Undergraduate dental students and their potential role in disaster victim identification procedures: A scoping review under a Chilean perspective.

BACKGROUND: A mass fatality incident is an unexpected event that can cause the death of many people, which has motivated careful analysis and development of appropriate strategies for planning and response with all available resources. As these events involve multiple victims, their identities must be confirmed using the highest possible quality standards. Forensic Odontology (FO) has proven to be a scientific resource for disaster victim identification (DVI) procedures; however, it is highly dependent on the proper management not only of material resources but also of human resources. Chile is a country recognised as prone to natural disasters, but an insufficient number of forensic odontologists has been reported. The aim of the study was to review the literature on a dental undergraduate (UG) student's potential value in a DVI process. METHODOLOGY: A scoping review was performed using a specific search strategy in PubMed/Medline, Web of Science, Scopus, SciELO and EBSCO databases. RESULTS: The search identified 27 articles in which the basic dental degree, the necessary training and the need for human resources are variables considered in different priorities by those articles. DISCUSSION: It is vital to assess the local needs of Chile based on its UGs, considering that FO is an underestimated resource that should be included early on in dental curriculums. Furthermore, it should align with public policies to ensure viability and inclusion in standardised protocols. CONCLUSION: Although there is "potential" usage of UG dental students in DVI is not ideal, circumstances will dictate their use. The better trained they are as students, the more valuable their "potential" contribution will be.

A disaster victim identification workshop focused on forensic odontology using embalmed human remains.

A high number of victims of mass casualty incidences are identified through their teeth. While forensic odontologists need to have a complex skillset during a disaster victim identification (DVI) response, hands-on training opportunities are rare. In countries with very limited forensic casework, such as New Zealand, many forensic odontologists find it difficult to achieve the number of annual forensic dental identifications required to maintain their credentialling. This report details the development of a hands-on forensic odontology-focused DVI workshop using human Crosado-embalmed remains. Anonymous participant evaluations, including five-point Likert and open-ended items, were performed in both years the workshop was held. A total of 10 and 17 participants, predominantly dentists, attended the workshop in 2020 and 2021, respectively. Participant feedback was extremely positive. Likert items were statistically similar between participants in both years. Open-ended items revealed positive feedback regarding the use of cadaveric remains, the gained hands-on experience, or the teamwork aspect. Participants who attended the workshop in both years commented on the positive aspect of repetition to cement their skills. As areas of improvement, participants named (for example) time management and the number of portable X-ray devices, leading to changes that were implemented in 2021. Moreover, the participants expressed interest to further their skills on decomposed, burnt, and fragmented human remains, which for ethical reasons has yet to be implemented. The DVI workshop described here, using embalmed human remains, provides an opportunity to add dental identifications toward annual credentialling requirements for forensic odontologists. Participants rated the course to be excellent overall and highly relevant for their role. For future workshops, there is an interest to include further aspects of the DVI response such as fingerprinting or police work as well as remains, which are altered due to natural or physical reasons.

An in-field evaluation of rapid DNA instruments for disaster victim identification.

In 2019 and 2020, disaster victim identification (DVI) simulations were conducted at the Australian Facility for Taphonomic Experimental Research. Whole and fragmented cadavers were positioned to replicate a building collapse scenario and left to decompose for up to 4 weeks. This study evaluated the utility of the ANDE™ 6C Rapid DNA System and the RapidHITTM ID System for DVI in the field and mortuary. Applying post-mortem nail and tissue biopsy samples showed promise, with the added benefit of minimally invasive collection procedures and limited preparation requirements. The preferred platform will depend on a number of factors, including its intended use and operating environment.

New Method of Dental Personal Identification of Disaster Victims Using Oral Scanner.

