Were there enough physicians in an emergency department in the affected area after a major earthquake? An analysis of the Taiwan Chi-Chi earthquake in 1999

Study objective: The purpose of this study was to evaluate physician manpow er and mobilization in an urban emergency department receiving patients aft er a major earthquake. Methods: Patient charts were reviewed. The workload of physicians was asses sed semiquantitatively before and after a major earthquake, The physicians' mobilization in the postearthquake emergency response was assessed by usin g a confidential questionnaire. Results: In the 3 days after the earthquake, 566 patients with earthquake-r elated illnesses or injuries were sent to the urban ED. Three hundred one ( 53.2%) patients arrived within the initial 10 hours. In the initial hours, there was no significant difference between the number of patients per phys ician per hour before and after the earthquake. Workloads of wound treatmen t and advanced life support procedures were significantly higher after the earthquake compared with before the earthquake, during the first to sixth h our and second to fifth hour, respectively. Sixty-five percent of the hospi tal's physicians did not assist in either the ED or in any other parts of t he hospital in the initial 6 hours after the earthquake. Conclusion: The number of physicians in the ED was insufficient in the init ial hours after the earthquake because of the sudden influx of a large numb er of patients. Future disaster planning must address the issue of physicia ns' behavior with regard to their priorities immediately after a major eart hquake and include greater provision for efficient mobilization of physicia ns.