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Prehospital Communications During the Loma Prieta Earthquake

Published online by Cambridge University Press:  28 June 2012

Julie Martchenke*
Affiliation:
Emergency Department, San Francisco General Hospital, San Francisco, California Emergency Medical Services Agency, Department of Public Health, City and County of San Francisco, San Francisco, California
Jeff Rusteen
Affiliation:
Piedmont Fire Department, Piedmont, California
James E. Pointer
Affiliation:
Emergency Medical Services Agency, Department of Public Health, City and County of San Francisco, San Francisco, California The Department of Medicine, University of California, San Francisco, San Francisco, California
*
City and County of San Francisco, 1540 Market St., Suite 220, San Francisco, CA 94102USA

Abstract

Introduction:

On 17 October 1989, the Loma Prieta Earthquake shook the San Francisco Bay area, home to more than 6 million people. This study examined the effectiveness and function of emergency medical services (EMS) communications after this event.

Methods:

The six Bay area counties most affected by the Loma Prieta Earthquake were surveyed using a 156-part questionnaire. This study examined the functioning of the primary 9-1-1 county dispatch centers. Paramedics involved in a set of defined activities during the period after the earthquake also were surveyed. Emergency medical services directors also were questioned by telephone using an interview tool developed for this purpose. All areas concerning disaster response were not queried. Ten specific areas were considered, including: 1) preparation for disaster; 2) the impact of the earthquake; 3) reconnaissance; 4) call volume; and 5) others.

Results:

Coordination among the various agencies responsible for disaster response and mitigation needs more study. Uniform response plans for medical mutual aid need development. Government support similar to police and fire department arrangements for mutual aid are not in place. Additional planning and training for disasters at all levels need reassessment. The communication-center personnel indicated that they did not call for more resources, but instead accepted volunteers at dispatch centers and extra assistance. Once engaged, however, most communications centers (CCs) had great difficulty tracking and controlling all the units under their jurisdiction. In some large urban counties, some ambulances were idled awaiting calls but lost their communications centers, while other ambulance personnel were trying to handle multiple patients and requests for services.

Conclusions:

Significant help from a state or federal agency likely will be unavailable for a substantial period after a catastrophic regional event. Important coordination among EMS agencies for disaster response is poor or absent. Although fatalities and casualties were limited compared to what could have occurred, great confusion reigned for varying periods of time after the earthquake. Communications among local agencies, counties, and the state were problematic. Information flow to hospitals was cited frequently as a problem, making it difficult for hospitals to prepare adequately. Medical mutual-aid help was disorganized and inadequately controlled. The training of personnel and the method of recall for disaster response need to be examined.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1995

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References

1. Earthquake-associated deaths California. MMWR Morb Mortal Wkly Rep 1989;38:767.Google Scholar
2. Ward, PL, Page, RA: The Loma Prieta Earthquake of October 17, 1989. U.S. Geological Survey Pamphlet, U.S. Government Printing Office: January 1990.Google Scholar
3. Clawson, JJ, Dernocoeur, KJ: Principles of Emergency Medical Dispatch. New Jersey: Prentice Hall, 1988.Google Scholar
4. Palafox, J, Pointer, JE, Martchenke, JA, et al. : The 1989 Loma Prieta earthquake: Issues in medical control. Prehospital and Disaster Medicine 1993;8:291297.CrossRefGoogle ScholarPubMed
5. Martchenke, J, Pointer, J, Michealis, J, et al. : Hospital disaster operations during the 1989 Loma Prieta earthquake. Prehospital and Disaster Medicine 1994;9:146153.CrossRefGoogle ScholarPubMed
6. The National Emergency Training Center at the National Fire Academy in Emmitburg, Md.Google Scholar
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