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Medicine (Baltimore). 2014 Dec;93(27):e186. doi: 10.1097/MD.0000000000000186.

Adaptation and promotion of emergency medical service transportation for climate change.

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From the Graduate School of Engineering Science and Technology, National Yunlin University of Science & Technology, Douliou, Yunlin (C-LP); Department of Emergency Medicine, Changhua Christian Medical Center, Changhua (C-WC); and Department and Graduate School of Safety and Environment Engineering, Research Center for Soil & Water Resources and Natural Disaster Prevention, National Yunlin University of Science & Technology (J-CW), Douliou, Yunlin, Taiwan, ROC.


The purpose of this study is to find a proper prehospital transportation scenario planning of an emergency medical service (EMS) system for possible burdensome casualties resulting from extreme climate events. This project focuses on one of the worst natural catastrophic events in Taiwan, the 88 Wind-caused Disasters, caused by the Typhoon Morakot; the case of the EMS transportation in the Xiaolin village is reviewed and analyzed. The sequential-conveyance method is designed to promote the efficiency of all the ambulance services related to transportation time and distance. Initially, a proposed mobile emergency medical center (MEMC) is constructed in a safe location near the area of the disaster. The ambulances are classified into 2 categories: the first-line ambulances, which reciprocate between the MEMC and the disaster area to save time and shorten the working distances and the second-line ambulances, which transfer patients in critical condition from the MEMC to the requested hospitals for further treatment. According to the results, the sequential-conveyance method is more efficient than the conventional method for EMS transportation in a mass-casualty incident (MCI). This method improves the time efficiency by 52.15% and the distance efficiency by 56.02%. This case study concentrates on Xiaolin, a mountain village, which was heavily destroyed by a devastating mudslide during the Typhoon Morakot. The sequential-conveyance method for the EMS transportation in this research is not only more advantageous but also more rational in adaptation to climate change. Therefore, the findings are also important to all the decision-making with respect to a promoted EMS transportation, especially in an MCI.

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