TY - JOUR
T1 - Medical response of a physician and two nurses to the mass-casualty event resulting in the phi phi islands from the tsunami
AU - Ammartyothin, Surasak
AU - Ashkenasi, Issac
AU - Schwartz, Dagan
AU - Leiba, Adi
AU - Nakash, Guy
AU - Pelts, Rami
AU - Goldberg, Avishay
AU - Bar-Dayan, Yaron
PY - 2006/1/1
Y1 - 2006/1/1
N2 - The Phi Phi Islands are isolated islands located about one hour by ship from the mainland in Krabi province of Thailand. There is a small medical facility where the director is the one physician that provides care to residents and tourists. This small medical facility faced an enormous mass casualty incident due to the 2004 Tsunami. The hospital was damaged by the Tsunami wave and was not functional, one crew member died and another was injured. Medical care and evacuation posed a unique problem in the Phi Phi Islands due to remoteness, limited medical resources, lack of effective communication with the main land and the large number of victims. An alternative medical facility was located in a nearby hotel. The crew included the medical director, two nurses, two additional staff members, 10 local volunteers, and hotel staff members. The medical crew had to treat 600-700 casualties in 24 hours. Most of the victims were mildly injured, but approximately 100 (15%) of the victims could not walk due to their injuries. The medical director, made a conscious decision to initially treat only circulation ("C") problems, by con-trolling external hemorrhages. This decision was driven by the lack of equip-ment and personnel to deal with airway ("A") and breathing ("B") problems. In the post-disaster debriefing, the Phi Phi Island hospital physician noted five major lessons concerning disaster management in such extreme situation in a small facility located in a remote area: (1) effective resistant communica-tion facilities must be ensured; (2) clear, simple "evacuation plans" should be made in advance; (3) plans should be made to ensure automatic reinforcement of remote areas with evacuation vehicles, medical equipment and medical personnel; (4) efficient cooperation with medical volunteers must be planned and drilled; and (5) every team member of such a hospital must participate in an educational program and periodic drills should be done to improve the dis-aster and emergency medicine capabilities. This case report is an example for caregivers all over the world, of an amazing lesson of leadership and courage.
AB - The Phi Phi Islands are isolated islands located about one hour by ship from the mainland in Krabi province of Thailand. There is a small medical facility where the director is the one physician that provides care to residents and tourists. This small medical facility faced an enormous mass casualty incident due to the 2004 Tsunami. The hospital was damaged by the Tsunami wave and was not functional, one crew member died and another was injured. Medical care and evacuation posed a unique problem in the Phi Phi Islands due to remoteness, limited medical resources, lack of effective communication with the main land and the large number of victims. An alternative medical facility was located in a nearby hotel. The crew included the medical director, two nurses, two additional staff members, 10 local volunteers, and hotel staff members. The medical crew had to treat 600-700 casualties in 24 hours. Most of the victims were mildly injured, but approximately 100 (15%) of the victims could not walk due to their injuries. The medical director, made a conscious decision to initially treat only circulation ("C") problems, by con-trolling external hemorrhages. This decision was driven by the lack of equip-ment and personnel to deal with airway ("A") and breathing ("B") problems. In the post-disaster debriefing, the Phi Phi Island hospital physician noted five major lessons concerning disaster management in such extreme situation in a small facility located in a remote area: (1) effective resistant communica-tion facilities must be ensured; (2) clear, simple "evacuation plans" should be made in advance; (3) plans should be made to ensure automatic reinforcement of remote areas with evacuation vehicles, medical equipment and medical personnel; (4) efficient cooperation with medical volunteers must be planned and drilled; and (5) every team member of such a hospital must participate in an educational program and periodic drills should be done to improve the dis-aster and emergency medicine capabilities. This case report is an example for caregivers all over the world, of an amazing lesson of leadership and courage.
KW - evacuation
KW - leadership
KW - mass-casualty event
KW - nurse
KW - preparedness
KW - triage
KW - tsunami
UR - http://www.scopus.com/inward/record.url?scp=33748109235&partnerID=8YFLogxK
U2 - 10.1017/S1049023X00003691
DO - 10.1017/S1049023X00003691
M3 - Article
AN - SCOPUS:33748109235
VL - 21
SP - 212
EP - 214
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
SN - 1049-023X
IS - 3
ER -