Dentistry plays an important role in the identification of victims in large-scale disasters. The current poor status of and problems with victim identification work were highlighted in the aftermath of the Great East Japan Earthquake of March 11, 2011, in which some 10,000 people lost their lives. The techniques of dental identification therefore need to be improved if they are to cope with the problems associated with identification that will accompany the predicted Tokai earthquake and other unexpected large-scale disasters in the future. The purpose of this study was to determine the effectiveness of applying a digital impression-taking device employed in regular dental care to dental personal identification. The Trophy 3DI pro (Yoshida Dental) was applied to a total of 150 dental models. The diagnosis was accurate in 2,096 teeth from a sample of 2,100 comprising 1,240 non-treated teeth, 670 treated teeth, and 190 missing teeth, yielding a 99.8% level of statistical precision. These results suggest that the level of accuracy offered by this impression-taking device indicates that it would be a useful tool in establishing personal identification in disaster victims.

Navigating Identity: The Intersection of Social and Biological Identity from the World War II Battle of Tarawa.

The 1943 Battle of Tarawa resulted in the loss of approximately 1,000 US service members on or around Betio Island, Tarawa Atoll, Republic of Kiribati. Nearly half these casualties were accounted for after the battle. The Defense POW/MIA Accounting Agency (DPAA) has worked to identify the remaining ∼510 unaccounted-for service members and has successfully identified ∼160 service members to date. Demographic data pulled from historical documentation of the US losses indicate a relatively homogeneous population (99% White, 81% 17-23 years of age, and only two individuals with a documented religious preference other than Protestant or Catholic). Using this demographic data as a framework, three case studies are presented to demonstrate how a holistic biosocial approach to building identity could facilitate forensic identifications. The temporal and sociocultural contextualization of analyses enables anthropologists to navigate inconsistencies between 21st-century and historical (1940s) social identity concepts to overcome challenges to identification. The case studies demonstrate how biological evidence, genetic evidence, and material evidence (material culture) differently contribute to the social identity of an individual and can impact identification efforts when analytical conclusions are incongruent with historical documentation. The first case of US Battle of Tarawa casualties examines how morphometric biological affinity assessments are biased by the fluidity of social identity concepts when complex morphological and metric indicators of biological affinity are not represented in historical race categories. The second case demonstrates how biogeographic genetic affinity predictions, through a discussion of the G2a4 haplogroup, need to be examined holistically in the context of other lines of evidence. The third case highlights how material evidence can further define social identity beyond physicality, genetic structure, and race. The challenges of interpreting identity from human remains, as highlighted through these examples, are commonly encountered by anthropologists working in disaster victim identification and other humanitarian contexts. Thus, it is imperative for anthropologists to be self-aware of implicit biases toward the current prevailing definitions of biological and social identity and to consider historical perceptions of identity when working in these contexts.

The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review.

The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.

Calling nurses to care for burn victims after color-dust explosion.

BACKGROUND: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse-patient relationships. AIM: This study aimed to understand the experience of nurses who cared for burn victims of the color-dust explosion and the meaning of ethical relationships between nurse and patient. RESEARCH DESIGN: A qualitative descriptive study using a phenomenological approach. PARTICIPANTS AND RESEARCH CONTEXT: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi's method. ETHICAL CONSIDERATIONS: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. FINDINGS: Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths. CONCLUSIONS: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient-nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving.

[Daily information-gathering behavior of natural disaster victims: Focusing on residents who experienced the Great East Japan Earthquake and the Kanto-Tohoku Heavy Rainfall Disaster].

