Disaster-Site Medical Support Organization in a Small Country

Optimal, initial medical care given at the disaster site to victims of civil disasters requires an organized, pre-planned, disaster-site medical support system. Such a system has been developed in Singapore. On notification of a serious civil disaster, the Coordinating Health Agency (CHA) initially dispatches up to three medical teams. Each team consists of two doctors, four nurses, and an allotment of pre-packaged medical supplies. A Disaster-site Medical Command (DSMC) head-quarters (HQ) is established, consisting of a Medical Commander (MC), a Deputy Medical Commander (Dy MC), three hospital staff, and a clerk. The MC conducts an initial assessment of the disaster site and then deploys medical teams and establishes the headquarters. The MC also informs the CHA (via cellular telephone) of the situation at the disaster site and when deemed necessary requests further medical assistance. The MC has two-way radio contact with all medical teams. The medical teams relay information regarding the casualty situation, requirements for ambulances, stretchers, and medical supplies. Direct channel communication with the CHA enables the MC to direct ambulance transport of patients from the disaster site. The MC also has operational control over other paramedical teams from the Fire Service, the Singapore Red Cross, and the Singapore Armed Forces. Prior to transportation to the hospital, the medical teams only carry out trauma resuscitative procedures such as maintenance of airway, ventilation, and circulation. This system is expected to provide a coordinated and rapid medical response to a civil disaster situation.