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Emergency Medical Services in the Reconstruction Phase following a Major Earthquake: A Case Study of the 1988 Armenia Earthquake

Published online by Cambridge University Press:  28 June 2012

Bruce M. Becker ,
Michael T. Handrigan ,
Liudvikas Jagminas  and
Tanya J. Becker
Bruce M. Becker*
Affiliation:
Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
Michael T. Handrigan
Affiliation:
Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
Liudvikas Jagminas
Affiliation:
Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
Tanya J. Becker
Affiliation:
Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA
*
Rhode Island Hospital, Department of Emergency Medicine, 593 Eddy Street, Samuels Building, 2nd Floor, Providence, RI 02903 USA, E-Mail: bmbecker@igc.apc.org
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Abstract

Study Objective:

To use the clinical activities of an ambulance service as a tool to assess the residual and unmet medical need of a city in the aftermath of a major earthquake and to apply that assessment to the development of a training curriculum for the prehospital personnel.

Methods:

The researchers conducted structured interviews with health care workers at all levels of the emergency health care delivery system in Gyumrii, Armenia, and carried out a retrospective frequency analysis of 29,010 ambulance runs for an 11-month period from February through December 1992. Runs first were assigned into the broad categories of: 1) Adult Medical; 2) Pediatric Medical; or 3) Trauma, and then, according to diagnosis. The runs then were classified further as: 1) Primary Care; 2) Basic Life Support (BLS); or 3) Advanced Life Support (ALS).

Results:

Adult Medical calls represented 24,684 (85%), Pediatric Medical calls 459 (1.6%), and Trauma calls 3,867 (13%). Only 12% of all ambulance calls resulted in transport to a medical facility, although this percentage was higher in children. Thirty percent of Adult Medical patients were diagnosed by the emergency medical providers as having exclusively a psychiatric problem.

Conclusion:

In the late aftermath of a devastating earthquake, the ambulance service in Gyumrii, Armenia has been delivering a substantial proportion of non-emergency, primary care services. They have adopted this unconventional role to compensate for the deficit in health care facilities and personnel created by the disaster. The training program that the investigators developed reflected the actual work activities of the prehospital personnel demonstrated in their assessment.

Keywords

Armeniaearthquakeemergency medical servicesreconstruction and communityrecoveryrelieftraining
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 13 , Issue 1 , March 1998 , pp. 28 - 33
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1998

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