Objectives　To obtain suggestions for improving disaster-prevention literacy, this study elucidated the daily information-gathering behavior of residents living in areas affected by two Japanese natural disasters (the Great East Japan Earthquake of 2011 and the Kanto-Tohoku Heavy Rainfall Disaster in September 2015) and examined factors affecting life backgrounds and disaster experiences.Methods　In June 2017, we administered a cross-sectional survey using a self-administered questionnaire to 1,065 households in areas affected by the Great East Japan Earthquake and the Kanto-Tohoku Heavy Rainfall. One person in each household responded to the questionnaire. Of 362 respondents (response rate 34.0%), 336 with definite attributes were analyzed. After ascertaining their daily information-gathering behavior, we applied binary logistic regression analysis, incorporating-as dependent variables-three variables previously used in times of disaster.Results　Of the respondents, 179 were men (53.3%); the average age (standard deviation) was 65.5 (10.6) years. Information-gathering modes used by more than half the subjects were "television," "newspaper," "conversation/word of mouth," "radio," and "community magazine" in descending order of use.　Examination of the factors of the three variables revealed the following. (1) Four variables were significantly and positively correlated with "conversation/word of mouth": "woman" (1.82 odds ratio [OR]; 1.05-3.15 95% confidence interval [CI]); "I have" a co-resident family member (OR, 2.46; 95% CI, 1.06-5.72); "I can expect" mutual aid from community residents (OR, 2.31; 95% CI, 1.27-4.21); and "I feel more" fear of typhoons and heavy rains now than before (OR, 1.82; 95% CI, 1.04-3.18). (2) "Radio" has two variables with significant and positive correlations: "I have" a co-resident family member (OR, 3.22; 95% CI, 1.35-7.67) and "I was affected" by the Great East Japan Earthquake and the Kanto-Tohoku Heavy Rainfall Disaster (OR, 1.73; 95% CI, 1.01.2.97). (3) Two variables are significantly correlated with "Internet service": "Age" has a negative correlation (OR, 0.91; 95% CI, 0.88-0.94); "I can expect" mutual aid from community residents has a positive correlation (OR, 2.66; 95% CI, 1.19-5.93).Conclusion　Damage and fear instilled by natural disasters influence subsequent information-gathering behavior. Disaster prevention literacy in ordinary times can be improved because of the correlation between awareness of mutual aid in local communities and information-gathering behavior.

[Falls and associated risk factors among elderly survivors of the Great East Japan Earthquake: RIAS Study].

Objective　An increasing incidence of disuse syndrome is commonly observed in areas affected by large-scale natural disasters. Consequently, the fall risk is high in such populations, necessitating adequate attention to fall prevention measures. It is important to identify factors associated with falls to prevent deterioration in functional ability. We investigated the risk factors associated with falls among elderly survivors in disaster-stricken areas using longitudinal data from the Research project for the prospective Investigation of health problems Among Survivors of the Great East Japan Earthquake (RIAS) Study.Methods　Of all data obtained from the RIAS Study, we used the data of 1,380 survivors who were aged ≥65 years, were not diagnosed with cancer or cardiovascular disease, did not need supportive care, and could participate in the annual survey between 2011 and 2016. Self-administered questionnaires were distributed, and anthropometric and grip tests were performed during the 2011 survey to obtain information regarding housing damage, the fear of falls, arthralgia, cognitive function psychological distress, insomnia, frequency of leaving the house, a history of hypertension, dyslipidemia, diabetes, alcohol consumption status, smoking status, and/or body mass index, and grip strength. Based on the responses obtained from each annual survey, a fall was defined as an event during which an individual had fallen at least once. Multivariate-adjusted odds ratio(OR) and 95% confidence interval(CI) for all variables related to falls were calculated using logistic regression with adjustment for sex and residential area. Similar analyses were performed based on age groups (65-74 years and ≥75 years).Results　The 5-year fall incidence rate was 35.5% (31.9% [men], 37.9% [women]). In men, cognitive dysfunction was significantly associated with falls (OR 1.50, 95%CI 1.01-2.22). In women, cognitive dysfunction (OR 1.82, 95%CI 1.34-2.47), insomnia (OR 1.41, 95%CI 1.02-1.94), dyslipidemia (OR 1.58, 95% 95% CI 1.11-2.25), and a history of smoking (OR 4.30, 95%CI 1.08-17.14) were significantly associated with falls. In women aged ≥75 years, partial housing damage (OR 7.93, 95%CI 1.85-33.91) and psychological distress (OR 2.83, 95%CI 1.09-.7.37) were also significantly associated with falls.Conclusion　This study suggests that cognitive dysfunction in both sexes and insomnia, dyslipidemia, and a history of smoking in women were significantly associated with falls, and partial housing damage and psychological distress were risk factors for falls in women aged ≥75 years. Fall prevention after large-scale natural disasters warrants close attention to known risk factors and environmental and mental health changes.

