Disasters are unpredictable and unavoidable. The definition of disaster is a serious disruption of the functioning of society, causing widespread human, material, or environmental losses that exceed the ability of affected society to cope using only its own resources. Disaster medicine is a discipline resulting from combination of emergency medicine and disaster management. The field of disaster medicine involves the study of subject matter from multiple medical disciplines, and disaster medicine presents unique ethical situations not seen in other areas of medicine. Disaster can be classified into two categories, natural disaster and manmade disaster, each type of disaster has its own characteristics. Disaster management has a cycle of 4 activities, preparedness, response, recovery, and prevention/mitigation. Disaster medicine specialists have a role in each part of this cycle. To achieve effective disaster response, the National Disaster Life Support Foundation suggests the DISASTER Paradigm(TM), which consists of detection, incident command, safety and security, assess hazards, support, triage and treatment, evacuation, and recovery.
Disaster Medicine ; Disaster Planning ; Disasters* ; Emergencies ; Emergency Medicine ; Humans ; Mass Casualty Incidents ; Specialization ; Triage

PURPOSE: On July 27, 2011, landslides occurred on Woomyun Mountain, resulting in development of mass casualties. Seoul St. Mary's Hospital was the primary recipient of patients. This experience prompted the drafting of a formal disaster plan. Therefore, we outline the Emergency Management External Disaster Plan of Seoul St. Mary's Hospital and discuss the time course of presentation and medical characteristics of the patients. METHODS: We conducted a retrospective review of medical records of patients who visited Seoul St. Mary's Hospital from Woo-myun Mountain landslides. In addition, we reviewed the time course of hospital disaster response. RESULTS: A total of 33 patients participated in this study. Mean age was 40.2 (+/-21.8) years; eight patients died at the time of admission and cardiopulmonary resuscitation was performed in one patient. Mean Injury Severity Score (ISS) was 9.19 and four patients were ISS above 15. Six patients were admitted to our hospital and two patients underwent an emergency operation. Overall, the emergency disaster management was appropriate due to the formal disaster plan and experiences in conduct of disaster drills. However, there were also several problems. The major problems of our disaster response were as follows: delayed activation of external disaster, difficulties in securing a treatment section, and absence of a decontamination facility. CONCLUSION: We observed several problems from our experience with Woo-myun Mountain landslides. Reassessment of the disaster plan and additional planning for other possibilities are needed.
Cardiopulmonary Resuscitation ; Decontamination ; Disaster Planning ; Disasters ; Emergencies ; Humans ; Injury Severity Score ; Landslides ; Mandrillus ; Mass Casualty Incidents ; Medical Records ; Retrospective Studies

A study of the dental professional action to the struggle for the mass casualty and disaster events was reported. The dental professional first aid and care, triage of casualties, maxillofacial surgery, forensic odontology to the struggle for the mass casualty and disaster events were discussed. The dental profession personals must make the more specific contribution in the mass casualty and disaster events in the future.
Dentists ; Disaster Planning ; Disasters ; Humans ; Mass Casualty Incidents ; Professional Role ; Triage

PURPOSE: Effective triage at the emergency department entrance is the key to dealing with mass casualty incidents. However, in Korea, triage has been accomplished at the disaster scene or at the hospital in only a few cases. Thus, we report on the planning and preparation for triage at Asan Medical Center (AMC) for mass casualty incidents. METHODS: We review the AMC disaster plan and the triage systems used in previous disasters. Also, we review triage principles appearing in the literature. We describe basic hospital triage principles, which include the treatment site, the triage site, the triage officer, triage categories, and triage tags. RESULTS: 1) For external disaster, the emergency department is reassigned to four treatment sites before patients arrive. At the triage site, an emergency medicine specialist classifies patients into six groups according to treatment priority and resources. After classification, a triage tag is attached to each patient, and patients are moved to the previously designated treatment site. 2) For internal disaster, the head nurse (or senior nurse) classifies patients into three groups: urgent, minor, and delayed. The minor group is sent to the casualty collection point while the urgent and delayed groups are moved to the triage site. CONCLUSION: Hospitals should prepare a disaster plan. In particular, preplanning for triage is essential to cope with internal and external disasters. In addition, emergency medicine specialists should play a key role in disaster planning and are essential for successful implementation of the disaster plan.
Chungcheongnam-do ; Classification ; Disaster Planning ; Disasters ; Emergency Medicine ; Emergency Service, Hospital ; Humans ; Korea ; Mass Casualty Incidents* ; Nursing, Supervisory ; Specialization ; Triage*

