Medical Rescue Teams Research Articles

Standard 12-lead electrocardiogram tele-transmission: Support in diagnosing cardiovascular diseases in operations undertaken by Warsaw-area basic medical rescue teams between 2009 and 2013.

Basic medical rescue teams (BMRTs) administer aid in the pre-hospital phase to people in a life-threatening condition. A tele-transmission and teleconsultation system (TTaTC) supports the team without a physician. The aim of the presented study was to evaluate the application and spectrum of use of a 12-lead ECG TTaTC in BMRT operations. Medical records of BMRTs in Warsaw from September 2009 to August 2013 regarding TTaTC were checked. Successful TTaTC, electrocardiography (ECG) results, sex, age, consultant advice, and decisions of BMRT leaders were analyzed. BMRTs performed 28,557 12-lead ECG transmissions within the analyzed period. The teams recorded 26,208 (91.8%) successful tele-transmissions, while 2,349 tests (8.2%) failed to reach the TC. The average TTaTC time was 6 min 12 s. The most common reason for using the ECG TTaTC was chest pain. ST-segment elevation myocardial infarction (STEMI) was diagnosed in 2.1% of the cases, and non-ST segment elevation myocardial infarction - NSTEMI - in 3.8%. Cardiac arrhythmia was recorded in 20.5% of the events. TTaTC proved to be useful when making decisions on transporting patients to appropriate hospitals. One hundred percent of STEMI cases - all confirmed by TC - were transported directly to cardiac centers. 1. TTaTC constitutes an increasing support in BMRT everyday operations and is widely used. 2. Standard ECG TTaTC with a physician improved BMRT diagnostic capaci-ties and exerted a beneficial impact on cardiovascular patient segregation and target hospital selection. 3. It seems possible to expand the scope of operations performed by BMRT members based on TTaTC.

Emergency response to nuclear, biological and chemical incidents: challenges and countermeasures.

Given the multiple terrorist attacks that have occurred in recent years in China, medical rescue teams and specialized incident assessment teams have been established by the government; however, medical rescue after nuclear, biological, and chemical incidents remains challenging and is often inefficient. In the present article, problems were analyzed regarding the assessment of responder countermeasures, training of professionals and the management of emergency medical incidents related to nuclear, biological and chemical attacks. Countermeasures, the establishment of response coordination, public education, practical training and exercise, and a professional consultant team or system should be the focus of emergency medical response facilities. Moreover, the government was offered professionals who are involved in managing nuclear, biological and chemical incidents.

Post-earthquake allocation approach of medical rescue teams

Earthquakes result in overwhelming demand for medical resources at once, and affected areas requires reinforcement from neighbor cities. An effective allocation approach of medical rescue teams in early stage of disaster relief can improve rescue performance significantly. To find optimal allocation strategy, an integer nonlinear programming model is established, following utility principle. To construct the optimization model, stochastic transition probability of triage levels is introduced. Meanwhile, function from allocation scheme to fatalities of areas is established. Next, we design algorithm based on Lingo software to find solution of utility model. Finally, numerical experiments based on real data in 2008 Sichuan earthquake in China are used to compare utility approach with existing approaches in practice. The results of experiments indicate that: (1) to save more lives, a support team should preferentially be allocated to a worse and nearer affected area. When the worst area is not the nearest, the team also may be sent to an area with moderate severity and moderate distance. (2) Compared with severity strategy and distance strategy, utility strategy improves rescue efficiency significantly.