Baggage scanners and their use as an imaging resource in mass fatality incidents.

Disaster victim identification following a mass fatality incident is focussed on identifying the deceased and returning them to their families as quickly as possible, while gathering as much information as practical to aid investigators in establishing the cause of the incident. Ante-mortem data is gathered and compared with the post-mortem data obtained in order to positively identify the deceased. This paper presents results from a study concerned with the first part of the process of identifying the deceased-the triage or Primary Survey and how this can be done without access to hospital facilities such as conventional X-ray imaging or computed tomography. In particular, this study focuses on the imaging undertaken prior to the opening of the body bag by a multidisciplinary team, and how this imaging can assist particularly when forensic anthropologists are involved in the identification process. There are several advantages to imaging the body bags before they are opened and one of the most important is safety. Thus, this paper examines the viability of using a baggage scanner as a practical resource for X-ray imaging, as many regions worldwide may not be able to access conventional imaging equipment. Baggage scanners are readily available and found in airports and various government buildings. The baggage scanner is particularly suited to this task and produces images that can be used by forensic anthropologists to distinguish between human and non-human remains, identify items of evidence and personal effects, and even perform a preliminary or partial biological profile. When considering their response plans, emergency responders should consider including baggage scanners as a contingency for screening body bags if no other imaging system is available.

Remote post-mortem radiology reporting in disaster victim identification: experience gained in the 2017 Grenfell Tower disaster.

On 14 June 2017 at 00:54 h, the worst residential fire since the conclusion of the Second World War broke out in Flat 16, 4th floor of the 24-storey residential Grenfell Tower Block of flats, North Kensington, West London, UK. Seventy-one adults and children died, including one stillbirth. All victims of the Grenfell Tower disaster who died at the scene underwent post-mortem computed tomography (PMCT) imaging using a mortuary-sited mobile computed tomography scanner. For the first time, to the authors' knowledge, the disaster victim identification (DVI) radiology reporting was undertaken remote to the mortuary scanning. Over an 11-week period, 119 scans were undertaken on 16 days, with up to 18 scans a day. These were delivered to a remote reporting centre at Leicester on 13 days with between 2 and 20 scans arriving each day. Using a disaster-specific process pathway, a team of 4 reporters, with 3 support staff members, trialled a prototype INTERPOL DVI radiology reporting form and produced full radiology reports and supporting image datasets such that they were able to provide 96% of prototype DVI forms, 99% of image datasets and 86% of preliminary reports to the DVI teams in London within one working day of image receipt. This paper describes the first use of remote radiology reporting for DVI and exemplifies how remote PMCT reporting can be used to support a DVI process of this scale.

Identification of human remains using Rapid DNA analysis.

Rapid identification of human remains following mass casualty events is essential to bring closure to family members and friends of the victims. Unfortunately, disaster victim identification, missing persons identification, and forensic casework analysis are often complicated by sample degradation due to exposure to harsh environmental conditions. Following a mass disaster, forensic laboratories may be overwhelmed by the number of dissociated portions that require identification and reassociation or compromised by the event itself. The interval between the disaster and receipt of victim samples at a laboratory is critical in that sample quality deteriorates as the postmortem interval increases. When bodies decompose due to delay in collection, transport, and sample processing, DNA becomes progressively fragmented, adversely impacting identification. We have previously developed a fully automated, field-forward Rapid DNA identification system that produces STR profiles (also referred to as DNA IDs or DNA fingerprints) from buccal and crime scene samples. The system performs all sample processing and data interpretation in less than 2 h. Here, we present results on Rapid DNA identification performed on several tissue types (including buccal, muscle, liver, brain, tooth, and bone) from exposed human bodies placed above ground or stored in a morgue/cooler, two scenarios commonly encountered following mass disasters. We demonstrate that for exposed remains, buccal swabs are the sample of choice for up to 11 days exposure and bone and tooth samples generated excellent DNA IDs for the 1-year duration of the study. For refrigerated remains, all sample types generated excellent DNA IDs for the 3-month testing period.