PURPOSE: This study describes the disaster medical responses to the disaster scene of long-distance on a highway; 106-vehicle chain collision on Yeong-Jong Grand Bridge on February 11, 2015 and we discuss the disaster communication by social media. METHODS: Records of disaster medical responses from records of relevant organizations and messages of social media were collected. Medical records and the results of triage were reviewed retrospectively. Casualties were categorized into four groups according to results of triage; Red- Yellow-Green-Black. Kappa statistics were used to measure agreement between results of triage and casualties' outcome. RESULTS: Disaster Medical Assistant Team (DMAT) arrived on the scene one hour after accidents occurred. DMAT settled in a temporary base camp in the middle part of the scene and did not build an emergency air shelter. DMATs from four hospitals were separated into four mobile units of DMAT and they joined the rescue team. Disaster communication by social media was useful. Seventy six casualties were transported and two died; 28.9% of casualties were transported to the nearest regional emergency medical center; 20.0% of red casualties were transported to a higher level of care again. Kappa statistics were 0.122 (95% CI, - 0.049~0.291; p=0.094). CONCLUSION: In the disaster scene of long-distance on a highway, adequate location of triage and treatment area may be the front or rear of the scene and separation of DMATs can be helpful. Disaster communication by social media was helpful. Education and policies will be required for more effective triage and dispersion of casualties.
Disasters* ; Education ; Emergencies ; Mass Casualty Incidents ; Medical Assistance ; Medical Records ; Retrospective Studies ; Social Media* ; Triage*

The fatality rate of a disaster is associated with the impact of the disaster and the case fatality rate. The severity of the disaster can be reduced by an efficient disaster management system, and the capacity of the trained disaster response system can lower the case mortality rate. The severity of a disaster is determined by the interaction of risk factors and vulnerabilities in a particular area, and the case-fatality rate is determined by a correlation between the capacity of the disaster response team and the survivability of the victims. The disaster management system and the disaster response system are complementary and interconnected, and the efficiency of cooperation and linkage can be improved by developing well organized digitalization. Efforts to increase the survival rate of victims through digitalization has been a continued process and new alternatives are being developed in accordance with the advances in information and communication technology to manage disaster risk factors and to improve disaster response capabilities. However, in case of mass casualty incidents, it is still difficult to reduce the case mortality rate by securing the survival time limit of the victims. Often, sharing the disaster scene information and communicating with the victim is not feasible. A lack of ability to provide real time escape route to exit or safe zone proves fatal. The communication revolution of the next generation wireless wide area network called 5G can overcome the disruption of communication network during the disaster incidents. It can enable real time tracking of the position of victim and linking the victims with its rescuers. Hence, it is possible to increase the survival rate of victims during mass casualty incidents by associating information and communication technologies with appropriate disaster management and response strategies, real-time information exchange and education and training of rescuers and citizens.
Disasters ; Education ; Emergencies ; Mass Casualty Incidents ; Mortality ; Risk Factors ; Survival Rate ; United Nations

