[Organization of medical rescue during catastrophes with limited effects occurring in urban areas].
OBJECTIVE
We conducted a survey regarding the organization of medical rescue during major events (catastrophes with limited effects) occurring in urban areas (Paris and immediate suburbs). The goal of this work was to study the availability of on site medical help and the real needs.Study design - Retrospective survey.


METHODS
Thirty-eight major events were analysed between 1988 and 2000. The median number (25th-75th percentiles) of victims per event was 42 (21-68) (range 8 to 424).


RESULTS
The median percentage of true emergencies (TE) was 5% with regard to the total number of victims per event. Thirty minutes after the event, 92% of the sites had a number of physician-manned ambulances greater than the number of severe victims. The median time to first evacuation was 79 (62-102) min.


CONCLUSIONS
Disasters with limited effect occurrence in Paris and its immediate suburbs are characterized by a small percentage of TE and by a constant oversupply of medical means onsite. These observations led us to propose a new organization of medical rescue during this type of catastrophe, abandoning the classical notion of forward medical command post (FMCP) for a collection point of medical services (CPMS) consisting all means of evacuation (physician-manned and other ambulances). Also, a new type of victim identification, based on hospital base-station medical direction is discussed in this paper.
Samu 93, UPRES UA 34-09, hôpital Avicenne, université Paris XIII, 93009 Bobigny cedex, France. frederic.adnet@avc.ap-hop-paris.fr
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D000401:Aircraft / Q000706:statistics & numerical data; D000552:Ambulances; D003625:Data Collection; D004189:Disaster Planning / Q000458:organization & administration*; D004282:Documentation; D004632:Emergency Medical Services; D005602:France; D006761:Hospitals; D006801:Humans; D010297:Paris; D010355:Patient Identification Systems; D010820:Physicians; D018635:Rescue Work / Q000458:organization & administration*; D012189:Retrospective Studies; D014187:Transportation of Patients; D014505:Urban Population