Emergency medical assistance team response following Taiwan Chi-Chi earthquake

Edbert Hsu, Matthew Ma, Fang Yue Lin, Michael J. Vanrooyen, Frederick M. Burkle

Research output: Contribution to journalArticle

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 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 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.

Original languageEnglish (US)
Pages (from-to)17-22
Number of pages6
JournalPrehospital and Disaster Medicine
Volume17
Issue number1
DOIs
StatePublished - 2002

Fingerprint

Medical Assistance
Earthquakes
Taiwan
Emergencies
Disasters
Patient Acuity
Triage
Health
Interviews
Wounds and Injuries

Keywords

  • disaster
  • earthquake
  • emergency
  • emergency response
  • integration
  • medical assistance team
  • mitigation
  • Taiwan

ASJC Scopus subject areas

  • Emergency
  • Emergency Medicine

Cite this

Emergency medical assistance team response following Taiwan Chi-Chi earthquake. / Hsu, Edbert; Ma, Matthew; Lin, Fang Yue; Vanrooyen, Michael J.; Burkle, Frederick M.

In: Prehospital and Disaster Medicine, Vol. 17, No. 1, 2002, p. 17-22.

Research output: Contribution to journalArticle

Hsu, Edbert ; Ma, Matthew ; Lin, Fang Yue ; Vanrooyen, Michael J. ; Burkle, Frederick M. / Emergency medical assistance team response following Taiwan Chi-Chi earthquake. In: Prehospital and Disaster Medicine. 2002 ; Vol. 17, No. 1. pp. 17-22.
@article{7b3448cdf07940d5a9b9c8a82d733cde,
title = "Emergency medical assistance team response following Taiwan Chi-Chi earthquake",
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 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 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 = "disaster, earthquake, emergency, emergency response, integration, medical assistance team, mitigation, Taiwan",
author = "Edbert Hsu and Matthew Ma and Lin, {Fang Yue} and Vanrooyen, {Michael J.} and Burkle, {Frederick M.}",
year = "2002",
doi = "10.1017/S1049023X00000066",
language = "English (US)",
volume = "17",
pages = "17--22",
journal = "Prehospital and Disaster Medicine",
issn = "1049-023X",
publisher = "World Association for Disaster and Emergency Medicine",
number = "1",

}

TY - JOUR

T1 - Emergency medical assistance team response following Taiwan Chi-Chi earthquake

AU - Hsu, Edbert

AU - Ma, Matthew

AU - Lin, Fang Yue

AU - Vanrooyen, Michael J.

AU - Burkle, Frederick M.

PY - 2002

Y1 - 2002

N2 - 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 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 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.

AB - 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 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 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.

KW - disaster

KW - earthquake

KW - emergency

KW - emergency response

KW - integration

KW - medical assistance team

KW - mitigation

KW - Taiwan

UR - http://www.scopus.com/inward/record.url?scp=0036370468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036370468&partnerID=8YFLogxK

U2 - 10.1017/S1049023X00000066

DO - 10.1017/S1049023X00000066

M3 - Article

VL - 17

SP - 17

EP - 22

JO - Prehospital and Disaster Medicine

JF - Prehospital and Disaster Medicine

SN - 1049-023X

IS - 1

ER -