Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2011

Open Access 01-12-2011 | Original research

Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study

Authors: Ahmadreza Djalali, Hamidreza Khankeh, Gunnar Öhlén, Maaret Castrén, Lisa Kurland

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2011

Login to get access

Abstract

Background

Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days.

Methods

The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation.

Results

The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators.

Conclusions

The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels.
Appendix
Available only for authorised users
Literature
1.
Ashkenazi I, Isakovich B, Kluger Y, Alfici R, Kessel B, Better OS: Prehospital management of earthquake casualties buried under rubble. Prehosp Disast Med. 2005, 20 (2): 122-133.CrossRef
2.
3.
Green GB, Modi S, Lunney K, Thomas TL: Generic evaluation methods for disaster drills in developing countries. Ann Emerg Med. 2003, 41 (5): 689-699. 10.1067/mem.2003.147.CrossRefPubMed
4.
5.
Asef MR: Modeling the elements of country vulnerability to earthquake disasters. Disasters. 2008, 32 (3): 480-498. 10.1111/j.1467-7717.2008.01051.x.CrossRefPubMed
6.
7.
8.
Gautschi OP, Cadosch D, Rajan G, Zellweger R: Earthquakes and trauma: Review of triage and injury-specific, immediate care. Prehospital Disast Med. 2008, 23 (2): 195-201.
9.
10.
Mirhashemi S, Ghanjal A, Mohebbi HA, Moharamzad Y: The 2003 Bam earthquake: Overview of first aid and transport of victims. Prehospital Disast Med. 2007, 22 (6): 513-6.
11.
Tahmasebi MN, Kiani K, Mazlouman SJ, Taheri A, Kamrani RS, Panjavi B, Harandi BA: Musculoskeletal injuries associated with earthquake: A report of injuries of Iran's December 26, 2003 Bam earthquake casualties managed in tertiary referral centers. Injury, Int J Care Injured. 2005, 36: 27-32.CrossRef
12.
Saghafinia M, Araghizade H, Nafissi N, Asadollahi R: Treatment management in disaster: A review of the Bam earthquake experience. Prehospital Disast Med. 2007, 22 (6): 517-521.
13.
Abolghasemi H, Radfar MH, Khatami M, Nia MS, Amid A, Briggs SM: International medical response to a natural disaster: Lessons learned from the Bam earthquake experience. Prehosp Disast Med. 2006, 21 (3): 141-147.
14.
Motamedi HMK, Saghafinia M, Bafarani AH, Panahi F: A reassessment and review of the Bam earthquake five years onward: What was done wrong?. Prehosp Disaster Med. 2009, 24 (5): 453-460.PubMed
15.
Sengezer B, Koc E: A critical analysis of earthquakes and urban planning in Turkey. Disasters. 2005, 29 (2): 171-194. 10.1111/j.0361-3666.2005.00279.x.CrossRefPubMed
16.
Hsu EB, Ma M, Lin FY, VanRooyen MJ, Burkle FM: Emergency medical assistance team response following Taiwan Chi-Chi earthquake. Prehospital Disast Med. 2002, 17 (1): 17-22.
17.
Gavagan TF, Smart K, Palacio H, Dyer C, Greenberg S, Sirbaugh P, Fishkind A, Hamilton D, Shah U, Masi G, Ivey RT, Jones J, Chiou-Tan FY, Bloodworth D, Hyman D, Whigham C, Pavlik V, Feigin RD, Mattox K: Hurricane Katrina: medical response at the Houston Astrodome/Reliant Center Complex. South Med J. 2006, 99 (9): 933-9. 10.1097/00007611-200609000-00012.CrossRefPubMed
18.
de Ville de Goyet C: Health lessons learned from the recent earthquakes and Tsunami in Asia. Prehosp Disast Med. 2007, 22 (1): 15-21.
19.
Sklar DP, Richards M, Shah M, Roth P: Responding to disasters: academic medical centers' responsibilities and opportunities. Acad Med. 2007, 82 (8): 797-800. 10.1097/ACM.0b013e3180d0986e.CrossRefPubMed
20.
21.
Emami MJ, Tavakoli AR, Alemzadeh H, Abdinejad F, Shahcheraghi G, Erfani MA, Mozafarian K, Solooki S, Rezazadeh S, Ensafdaran A, Nouraie H, Jaberi FM, Sharifian M: Strategies in evaluation and management of Bam earthquake victims. Prehosp Disast Med. 2005, 20 (5): 327-330.
22.
Malterud K: Qualitative research: Standards, challenges and guidelines. The Lancet. 2001, 358: 483-488. 10.1016/S0140-6736(01)05627-6.CrossRef
23.
Elo S, Kyngäs H: The qualitative content analysis process. Journal of Advanced Nursing. 2008, 62 (1): 107-115. 10.1111/j.1365-2648.2007.04569.x.CrossRefPubMed
24.
Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004, 24 (2): 105-12. 10.1016/j.nedt.2003.10.001.CrossRefPubMed
25.
Peleg K, Michaelson M, Shapira SC, Aharonson-Daniel L: Principles of emergency management in disasters. Adv Ren Replace Ther. 2003, 10 (2): 117-21. 10.1053/jarr.2003.50019.CrossRefPubMed
26.
Mohebbi HA, Mehrvarz S, Saghafinia M, Rezaei Y, Kashani SM, Naeeni SM, Motamedi MH, Hoseini SH, Moharamzad Y: Earthquake related injuries: Assessment of 854 victims of the 2003 Bam disaster transported to tertiary referral hospitals. Prehospital Disast Med. 2008, 23 (6): 510-515.
27.
