tissue and bone/joint injuries. Operative care categorization included: (1) orthopedic surgery (operations performed for fractures, dislocations, tendon injuries, and amputations); (2) general surgery (included soft tissue debride- ment, laceration repair, deep wound repair, wound infections, abscesses, vas- cular injuries, neural injuries, and repair of thoracic and abdominal injuries); and (3) neurosurgery (all head and spinal column operations). Patients with mul- Abstract The Bam Earthquake caused one of the most destructive disasters from naturally occurring hazards in recent years. Children are one of the most vulnerable age groups during disasters, in terms of both physical and psychological injuries. The assessment of pedatric injuries in the aftermath of the Bam Earthquake is dis- cussed is this article. Within one week of the Earthquake, 119 patients <16 years of age were admitted to three tertiary-level referral hospitals in Tehran, Iran. Extremity, chest, and abdomen, and head and spinal column injuries were present in 83, 17, and 36 patients, respectively. Lower extremity injuries were more com- mon than upper extremity injuries. A total of 65 operations were performed: 52 (80%) orthopedic, eight (12.3%) general, and five (7.7%) neurosurgical. Sabzehchian M, Abolghasemi H, Radfar MH, Jonaidi-Jafari N, Ghasemzadeh H, Burkle FM: Pediatric trauma at tertiary-levels hospital in the aftermath of the Bam, Iran earthquake. Prehosp Disaster Med 2006;21(5):336–339.