Publication:

Clinical profile of a firework disaster in Kerala: lessons learnt

Background This study is based on the tragic firework accident, with the highest death toll in India, that occurred in Puttingal Devi Temple, Kollam District, Kerala, at 3.30 am on 10/04/2016.  Around 1500 people were injured. On the spot death toll was 109 and 12 others died in hospitals later. 1039 were treated as OP case and 410 as inpatients in various secondary and tertiary care hospitals in Kollam and Thiruvananthapuram with the help of the team of experts from AIIMS, Delhi. The aim was to study the clinical profile of inpatients admitted with trauma and/or burns following the incident and to formulate a Medical action- plan of in such eventualities.

Methods The present study is descriptive in nature with study setting in secondary and tertiary care hospitals in Kollam and Thiruvananthapuram districts. The study subjects were all the inpatient victims of the firework tragedy. The study method used analysis of relevant patient details collected from hospitals records.

Results 410 inpatients of various hospitals were analysed.  Majority of the victims were males. (95.6%) Major age group affected is 20-50 years (66.1%). 79.5% of patients were treated in wards and 20.5% in various ICUs. 54.4% in secondary care centres and 45.6% in tertiary care centres.  78.2% of patients had traumatic injuries alone, 19.8% had trauma and burn injuries and 2% had burn injuries alone. 37.3% had major injuries, 21.5% had multiple fractures and 39.1% had minor injuries. 29% of patients had to undergo various surgeries. Hospital stay -76.4% of patients <2 weeks, 16.6% 2-4 weeks and 7.1% more than 30 days. Outcome: 70.7% were completely cured, 21.5% had temporary disability, 4.9% developed permanent disability. Mortality was 2.9%.

Conclusions Dedicated team work and inter-disciplinary care at Secondary and tertiary care centres of Kollam and Trivandrum districts with the timely help of medical team from Delhi has brought down the mortality rate to 2.9% in a major firework disaster with 1500 victims, which is comparable with the international standards.