Influence of post-disaster evacuation on incidence of hyperuricemia in residents of Fukushima Prefecture: the Fukushima Health Management Survey.

AIM: After the Great East Japan Earthquake, over 160,000 residents in Fukushima Prefecture were forced to evacuate the area around the Fukushima Daiichi power plant following nuclear accident there. Health problems in these evacuees have since become a major issue. We have examined the association between evacuation and incidence of hyperuricemia among residents in Fukushima. METHODS: We conducted a cohort study of residents aged 40-90 years without hyperuricemia at the time of the Fukushima disaster. Among 8173 residents who met the inclusion criteria before the disaster, 4789 residents (men: 1971, women: 2818; follow-up duration: 1.38 years; and follow-up rate: 58.6%) remained available for follow-up examinations at the end of March 2013. The main endpoint was incidence of hyperuricemia, defined by the Japanese committee guidelines, using local health data from before and after the disaster. We divided participants by evacuation status and compared outcomes between groups. Using a logistic regression model, we estimated the odds ratio for incidence of hyperuricemia, adjusting for potential confounders, age, gender, waist circumference, physical activity, and alcohol consumption. RESULTS: Incidence of hyperuricemia was higher in evacuees (men 10.1%; women 1.1%) than in non-evacuees (men 7.4%, women 1.0%). Evacuees had higher body mass index, waist circumference, triglycerides, LDL-cholesterol, fasting plasma glucose, HbA1c, and lower HDL-cholesterol after the disaster than non-evacuees. We found that evacuation was associated with incidence of hyperuricemia (adjusted odds ratio: 1.38; 95% confidence interval: 1.03-1.86). CONCLUSION: This is the first study to demonstrate an association between evacuation after a disaster and increased incidence of hyperuricemia.

Experiences of rural women with damages resulting from an earthquake in Iran: a qualitative study.

BACKGROUND: Women, with more vulnerabilities and less access to resources, are often seen as victims of natural disasters. Therefore, the present study aimed to investigate the experiences of rural women with damages resulting from an earthquake in Iran. METHODS: In this research, a qualitative approach, as well as the conventional content analysis was employed. The study population consisted of rural women residing in the earthquake-stricken areas of Sarpol-e Zahab and Salas-e Babajani counties in Kermanshah Province, Iran. Semi-structured interviews were used for data collection. Moreover, sampling was purposeful, theoretical saturation was achieved by conducting 22 interviews, and the data analysis process was performed according to the steps proposed by Graneheim and Lundman. For the strength and transferability of the research, Lincoln and Guba's Evaluative Criteria were used. RESULTS: There were seven categories regarding the experiences of rural women after the earthquakes including neglecting the health needs; tension in the family and marital relations; gender inequality in the provision of assistance; feeling insecure; ignoring the ruling culture of the region; concealing needs for fear of stigmatization, and incoherent mourning as well as two categories regarding their reactions to and interaction with the earthquake consequences including positive and negative interactions. CONCLUSIONS: Paying more attention to the needs of rural women, taking the culture governing the village into account at the time of service delivery, and helping them with positive adaptations are some indispensable measures that should be taken.

Quality healthcare in extreme adversity: Developing a framework for action.

