Break a leg in front of the hospital? Super minor.
Break a leg 40 miles from the nearest road? Extremely serious.
Mud, especially with huge numbers of people, has a way of turning the former situation into the latter situation rather quickly.
Also who’s being breathless? The article didn’t mention FEMA.
A couple miles of hard-to-navigate terrain and a bit of hubris is plenty to kill someone.
No one is asking to fly in the military here or something. People are observing: “oh, that seems like a risky situation that could go very south very quickly.”
One advantage of everything being deep intractable mud - mud is soft! So less chance of compound fractures from a fall at least.
Though vehicle recovery is going to be epic. And that is a good way to break/kill people if not done very carefully.
I’ve seen (very expensive) vehicles end up completely destroyed and abandoned when someone wandered a bit too far out into a surprisingly wet/soft lakebed (around Ballarat/Trona - I can still see it on Google Maps, and it got stuck well over 20 years ago!), so I imagine we’ll have plenty of stories of drama to snack on popcorn over when this is all said and done.
-- when prompt attention is available.
falls are not the only cause of bone fracture.
Otherwise us humans would have a MUCH lower survival rate than we already do out in the wild.
Or as the paper notes “The etiology may be traumatic or, rarely, nontraumatic.”
Non-compound fractures can still cause serious issues if complicated somehow, or even long term loss of function of course if they aren’t set correctly, among other less than ideal chronic issues, which should be done ASAP.
But it’s not like someone is likely to die (or even suffer serious long term issues) from an uncomplicated ulnar fracture if they don’t get to the ER within a few days, for instance.
The amount of water I’m seeing come down in the Truckee area right now sure is epic though, so no question they are in for a ride!
nope. there is no prompt attention in the current situation
as noted in the paper incidence of fat embolism approaches 30%
many undiagnosed incidence are discovered post mortem.
you are attempting to minimize a dangerous situation.
===========
>> EPIDEMIOLOGY
The incidence of FES ranges from < 1 to 29% in different studies. It varies considerably according to the cause. The actual incidence of FES is not known, as mild cases often go unnoticed.
Bulger et al.,[3] in their retrospective study, reported an incidence of < 1%, while Fabian et al. in their prospective study, reported an incidence of 11–29%.[4] Surprisingly, the incidence was 0.9% when only clinical criteria were used to diagnose FES, whereas with the aid of postmortem examination the incidence was as high as 20%.[2] <<
2. Georgopoulos D, Bouros D. Fat embolism syndrome clinical examination is still the preferable diagnostic method. Chest. 2003;123:982–3.
3. Bulger EM, Smith DG, Maier RV, Jurkovich GJ. Fat embolism syndrome: A 10 years review. Arch Surg. 1997;132:435–9.
4. Fabian TC, Hoots AV, Stanford DS, Patterson CR, Mangiante EC. Fat embolism syndrome, prospective evaluation in 92 fractured patients. Crit Care Med. 1990;18:42–6.
The folks seeing higher rates are seeing them because their samples are coming from data sets with specific trauma backgrounds. Which is not surprising. If you look at postmortem results for people who died with broken bones, those folks all had severe issues! They died.
Probably none of them caused by getting their arm slammed in a car door, for example. Most likely caused by long falls off ladders, or car accidents, or industrial accidents, or getting beaten to death, or shot, or any number of traumatic events.
If you look at a dataset of all broken bones (which will be difficult to do frankly, as 90% of them won’t even show up in a database as they’ll be handled in an outpatient setting), the numbers will look wildly different.
In this situation if it was serious they’d just get medivac’d then. Which is not going to be difficult in this situation. If someone gets hit/run over with a vehicle, or hit by machinery, or has a giant pile of lumber collapse on them, or whatever, it’s not like anyone is going to tell them ‘oops, nothing we can do!’.
It’s mud. It makes walking and driving difficult. It isn’t going to make it hard for a helicopter with a decent pilot, especially with a helpful ground team. Reno has a very good medical center (several, actually).
there we go, good one.