Flood Disaster Risk Reduction and Adaptation Around the Coastal Area of Bangladesh

This study was undertaken to investigate the strategies for flood disaster risk reduction and adaptation around the coastal area of Bangladesh. Education level and environmental awareness, family size, farm size, adaptation tools, loss due to flood disaster, adaptation tools and area of the rivers and canals of the localities were taken as independent variables. On the other hand, pre and post flood activities were considered as dependent variable of the study. Pre flood activities such as miking around the flood disaster areas reduced flood risk 44.2%, radio and TV bulletin 25.0%, enclosure tube-well by polythene bag 16.7% and shifting the people to cyclone center reduced flood risk 14.2%. However, post flood activities such as food and water supply contributed 48.3% and activities of medical rescue team (i.e. provide medicine, vaccination and saline) and agricultural inputs supply (i.e. seed, fertilizer, livestock’s, fisheries) contributed the same percentage i.e. 25.8% to adapt flood disaster. These variables were tested to explore the relationship between the dependent and independent variables. Education level and environmental awareness, family size, farm size, adaptation tools, loss due to flood disaster were significantly correlated with the pre and post flood activities for flood disaster risk reduction and adaptation around the coastal areas. The findings indicated that the lower the education level and environmental awareness of the coastal area people the lower is the activities (pre and post) during flood disaster in flood disaster risk reduction and adaptation. The findings also indicated that the pre flood preparation is not enough for flood disaster risk reduction and adaptation around the coastal area of Bangladesh and adaptation tools were not sufficient for flood disaster risk reduction and adaptation around the coastal area s of Bangladesh.DOI: http://dx.doi.org/10.3329/jesnr.v6i1.22040 J. Environ. Sci. & Natural Resources, 6(1): 53-57 2013

Epidemiological and medical aspects of canyoning rescue operations

AimTo describe the characteristics of canyoning rescue operations (CRO), type and severity of injuries or illnesses, and on-site medical procedures. Patients and methodsA retrospective analysis of all CRO data from an emergency medical rescue team in Aragon, Spain, between 1 August 1999 and 31 July 2009. ResultsA total of 520 patients were identified, with a male to female ratio of 1.4. The median age was 32 years (range 10–73 years). The median time from the emergency call to admission to an acute care facility (or evacuation for uninjured patients) was 90min (range 10–860min). In 329 (63.3%) cases technical skills or ability in the terrain with some grade of difficulty was required. Accessibility of the incident site was associated with type of rescue (p<0.0001), where patients in incident sites with moderate to extremely difficult access were more often rescued by ground rescue alone or supported by air rescue than by air rescue alone. 419 (80.6%) patients had trauma-related injuries. The most common injuries involved the lower extremities (74%). The percentage of patients with a NACA score ≥4 was higher for medical/environmental illnesses than traumatic injuries (p<0.0001), despite that the total number was smaller. 175 (33.7%) patients received analgesics. 370 (71.2%) patients required splinting/immobilization. Major life-saving medical interventions were rarely performed on-site. ConclusionsThe length and exposure to environmental factors validates the importance of emergency physicians and paramedics in CRO. Physicians and paramedics should be familiar with Pre-hospital Trauma Life Support, medical procedures related to environmental, topographical and logistical conditions, and helicopter rescue operations including winch operations.

Identification of Design Requirements for Ergonomic Long Spinal Board Using Quality Function Deployment (QFD)

Emergency Medical Services (EMS) is a basic medical acts carried to an accident victim with the purpose of sustaining life and preventing a decline in body condition before the victim finally getting further treatment from medical personnel. One evacuation tool of first aid commonly used is Long Spinal Board (LSB). This tool is set up as an emergency stretcher boards made from wood or polymer with a flat surface that is used to perform the evacuation of the injured spinal cord. The basic principle of the LSB use is to immobilize the position of the spine so that the secondary injury on the spine due to swing, clash, or shocks that occurred during the evacuation process can be minimized. However, the existing LSB has several disadvantages, both in terms of user comfort, and also the effectiveness and efficiency of the evacuation process when done. A recent study found the LSB use can cause pain, discomfort, and respiratory disorders to the patients. Furthermore, the LSB can blockage the flow of oxygen in the tissue capillaries at the placement of strap. Therefore, it is important to improve the design of the LSB with the aims to achieve mobility and better equipment compatibility when used, so that the evacuation process can be done more effectively, efficiently and safely. This study identifies the design requirements of ergonomic LSB using Quality Function Deployment (QFD). QFD is an effective design method to integrate ergonomics needs and comfort into LSB design because it explicitly addresses the translation of customer requirements into engineering characteristics. Preliminary survey was conducted through direct observation of the actual use of LSB that exists today and interviews with volunteers from the Indonesian Red Cross of West Sumatera. Data gathered was translated into questionnaire and answered by 47 participants from medics, Red Cross, Ambulance Unit Medical Officer and rescue team of Padang, West Sumatera. Then it was clarified and used in the House of Quality matrix. The QFD analysis of the LSB revealed that the selection of LSB main board materials, the application of LSB strap systems, as well as the addition of LSB features were receiving the highest overall weighting, which means that improving the design of those criteria would lead to higher customer satisfaction.

Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

Background As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility. Conclusions The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities.

Retrospective on the construction and practice of a state-level emergency medical rescue team.

For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

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The Rapid growth of technology and infrastructure has made our lives easier. The advent of technology has also increased the traffic hazards and the road accidents take place frequently which causes huge loss of life and property because of the poor emergency facilities. Our project will provide an optimum solution to this draw back. An accelerometer can be used in a car alarm application so that dangerous driving can be detected. It can be used as a crash or rollover detector of the vehicle during and after a crash. With signals from an accelerometer, a severe accident can be recognized. According to this project when a vehicle meets with an accident immediately Vibration sensor will detect the signal or if a car rolls over, and Micro electro mechanical system (MEMS) sensor will detects the signal and sends it to ARM controller. Microcontroller sends the alert message through the GSM MODEM including the location to police control room or a rescue team. So the police can immediately trace the location through the GPS MODEM, after receiving the information. Then after conforming the location necessary action will be taken. If the person meets with a small accident or if there is no serious threat to anyones life, then the alert message can be terminated by the driver by a switch provided in order to avoid wasting the valuable time of the medical rescue team. This paper is useful in detecting the accident precisely by means of both vibration sensor and Micro electro Mechanical system (MEMS) or accelerometer. As there is a scope for improvement and as a future implementation we can add a wireless webcam for capturing the images which will help in providing drivers assistance.

Disaster resilience in tertiary hospitals: a cross-sectional survey in Shandong Province, China

BackgroundHospital disaster resilience can be defined as a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one. This study aims to explore the status of resilience among tertiary hospitals in Shandong Province, China.MethodsA stratified random sample (n = 50) was derived from tertiary A, tertiary B, and tertiary C hospitals in Shandong Province, and was surveyed by questionnaire. Data on hospital characteristics and 8 key domains of hospital resilience were collected and analysed. Variables were binary, and analysed using descriptive statistics such as frequencies.ResultsA response rate of 82% (n = 41) was attained. Factor analysis identified four key factors from eight domains which appear to reflect the overall level of disaster resilience. These were hospital safety, disaster management mechanisms, disaster resources and disaster medical care capability. The survey demonstrated that in regard to hospital safety, 93% had syndromic surveillance systems for infectious diseases and 68% had evaluated their safety standards. In regard to disaster management mechanisms, all had general plans, while only 20% had specific plans for individual hazards. 49% had a public communication protocol and 43.9% attended the local coordination meetings. In regard to disaster resources, 75.6% and 87.5% stockpiled emergency drugs and materials respectively, while less than a third (30%) had a signed Memorandum of Understanding with other hospitals to share these resources. Finally in regard to medical care, 66% could dispatch an on-site medical rescue team, but only 5% had a ‘portable hospital’ function and 36.6% and 12% of the hospitals could surge their beds and staff capacity respectively. The average beds surge capacity within 1 day was 13%.ConclusionsThis study validated the broad utility of a framework for understanding and measuring the level of hospital resilience. The survey demonstrated considerable variability in disaster resilience arrangements of tertiary hospitals in Shandong province, and the difference between tertiary A hospitals and tertiary B hospitals was also identified in essential areas.

