Prehospital and Disaster Medicine

Comprehensive Review

Prehospital Management of Earthquake Casualties Buried Under Rubble

Itamar Ashkenazia1 c1, Boris Isakovicha2, Yoram Klugera3, Ricardo Alficia1, Boris Kessela1 and Ori S. Bettera4

a1 Surgery B/Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel

a2 Intensive Care Unit, Hillel Yaffe Medical Center, Hadera, Israel

a3 Surgery B, Rambam Medical Center, Haifa, Israel

a4 Supported by the Michael and Helen Schaffer Fund for research in Military Medicine


Earthquakes continue to exact a heavy toll on life, injury, and loss of property. Survival of casualties extricated from under the rubble depends upon early medical interventions by emergency teams on site. The objective of this paper is to review the pertinent literature and to analyze the information as a practical guideline for the medical management of casualties accidentally buried alive.

(Received August 30 2004)

(Accepted November 16 2004)

(Revised December 13 2004)


c1 Department of Surgery B, Hillel Yaffe Medical Center, POB 169, Hadera 38100, Israel E-mail: or

Ashkenazi I, Isakovich B, Kluger Y, Alfici R, Kessel B, Better OS: Prehospital management of earthquake casualties buried under rubble. Prehosp Disast Med 2005;20(2):122–133.