Quality issue: Improving quality of care has become a global health priority to improve health outcomes and strengthen health systems, particularly in the context of achieving universal health coverage. Initial assessment: The delivery of quality essential health services in settings of extreme adversity, such as fragile, conflict-affected, vulnerable or disaster contexts, has been identified as a high priority globally to address the massive level of need. Choice of solution: This paper provides an action framework to systematically address the quality of health services for state and non-state actors working in such settings. The framework is designed to be practical, comprehensible and simple in adoption and implementation. It describes challenges, a set of medical needs and population priorities, a menu of quality-related interventions, and a hierarchy of health system levels defining the roles and responsibilities of key actors. Conclusion: Optimizing the use of limited resources in delivering the best quality possible in 'the hardest of the hard settings' is imperative.

Design and Progress of Oral Health Examinations in the Tohoku Medical Megabank Project.

In order to assess the long-term impact of the Great East Japan Earthquake on the oral health of disaster victims and to evaluate gene-environmental interactions in the development of major oral diseases and oral-systemic associations, the oral part of two large-scale genome cohort studies by the Tohoku Medical Megabank Organization (ToMMo), including the Community-based cohort (CommCohort) study and the Birth and Three-Generation cohort (BirThree) study, have been conducted. The study population comprised 32,185 subjects, including 16,886 participants in the CommCohort study and 15,299 participants in the BirThree cohort study, recruited from 2013 to 2017. The oral studies consist of a questionnaire regarding oral hygiene behavior, clinical examinations by dentists, and oral plaque and saliva sampling for microbiome analyses, which were carried out at seven community support centers in Miyagi prefecture. The median age of all participants was 55.0 years, and 66.1% of participants were women. Almost all participants reported that they brushed their teeth more than once a day. The median number of present teeth was 27.0, and the decayed, missing and filled tooth number was 16.0, with a significant difference according to age and sex. The median periodontal pocket and clinical attachment level was 2.48 mm and 4.00 mm, respectively. Periodontal parameters increased significantly according to age, except for the accumulation of dental calculus. The oral part of these extensive cross-sectional studies provides a unique and important platform for future studies on oral health and diseases that elicit through interactions with systemic diseases, lifestyles, life events and genetic backgrounds, and contributes to researches clarifying the long-term effects of disasters on oral health.

Nurses' experience of providing ethical care following an earthquake: A phenomenological study.

BACKGROUND: Ethical care provided by nurses to earthquake victims is one of the main subjects in nursing profession. OBJECTIVES: Given the information gap in this field, the present study is an attempt to explore the nurses' experience of ethical care provided to victims of an earthquake. RESEARCH DESIGN AND METHOD: A hermeneutic phenomenological study was performed. The participants were 16 nurses involved in providing care to the injured in Kermanshah earthquake, Iran. They were selected using purposeful sampling, and in-depth and semi-structured interviews were carried out. The transcribed interviews were analyzed based on the hermeneutic approach using the analysis method proposed by Diekelmann et al. ETHICAL CONSIDERATIONS: The study was approved by the Research Council and Ethics Committee of Urmia University of Medical Sciences, Iran. FINDINGS: Data analyses revealed four themes and 10 sub-themes that illustrated nurses' experience of ethical care during earthquake. The themes were (1) Respecting humanistic values (sacrifice, stepping beyond task description, and voluntary work), (2) Commitment to ethics (honesty, confidentiality, and trustworthiness), (3) Respecting dignity of victims (respecting cultural values, maintaining privacy, having humanistic perspective, and effective communication), and (4) Spiritual support (helping patients to do religious rituals Psychological support). CONCLUSION: The results showed the nurses' experience with providing care to earthquake victims. The findings underlined ethics and ethical values in providing nursing care during disasters. It is suggested that special courses on the importance of nursing ethics in critical situations be incorporated into nursing curriculums and in-service educations.

Tropical cyclone Fani-perspective from the trauma and emergency department of an affected tertiary hospital.

PURPOSE: To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster. METHODS: A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated. RESULTS: Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure. CONCLUSION: In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.