Pre-hospital fluid resuscitation and return of spontaneous circulation in earthquake victims with cardiac arrest during the first 24 hours after the 2023 Kahramanmaraş earthquakes: Implications for disaster risk management.
5 affiliations
- 1Department of Emergency Medicine, Mersin Provincial Health Directorate, Mersin-Türkiye.
- 2Department of Emergency Medicine, Mersin City Hospital, Mersin-Türkiye.
- 3Department of Family Medicine, Adanalıoğlu Sabiha Can Family Health Center, Mersin-Türkiye.
- 4Department of Emergency Medicine, Canakkale Mehmet Akif Ersoy State Hospital, Çanakkale-Türkiye.
- 5Department of Emergency Medicine, Ministry of Healthy Başaksehir Cam and Sakura State Hospital, İstanbul-Türkiye.
Abstract
Background
Earthquakes can cause crush injuries and post-extrication deaths. Hyperkalemia, metabolic acidosis, hypovolemia, and circulatory failure are key mechanisms of cardiac arrest in victims at risk of crush syndrome. Although intravenous fluid resuscitation is recommended in disaster care, evidence on resuscitation outcomes remains limited. This study evaluated earthquake victims with cardiac arrest during the first 24 h after the 2023 Kahramanmaraş earthquakes and examined the association between pre-hospital fluid resuscitation, admission metabolic parameters, and return of spontaneous circulation (ROSC).Methods
This single-center retrospective study was conducted in the emergency department of a tertiary hospital in Mersin, Türkiye. Adult earthquake victims admitted within the first 24 h who developed cardiac arrest before or after emergency department arrival were included. Patients with fatal head, thoracic, or abdominal injuries or missing data were excluded. Initial admission blood gas values were analyzed. The primary outcome was ROSC.Results
Thirty-seven patients were included. The mean age was 49.30±18.63 years, and 20 patients (54.1%) were female. Pre-hospital fluid resuscitation was administered to 25 patients (67.6%), with a mean volume of 1540±611 mL. Patients receiving fluids had higher pH and lower lactate, potassium, and base excess values. ROSC occurred in 10 patients (27.0%), all of whom had received fluids (p=0.010).Conclusion
Pre-hospital fluid resuscitation was associated with a more favorable metabolic profile and higher ROSC rates in earthquake-related cardiac arrest. These findings support field-based fluid resuscitation and hyperkalemia management in disaster response planning; however, causality cannot be inferred.
Related
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- Posttraumatic Stress Symptoms and Related Factors Among Healthcare Workers in the Third Year After Kahramanmaraş Earthquakes
- A qualitative SWOT analysis of hospital medical service managers’ experiences during the 2023 Kahramanmaraş earthquakes
- Secondary traumatic stress and psychological distress among responders to the 2023 Kahramanmaraş earthquakes: a systematic review and meta-analysis
BibTeX
@article{erinmez2026prehospital,
title = {{Pre-hospital fluid resuscitation and return of spontaneous circulation in earthquake victims with cardiac arrest during the first 24 hours after the 2023 Kahramanmaraş earthquakes: Implications for disaster risk management.}},
author = {Muhammet Ali Erinmez and Kemal Şener and Gökhan Kaya and Rasit Baysal and Rojhat Kurt and Inan Beydilli and Tamer Colak and Adem Cakir and Ertugrul Altug},
journal = {Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma \& emergency surgery : TJTES},
year = {2026},
month = oct,
doi = {10.14744/tjtes.2026.25267},
url = {https://europepmc.org/article/MED/42841901},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Pre-hospital fluid resuscitation and return of spontaneous circulation in earthquake victims with cardiac arrest during the first 24 hours after the 2023 Kahramanmaraş earthquakes: Implications for disaster risk management.
AU - Muhammet Ali Erinmez
AU - Kemal Şener
AU - Gökhan Kaya
AU - Rasit Baysal
AU - Rojhat Kurt
AU - Inan Beydilli
AU - Tamer Colak
AU - Adem Cakir
AU - Ertugrul Altug
PY - 2026
DA - 2026/10/01
JO - Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
DO - 10.14744/tjtes.2026.25267
UR - https://europepmc.org/article/MED/42841901
AB - Background Earthquakes can cause crush injuries and post-extrication deaths. Hyperkalemia, metabolic acidosis, hypovolemia, and circulatory failure are key mechanisms of cardiac arrest in victims at risk of crush syndrome. Although intravenous fluid resuscitation is recommended in disaster care, evidence on resuscitation outcomes remains limited. This study evaluated earthquake victims with cardiac arrest during the first 24 h after the 2023 Kahramanmaraş earthquakes and examined the association between pre-hospital fluid resuscitation, admission metabolic parameters, and return of spontaneous circulation (ROSC).Methods This single-center retrospective study was conducted in the emergency department of a tertiary hospital in Mersin, Türkiye. Adult earthquake victims admitted within the first 24 h who developed cardiac arrest before or after emergency department arrival were included. Patients with fatal head, thoracic, or abdominal injuries or missing data were excluded. Initial admission blood gas values were analyzed. The primary outcome was ROSC.Results Thirty-seven patients were included. The mean age was 49.30±18.63 years, and 20 patients (54.1%) were female. Pre-hospital fluid resuscitation was administered to 25 patients (67.6%), with a mean volume of 1540±611 mL. Patients receiving fluids had higher pH and lower lactate, potassium, and base excess values. ROSC occurred in 10 patients (27.0%), all of whom had received fluids (p=0.010).Conclusion Pre-hospital fluid resuscitation was associated with a more favorable metabolic profile and higher ROSC rates in earthquake-related cardiac arrest. These findings support field-based fluid resuscitation and hyperkalemia management in disaster response planning; however, causality cannot be inferred.
SN - 1306-696X
SN - 1307-7945
ER -