Analysis of Transportation of Victims of the Subway Fire in Daegu

PURPOSE: The purpose of this study was to improve transportation and distribution of mass-casualty patients by reviewing the subway fire that occurred in Daegu on 18 February 2003. METHODS: We used the reports of the Daegu Emergency Medical Information Center and the medical records of each hospital to analyze retrospectively 199 patients who were transported to 22 initial receiving hospitals. We evaluated the appropriateness of transportation based on the distances of transportation, the capability of the receiving hospitals, and the severity of patients. Using the SAS program(version 6.12), the collected data was analyzed by frequency and x(2) test. RESULTS: The more severe the patients were, the nearer and larger the receiving hospitals were. There was no accurate triage at the scene, but the distribution of patients was good because members of Daegu Emergency Medical Information Center were dispatched to the scene and because communications between the scene and receiving hospitals were continuous. CONCLUSION: We do not expect disasters, but they happen. All we can do is plan and prepare appropriate responses for disasters. Appropriate transportation and distribution of patients based on triage is an important aspect of early disaster response.

Analysis of Early Results from the Emergency Department Syndromic Surveillance System for Bioterrorism

PURPOSE: This study reviewed the development of and analyzed the early results from syndromic surveillance based on emergency departments, which was developed to detect bioterrorism attacks, especially during the 2002 FIFA Korea-Japan World Cup games. METHOD: Data from homepages and server computers were analyzed from May 13 2002, to August 5 2002. The data were gathered everyday from 121 emergency departments in Korea via the internet by using PC or PDA. Some data gathered via telephone or FAX were also digitalized. RESULTS: The daily report rate was 82.5% on average. Most of the cases were acute respiratory syndrome (63.4%) and acute sporadic diarrheal syndrome (34.8%). No bioterrorism was confirmed during this period. The peak times and distributions of sporadic and cluster cases of acute diarrheal syndrome are not equivalent. In the case of level 2 reports, there was an average of 12 cases per one institute and 32.8 cases per institute of level 1 and 2 reports totally. CONCLUSIONS: The emergency department syndromic surveillance system for bioterrorism is the first everyday reporting system based on the clinical basis in emergency depart-ments. It has been and is functioning without large problems, but exact knowledge of and more participation by reporting institutes are required. It is necessary to survey the results for a longer period and to correct the early problems if we want to know the ultimate usefulness of this system.

A Preliminary Survey of Emergency Medicine in 12 Asian Countries

BACKGROUND: To assess the current level of development of emergency medicine (EM) systems in Asia. METHOD: Survey of EM professionals from 12 Asian countries during a 90-day period from August to November 1998. 12 EM professionals from 12 Asian countries completed the survey. All participants were physicians. 7 participants (58%) gave presentations at an international EM conference during the study period. Respondents completed a 103 question questionnaire about the status of EM specialty, academic, patient care, information and management systems and the factors influencing the future of EM in their countries. RESULTS: 92% of respondents stated that their countries have hospital-based emergency departments (ED). More than 80% of respondents reported that their countries have EMS systems and ED systems for trauma care and patient transfer. More than 70% stated that their countries have national EM organizations, EM research, national EMS activation phone numbers, ED systems for pediatric emergency care, emergency physician (EP) training in ACLS and ATLS and peer review. More than 60% reported official recognition of EM as an independent specialty status, ED triage systems and systems for customer service. More than 50% reported EM residency training programs, EM journals and EP ability to perform rapid sequence intubation (RSI). 50% reported EP ability to perform thrombolysis for acute MI and 33% reported EP ultrasonography. 92% felt that a lack of funding posed a moderate or great obstacle to the future development of EM in their countries. CONCLUSION: Many essential systems of EM now exist throughout Asia. In the systems of administration and emergency medical information in many countries, there are some parts to be developed further.