Iranian Emergency Medical Service Response in Disaster; Report of three Earthquakes

Saberian, Peyman; Kolivand, Pir-Hossein; Hasani-Sharamin, Parisa; Dadashi, Fatemeh; Farhoud, Amir Reza

Considering the damage to the health centers, there was no possibility to provide quick services to the injured in these centers, and the transfer of these injured to hospitals in Kermanshah province or neighboring provinces could create serious challenges for these injured; the rapid launching of field hospitals led to the transfer of the injured with critical priority to these centers and provided essential treatment and medical services to these patients and injured near the incident site before they were transferred to a permanent hospital. Performing various surgeries such as hand transplantation is one of the important functions of these hospitals. In this incident, considering the severity of the incident in the Sarpol-e-Zahab area and the complete destruction of the only regional hospital, the first 30-bed field hospital was set up in less than 6 hours of the incident in the area, followed by field hospitals in West Islamabad and Salas Babajani also launched. Interagency coordination and management carried out by the NEOC was another strength of the incident, as early as the aftermath of the incident, the Islamic Revolutionary Guard Corps (IRGC) and the Army arrived at the scene. The establishment of three field hospitals by the military forces in the region provided a great deal of assistance in managing injured and casualties. Another effective action to increase the capacity of health facilities was the discharge of nonemergency patients, which was done by alert to all medical centers in Kermanshah and neighboring provinces. There are no accurate statistics on the extent of surge capacity of the medical centers. The next effective action was converting the nonmedical centers into the temporary medical centers, as well as the conversion of singlespecialty hospitals to multi-specialty hospitals; in the earthquake of Varzaghan, the Martyr Madani and Taleghani single specialty hospitals were converted into general hospitals through the establishment of specialist expeditions from neighboring provinces. Upon the completion of the debris removal and the prediction of the second wave of injured, gyms No. 1 and 2 of the medical university were equipped with emergency facilities and turned to the health centers to be used in case of encountering a large number of patients. Also, by equipping all the capacities available in Imam Reza, Shohada, Sina and Razi hospitals, the capacity of these hospitals increased by 200 beds. ï‚· Increasing transfer capacity Immediately after assessing the situation, 30 ambulances from Kermanshah province and 90 ambulances settled on the western border of the country for Arbayeen, 3 helicopters and 12 ambulance buses were deployed to the site. In some of the affected centers where treatment facilities were severely damaged, the EMS bus ambulances were utilized as the outpatient and temporary treatment sites. According to coordination by the NEOC, with the commander of the army and the commander of IRGC, four aircraft, and 20 helicopters were provided to EMS for the transfer of the injured. A total of 206 flight missions resulted in the transfer of 2165 injured. ï‚· Handling, transportation and distribution of injuries After the occurrence of the earthquake and the presence of EMS forces, the triage of the injured and basic and advanced life support was carried out by EMS forces according to the predefined protocols and the transfer and distribution of the injured to the health centers was begun. Calls from the