Hostname: page-component-84b7d79bbc-2l2gl Total loading time: 0 Render date: 2024-07-25T09:10:16.140Z Has data issue: false hasContentIssue false

A Computer Simulation of a California Casualty Collection Point Used to Respond to a Major Earthquake

Published online by Cambridge University Press:  28 June 2012

Gus A. Koehler*
Affiliation:
Program Research Specialist, Emergency Medical Services Authority, State of California, Health and Welfare Agency, Sacramento, Calif.
Dennis Foley
Affiliation:
Computer Science Department, University of California at Sacramento, Sacramento, Calif.
Michelle Jones
Affiliation:
Computer Science Department, University of California at Sacramento, Sacramento, Calif.
*
EMS Authority, California Health and Welfare Agency, 1930 9th Street, Suite 100, Sacramento, CA 95814USA

Abstract

Purpose:

Casualty Collection Points (CCPs) are sites predesignated by county officials for the congregation, triage, austere medical treatment, holding, and evacuation of casualties following a major disaster. A CCP (and the simulation) is made up of a series of discrete, interrelated steps that collectively result in medical care being provided to a casualty.

Methods:

A series of computer simulations was run comparing differences in personnel, supplies, and evacuation configuration for a jurisdiction that has plans in place to establish a CCP, and for one that does not. Each simulation was for 650 earthquake-related casualties.

Results:

Generally, it was found that: 1) mortality appears to be related directly to performance of triage of casualties and to where they are directed for care. The least injured did not need to be treated at a CCP; 2) survival is related directly to arrival time, mix of medical staff, and the ability to form “care teams” on-site; 3) the sudden, massive arrival of casualties will result in a “snowball” mortality effect if staff numbers are low or do not include the proper mix of training to form care teams well before the peak arrival time of casualties; 4) holding ambulances until they are filled completely before evacuation may increase mortality; 5) during the first four hours, more lives may be saved by using transportation assets to move medical staff and supplies to a CCP, if large numbers of casualties are expected to congregate there. Generally, the local jurisdiction must be prepared to mobilize a significant number of medical staff and supplies to a predesignated CCP within 4–6 hours after an event.

Conclusions:

The simulation produced useful information. In particular, local disaster response planners need to develop rapid response methods to ensure that the best combination of medical staff are available early to care for casualties.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Freeman, C, Haynes, B: Casualty Collection Point Guidelines: Preliminary Draft. California Emergency Medical Services Authority, 1989.Google Scholar
2. Casti, J: Alternate Realities: Mathematical Models of Nature and Man. New York: John Wiley and Sons, 1989.Google Scholar
3. Rosen, R: Fundamentals of Measurement and Representation of Natural Systems. New York: Elsevier, 1978.Google Scholar
4. Richards, P: Development of a Planning Methodology for the Medical Protection for European Civilian Populations in Time of War or Major Civil Disasters. Naval Research Laboratory, Washington, D.C., 1983.Google Scholar
5. Fletcher, J, Richards, P: Predicting the Effectiveness of Concepts for Future Marine Corps Medical Support Systems. Naval Research Laboratory, Washington, D.C., 1981.Google Scholar
6. Fletcher, J, Delfosse, C: Computer model for simulation of emergency medical systems. Military Medicine 1979;144:231235.CrossRefGoogle ScholarPubMed
7. Koehler, G: The earthquake medical disaster: Chaos, self-organization and the state emergency medical services response. Western Governmental Researcher, Fall 1991.Google Scholar
8. Jones, N, Noji, E, Smith, G, Krimgold, F: International Workshop on Earthquake Injury Epidemiology for Mitigation and Response. John Hopkins University, Baltimore, Maryland, July 10–11, 1989.Google Scholar
9. Shiono, K, Krimgold, F: A Computer Model for the Recovery of Trapped People in a Collapsed Building: Development of a Theoretical Framework and Direction for Future Data Collection. In Jones, N, Noji, E, Smith, G, Krimgold, F (eds), International Workshop on Earthquake Injury Epidemiology for Mitigation and Response. John Hopkins University, Baltimore, Maryland, July 10–11, 1989, pp 260296.Google Scholar
10. Reaveley, L: “Salt Lake City Schools: Estimates of Death and Injury During Seismic Ground Shaking.” Workshop on Modeling Earthquake Casualties for Planning and Response. Emergency Medical Services Authority, 1990.Google Scholar
11. Durkin, M, Thiel, C: “Integrating Earthquake Casualty and Loss Estimation.” Workshop on Modeling Earthquake Casualties for Planning and Response. Emergency Medical Services Authority, 1990.Google Scholar
12. Holmes, W: “A Structural View of Casualty Estimation.” Workshop on Modeling Earthquake Casualties for Planning and Response. Emergency Medical Services Authority, 1990.Google Scholar
13. Valenzuela, T, Criss, E: Computer modeling of emergency medical system performance. Ann Emerg Med 1990;19:80.CrossRefGoogle ScholarPubMed
14. Coburn, A, Pomonis, A, Sakai, S: “Assessing Strategies to Reduce Fatalities in Earthquakes.” In Jones, 1989.Google Scholar
15. Freeman, C, Moorhead, G: Santa Rosa Casualty Collection Point Demonstration Report to the Governor's Emergency Council and the Governor's Emergency Executive Operations Council. Emergency Medical Services Authority, 1987.Google Scholar
16. Brewer, Hall: Policy Analysis by Computer Simulation: The Need for Appraisal. Santa Monica, Calif.: The Rand Corporation, 1972, p 4893.Google Scholar
17. de Boer, J, Brismar, B, Eldar, R, et al. : The medical severity index of disaster. JEMS 1989;7:269273.Google Scholar
18. Pollander, G, Rund, D: Analysis of medical needs in disasters caused by earthquakes: The need for a uniform injury reporting scheme. Disasters 1989;13:365369.CrossRefGoogle Scholar
19. Bronson, R: Computer simulation: What it is and how it's done. BYTE 1984, March, p 95.Google Scholar
20. Foley, D, Jones, M: Disaster Recovery System Model of a Casualty Collection Point. Computer Sciences Department, California State University at Sacramento, 1990.Google Scholar
21. Van Ness, C, Freeman, C, Moorhead, G: Injury Patterns in a Major Quake. California Emergency Medical Services Authority, 1984.Google Scholar
22. National Oceanic and Atmospheric Administration: A Study of Earthquake Losses in the Los Angeles, California Area. Federal Disaster Assistance Administration, 1973.Google Scholar