Schwartz D, Goldberg A, Ashkenasi I, Nakash G, Pelts R, Leiba A, Levi Y, Bar-Dayan Y: Prehospital care of Tsunami victims in Thailand: Description and analysis. Prehosp Disast Med. 2006, 21 (3): 204-210.
28.
Yasin MA, Malik SA, Nasreen G, Safdar CA: Experience with mass casualties in a subcontinent earthquake. Ulus Travma Acil Cerrahi Derg. 2009, 15 (5): 487-92.PubMed
29.
Jalali R: Civil society and the state: Turkey after the earthquake. Disasters. 2002, 26: 120-39. 10.1111/1467-7717.00196.CrossRefPubMed
30.
Liang NJ, Shih YT, Shih FY, Wu HM, Wang HJ, Shi SF, Liu MY, Wang BB: Disaster epidemiology and medical response in the Chi-Chi earthquake in Taiwan. Ann Emerg Med. 2001, 38 (5): 549-55. 10.1067/mem.2001.118999.CrossRefPubMed
31.
Akbari ME, Farshad AA, Asadi-Lari M: The devastation of Bam: an overview of health issues 1 month after the earthquake. Public Health. 2004, 118 (6): 403-8. 10.1016/j.puhe.2004.05.010.CrossRefPubMed
32.
Abolghasemi H, Poorheidari G, Mehrabi A, Foroutan G: Iranian Military Forces in the Bam Earthquake. Mil Med. 2005, 170 (10): 859-861.CrossRefPubMed
33.
Saghafi Nia M, Nafissi N, Moharamzad Y: Survey of Bam earthquake survivors' opinions on medical and health systems services. Prehospital Disast Medicine. 2008, 23 (3): 263-268.
34.
Kondo H, Koido Y, Morino K, Homma M, Otomo Y, Yamamoto Y, Henmi H: Establishing Disaster Medical Assistance Teams in Japan. Prehosp Disaster Med. 2009, 24 (6): 556-564.PubMed
35.
Tanaka H, Iwai A, Oda J, Kuwagata Y, Matsuoka T, Shimazu T, Yoshioka T: Overview of evacuation and transport of patients following the 1995 Hanshin-Awaji earthquake. J Emerg Med. 1998, 16 (3): 439-44. 10.1016/S0736-4679(98)00014-6.CrossRefPubMed
36.
Roy N, Shah H, Patel V, Coughlin RR: The Gujarat earthquake (2001) experience in a seismically unprepared area: community hospital medical response. Prehosp Disast Med. 2002, 17 (4): 186-195.CrossRef
37.
Djalali A, Hosseinijenab V, Hasani A, Shirmardi K, Castrén M, Öhlén G, Panahi F: A fundamental, national, disaster management plan: An education based model. Prehosp Disaster Med. 2009, 24 (6): 565-569.PubMed
38.
Health Disaster Management: Guidelines for Evaluation and Research in the Utstein Style. Glossary of terms. Prehosp Disast Med. 2002, 17 (S3): 144-167.
39.
Chan YF, Alagappan K, Gandhi A: Disaster management following the Chi-Chi Earthquake in Taiwan. Prehosp Disast Med. 2006, 21 (3): 196-202.
40.
Macintyre AG, Barbera JA, Smith ER: Surviving collapsed structure entrapment after earthquakes: A time-to-rescue analysis. Prehosp Disast Med. 2006, 21 (1): 4-19.
41.
Movahedi H: Search, Rescue, and Care of the Injured Following the 2003 Bam, Iran, Earthquake. Earthquake Spectra. 2005, 21 (S1): S475-S485. 10.1193/1.2090469.CrossRef
42.
Kohl PA, O'Rourke AP, Schmidman DL, Dopkin WA, Birnbaum ML: The Sumatra-Andaman Earthquake and Tsunami of 2004: The hazards, events, and damage. Prehosp Disast Med. 2005, 20 (6): 356-363.
43.
Zoraster RM: Barriers to disaster coordination: Health sector coordination in Banda Aceh following the South Asia Tsunami. Prehosp Disast Med. 2005, 21 (1): S13-S18.
44.
Bremer R: Policy development in disaster preparedness and management: Lessons learned from the January 2001 earthquake in Gujarat, India. Prehosp Disast Med. 2003, 18 (4): 370-382.
45.
Peltz R, Ashkenazi I, Schwartz D, Shushan O, Nakash G, Leiba A, Levi Y, Goldberg A, Bar-Dayan Y: Disaster healthcare management and crisis intervention leadership in Thailand-Lessons learned from the 2004 Tsunami disaster. Prehosp Disast Med. 2006, 21 (5): 299-302.
46.
Khankeh HR, Fallahi M, Ranjbar M: Health Management in Disasters with focusing on Rehabilitation. Journal of Rehabilitation. 2008, 9 (2): 66-73.
Metadata
Title
Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study
Authors
Ahmadreza Djalali
Hamidreza Khankeh
Gunnar Öhlén
Maaret Castrén
Lisa Kurland
Publication date
01-12-2011
Publisher
BioMed Central
DOI
https://doi.org/10.1186/1757-7241-19-30

Other articles of this Issue 1/2011

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2011 Go to the issue

Original research

The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial

Review

Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific Evidence

Original research

Reduced clot strength upon admission, evaluated by thrombelastography (TEG), in trauma patients is independently associated with increased 30-day mortality

Original research

The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration

Original research

Implementation of a new emergency medical communication centre organization in Finland - an evaluation, with performance indicators

Original research

Comparison of the McGrath® Series 5 and GlideScope® Ranger with the Macintosh laryngoscope by paramedics