title: Analysis of trends and emergency activities relating to critical victims of the Chuetsuoki Earthquake.
abstract: BACKGROUND
  When a large-scale disaster occurs, it is necessary to use the available resources in a variety of sites and scenes as efficiently as possible. To conduct such operations efficiently, it is necessary to deploy limited resources to the places where they will be the most effective. In this study, emergency and medical response activities that occurred following the Chuetsuoki Earthquake in Japan were analyzed to assess the most efficient and effective activities.
  
  
  METHODS
  Records of patient transports by emergency services relating to the Niigata Chuetsuoki Earthquake, a magnitude 6.8 earthquake that struck Japan on 16 July 2007 were analyzed, and interview surveys were conducted.
  
  
  RESULTS
  The occurrence of serious injuries caused by this earthquake essentially was limited to the day the earthquake struck. A total of 682 patients were treated on the day of the quake, of which about 90 were hospitalized. Of the 17 patients whose conditions were life-threatening, three were rescued and transported to hospital by firefighters, three were transported by ambulance, and 11 were transported to hospital using private means. Sixteen people were subsequently transferred to other hospitals, six of these by helicopter. There was difficulty in meeting all of the requests for emergency services within 4 to 6 hours of the earthquake's occurrence. Most transports of patients whose conditions were life-threatening were between hospitals rather than from the scene of the injury. Transfers of critical patients between hospitals were efficient early on, but this does not necessarily mean that inter-hospital transfers were given higher priority than treatment at emergency scenes.
  
  
  CONCLUSIONS
  During the acute emergency period following a disaster-causing event, it is difficult to meet all requests for emergency services. In such cases, it is necessary to conduct efficient activities that target critically injured patients. Since hospital transfers are matters of great urgency, it is necessary to consider assigning resource investment priority to hospital transfers during this acute period, when ambulance services may be insufficient to meet all needs. To deal with such disasters appropriately, it is necessary to ensure effective information exchange and close collaboration between ambulance services, firefighting organizations, disaster medical assistance teams, and medical institutions.
authors.affiliation: National Hospital Organization Disaster Medical Center, Tokyo, Japan. kondo@tdmc.hosp.go.jp
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kondo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Koido
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirose
authors.forename: Ken
authors.initials: K
authors.lastname: Kumagai
authors.forename: Masato
authors.initials: M
authors.lastname: Homma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Henmi
mesh_terms: D004190:Disasters; D055866:Earthquakes; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D015601:Injury Severity Score; D007407:Interviews as Topic; D007564:Japan / Q000453:epidemiology; D008297:Male; D014187:Transportation of Patients; D014218:Triage; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*