Mass casualty disasters have complex communication requirement. The involvement of many different communication systems and agencies and the difficulty of exchanging information between them is a perplexing problem. This may be compounded by telecommunication systems overload or failure, and electric service disruptions in the disaster area. In addition, emergencies are characterized by a sudden need for an increased information flow, an explosion in the topographical complexity of the information network, and a feeling of intense psychological pressure among the participants. The rescue, treatment, evacuation of a lot of patients from a natural disaster or mass casualties must be performed in accordance to several national agencies. Without an effective communication system, morbidity and mortality will needlessly rise. The stabilization and evacuation off lot of patients in a disaster is a serious and complex medical problem that must be resolved expeditiously. The potential far maximizing care depends on an well-organized rescue. However, without adequate communications, the patient may experience needless delays into the health care system an6 thus compromise prognosis. Established communication systems in most communities consist of private services, provincial and national agencies, and military and amateur radio operator. A disaster situation can severely disrupt routine telephone and radio communication. Customary frequencies may be incompatible with military and emergency civilian frequencies or become overloaded and useless because of intense activity. In a disaster, local telephone communication resources may be destroyed: qualified staffing of communications networks may be inadequate or unavailable to cope with the demands of the emergency. So, we recommend, that Amateur Radio should be provide as a effective emergency communication in a disaster.
Delivery of Health Care ; Disasters* ; Emergencies* ; Explosions ; Humans ; Information Services ; Mass Casualty Incidents ; Military Personnel ; Mortality ; Prognosis ; Telecommunications ; Telephone

PURPOSE: WHO (World Health Office) and WADEM (World Association of Disaster Emergency Medicine)have recommended that all countries should complete their preparedness for CBRNE disasters (chemical, biologic, radiological, nuclear, and explosive disaster) within a few years. To establish whether a biologic or chemical disaster plan is most appropriate in a given situation, essential information regarding biologic materials and chemicals should be provided to emergency personnel as rapidly as possible. METHODS: We prospectively investigated information systems operated by government bodies in Korea. We obtained data about toxic material information systems of Korea by contacting individuals in charge of toxic material information systems at seven government agencies between April and July 2007. RESULTS: There was no single toxic information system designated as a repository for all toxic material data in Korea. Instead, data were distributed among 9 institutes in 6 government cabinets. Moreover, redundant data were independently stored at four different cabinets or ministries the Ministry of Commerce, Industry and Energy; the Ministry of Labor; the National Emergency Management Agency; and the Ministry of Environment. Because each ministry or cabinet handled toxic material information system according to its own laws or legal guidelines, there were effectively eight sets of rules for toxic materials. CONCLUSION: Nine institutes in six government bodies were found to be operating computerized information systems for toxic materials independently, and four government bodies had redundant chemical information. In order to establish a central toxic material information center, a uniform set of guidelines for toxic materials should be established. Doing so, would result in financial savings, and improve the quality of information.
Academies and Institutes ; Commerce ; Disasters* ; Emergencies ; Government Agencies ; Income ; Information Centers ; Information Systems* ; Jurisprudence ; Korea* ; Mass Casualty Incidents* ; Prospective Studies

A modern Disaster Medical Assistance Team (DMAT) is a group of professional and para-professional medical personnel organized to provide rapid-response medical care during a disaster situation. DMAT is a part of the disaster response system that acts as a trained, mobile, self-contained medical team in the acute phase of a disaster to provide necessary services such as triage, treatment, and transportation of injured patients in the devastated disaster area. The timeliness of DMAT response is critical to the administration of medical care and reduction of immediate mortality in disaster. While the number of members in a DMAT may vary between different nations. A small-scale DMAT is often composed of five to six people and there is good reason to consider this an effective unit for early disaster medical responses. An adequate structure and training system should be provided for Korean DMAT development in the near future.
Disasters* ; Humans ; Mass Casualty Incidents ; Medical Assistance* ; Mortality ; Transportation ; Triage

China ; Disaster Medicine ; Disasters ; statistics & numerical data ; Earthquakes ; statistics & numerical data ; First Aid ; statistics & numerical data ; Humans ; Mass Casualty Incidents ; statistics & numerical data ; Rescue Work