Authors (including presenting author) :
Chan YW(1), Li CK(1), Yuen CW(1), Chan CC(1), Lau CL(1)
Affiliation :
(1) Accident & Emergency Department, Tuen Mun Hospital
Introduction :
Pre-hospital emergency care is a subspecialty of Emergency Medicine. Pre-hospital care is mainly provided by the Ambulance Command of the Fire Services Department (FSD). The airspace of Hong Kong and a significant proportion of the South China Sea is provided by Government Flying Service (GFS), which includes search & rescue (SAR), air ambulance, or casualty evacuation (CASEVAC). According to the Hong Kong Special Administrative Region Government (HKSAR) Emergency Response System (ERS), there are three principal phases of emergency response: rescue, recovery, and restoration phases. In the rescue phase, the HA plays an important role in providing emergency medical and hospital services in the event of massive casualties. This includes dispatching Medical Control Officer (MCO) and Emergency Medical Team (EMT) to the disaster scene, providing on-site triage, emergency stabilization treatment, and advice on orderly diversions to the hospital. It also includes collaborating with other rescue agencies to provide on-site emergency medical support.
Objectives :
1) To examine the nature of EMT activation, 2) To analyze the characteristic & outcomes of EMT patients, 3) To analyze the location of accident black spots in Tuen Mun District
Methodology :
Data were collected retrospectively from the Prehospital Emergency Care (PHEC) database in the Department of Accident and Emergency (AED) from Jan 1st, 2011, to Dec 31st, 2021. All clinical records were reviewed.
Result & Outcome :
There were 20 cases dispatched to EMT from 2011 to 2021. No EMT was dispatched in 2012, 2017, and 2018. More than two-thirds were male (90% male and 10% female). Most of the age group was adults (95% adults and 5% children). Nature of EMT activation: a) prolonged rescue, patient entrapped over 30 min: Motor vehicle crash (MVC) (45%), Severe industrial accident (30%), Building collapse (5%), b) No EMT dispatched for Mass casualty incident (MCI), c) Others: Escort cross-border critical ill case (20%). The nature of MVC cases: Driver (67%), Passenger (22%), Pedestrian (11%). The nature of Severe industrial accidents: Limb entrapped (50%), Whole body entrapped (50%). The discharge destination: Admission (70%), Death (30%). The location of the MVC black spot: Wong Chu Road (34%). Conclusions: Civil Disasters (major incidents) are events that place stress on the emergency services, both in the pre-hospital and hospital phases. There is often intense media interest, and staff must cope with additional pressures while trying to create order from chaos. In terms of clinical training of EMT, medical and nursing staff can follow the principles taught in COC(A&E) Disaster Field triage and Management workshop, COC (A&E) MCO workshop, ATLS, TNCC, PHTLS, or ITLS course. Emergency physicians and emergency nurses should ideally participate in government full-scale multiple-department disaster exercises. Clearly, not all staff will be able to participate in a full exercise, and a disaster drill report and video of the exercise can become a valuable training tool for staff.
