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

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

Response activities after the earthquake were focusing on the priorities of the response were immediately performed. A joint effort was made by government officials and international communities in the first week after the tragedy. Information is presented separately in Table 2 . ï‚· Rapid warning and response Due to the severity of the earthquake which was felt by most of the officials in Kermanshah, relative preparation was made at local authorities from first minutes, and immediately after the earthquake, the LEOC was activated. Since there was no damage to the ambulances of the region, EMS forces of the area immediately began to provide services to the injured. Notification to the NEOC was performed according to preplanned protocols for warning levels and activation levels. During the first hour after the incident, the first meeting of the emergency committee was held at the NEOC site. Local and central hospitals, rapid response teams at local, regional and national levels were called. The disconnection of communication and telecommunication networks in the affected areas has caused difficulties in calling, estimating damages, correct locating and estimating the required resources. The reports of the affected areas were collected from the Health Information Management Unit which was developed at NEOC. All local, regional and capital hospitals were on standby. One of the major strengths of the incident was its concurrence with the Arbaeen ceremony. Fortunately, these forces had been stationed on the western border of the country to manage mass gatherings from months ago that resulted in a more comprehensive, efficient and faster response. In total, 90 ambulances, 19 ambulance buses, two mobile communication vehicles were sent from the Mehran border to the earthquake zone, which began serving the wounded from the beginning hours. In the Varzaghan earthquake, the LEOC was immediately activated and the call for forces was made 5 minutes after the earthquake. Coordination was conducted to deploy forces from the province, road stations and neighboring provinces, and backup EMS teams were sent from the road stations, city and the province, as well as adjacent provinces of West Azerbaijan, Ardebil and Zanjan. The provincial teams were presented at the damaged site at 19:00. Unfortunately, in the Bam earthquake, the EOC structure was not established at the local and national levels. Also, due to the severity of the destruction of the area, the first relief teams in the affected region were announced at 8:40 (3:14 after the earthquake). There was no comprehensive warning and response system, which was one of the reasons for the lack of coordination in response plans. ï‚· Surge capacity plan Due to the extent of the Kermanshah earthquake, the care needs of patients and injured were more than available resources; therefore, the main focus of the medical emergency system was on increasing care capacity. Starting from the very early hours after the incident, the surge capacity in three axes of man resources, equipment and structure was started. Based on reports and evidence available, hours after the receipt of earthquake news, medical teams were called from most of the province's hospitals. But the damage to some health centers poses serious challenges to treatment operations. According to the information of EMS Capacity Assessment system and reports on the extent of damage, the amount of need for force, equipment, and ambulance was estimated by the