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Emergency Medical Assistance Team Response following Taiwan Chi-Chi Earthquake

Published online by Cambridge University Press:  28 June 2012

Edbert B. Hsu ,
Matthew Ma ,
Fang Yue Lin ,
Michael J. VanRooyen  and
Frederick M. Burkle Jr
Edbert B. Hsu
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland
Matthew Ma*
Affiliation:
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
Fang Yue Lin
Affiliation:
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
Michael J. VanRooyen
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland
Frederick M. Burkle Jr
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland
*
Department of Emergency Medicine, National Taiwan University Hospital, #7 Chung-Shan South Road, Taipei, Taiwan
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Abstract

Introduction:

On 21 September, 1999, an earthquake measuring 7.3 on the Richter scale, struck central Taiwan near the town of Chi-Chi. The event resulted in 2,405 deaths and 11,306 injuries. Ad hoc emergency medical assistance teams (EMATs) from Taiwan assumed the responsibility for initiating early assessments and providing medical care.

Objective:

To determine whether the EMATs served a key role in assisting critically injured patients through the assessment of number and level of hospitals responding, training background, timeliness of response, and acuity of patient encounters.

Methods:

Local and national health bureaus were contacted to identify hospitals that responded to the disaster. A comprehensive questionnaire was piloted and then, sent to those major medical centers that dispatched EMATs within the first 72 hours following the quake. In-depth interviews also were conducted with team leaders.

Results:

A total number of 104 hospitals/clinics responded to the disaster, including nine major medical centers and 12 regional hospitals. Each of the major medical centers/regional hospitals that dispatched EMATs during the first 72 hours following the quake were surveyed. Also, 20 individual team leaders were interviewed. Seventy-nine percent of the EMATs from the hospitals responded spontaneously to the scene, while only 21% were dispatched directly by national or local health authorities. Combining the phases of the disaster response, it is estimated that only 7% of EMATs were providing on-site care within the first 12 hours following the earthquake, 17% within <18 hours, and 20% within <24 hours. Thus, 80% of these EMATs required >24 hours to respond to the site. Based on a ED I-IV triage system (Level-I, highest acuity; Level-IV, lowest acuity), the vast majority of patient encounters consisted of Level-III and Level-IV patients. Fewer than 16% of teams encountered >10 Level-I patients, and <28% of teams evaluated >10 Level-II patients.

Conclusions:

1. The response from EMATs was impressive, but largely uncoordinated in the absence of a pre-existing dispatching mechanism.

2. Most of the EMATs required >24 hours to reach the disaster sites, and generally, did not arrive in time to affect the outcome of victims with preventable deaths. Therefore, there is an urgent need to strengthen local prehospital care.

3. A central governmental body that ensures better horizontal and vertical integration, and a comprehensive emergency management system is required in order to improve future disaster response and mitigation efforts.

Keywords

disasterearthquakeemergencyemergency responseintegrationmedical assistance teammitigationTaiwan
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 17 , Issue 1 , March 2002 , pp. 17 - 22
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2002

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