Comparison of two large earthquakes in China: the 2008 Sichuan Wenchuan Earthquake and the 2013 Sichuan Lushan Earthquake

Over a period of 5 years, two large earthquakes struck Sichuan Wenchuan and Lushan successively. The two main seismic zones are only 87 km apart along the same seismic belt on the Longmenshan fault. Although there was only one magnitude of difference between the two great quakes, losses from the 2013 Lushan Earthquake were much lower than that of 2008 Wenchuan Earthquake. This study compares these disasters in terms of preparation and response in order to develop effective ways to reduce casualty and economic loss in future earthquakes. By determining what was done right after the Wenchuan Earthquake, we can better understand how to reduce future losses. This study focuses on seven factors: basic information, preparedness, government response, local residents’ responses, medical rescue teams’ work, earthquake-induced secondary effects, and injury character. We also recommend that three major actions should be emphasized to facilitate the most effective course of disaster planning and action. First, sufficient preparedness and strict preventive measures form the foundation to minimize damage and reduce casualties. Once the disaster had occurred, a single, well-run headquarters increases efficiency in rescue efforts. Finally, local rescue strength of both professional staff and citizens is the most critical factor to lower disaster casualties.

Medical emergency rescue in disaster: the international emergency response to the Haiyan typhoon in Philippines.

Following Typhoon Haiyan, the World Health Organization (WHO) has been supporting the Government of the Philippines in coordinating the incoming relief supplies from more than 30 international humanitarian health organizations. During the 10 days in Abuyong, Philippines, the Chinese medical rescue team consisting of 50 experts specialized in clinical medicine and disease prevention and control action was taken including, medical treatment, environmental disinfection and health education. A total of 1,831 cases and 2,144 outpatients were treated, blood tests, B-ultrasound, electrocardiogram (ECG) and other laboratory examinations were carried out for more than 615 patients; a cumulative 90,000 square meters in external environment were disinfected, and more than 500 health education materials were handed out. Besides, measures of purifying drinking water, and rebuilding the local hospital have also been carried out. The international emergency response to the Haiyan typhoon in Philippines contributed to reconstruct the local disaster health system by the activities from international medical emergency rescue. To improve the capacity of international medical emergency rescue in disaster, the special project of foreign medical emergency rescue should be set in countries' medical emergency rescue, and disaster emergency medical rescue should be reserved as a conventional capacity.

Development of Automatic Geofencing and Accidental Monitoring System Based on GPS Technology

The main objective of this project is to design and develop an embedded system for vehicle to detect the road accident for immediate medical help as well as for security purpose in theft prevention using single shock sensor. In case of accidental mode the system should inform automatically via text message to medical rescue team indicating the position of vehicle location. When there is no car driver, vehicle should automatically go into security mode. When a person tries to steal the vehicle, this system should send an alert message to the owner. The system Geo fencing and accidental monitoring system based on AT89S52 as a central core. This includes various technologies: a shock sensor, Liquid crystal display (LCD), Dual relay and wireless communication. This system also includes Geo fencing technology. Geo fencing enables the remote monitoring of predefined set of boundaries and automatic detect when vehicle exit from these areas.

The Chinese national emergency medical rescue team response to the Sichuan Lushan earthquake

At 8:02 on 20 April 2013, an earthquake of magnitude 7.0 struck the Lushan area of Sichuan province, China. The affected population was 1.99 million, spread over 19 cities involving 115 countries. Over 458,000 people were resettled urgently (http://zh.wikipedia.org/wiki/ 2013Yaanearthquake). The number of those injured and killed is reported to be 13,000 and 196 by the time 12:00, 26 April (http://news.sina.com.cn/c/2013-04-27/090126968052.shtml). The decision to set out an emergency medical rescue team was taken at a national level the Ministry of Health, and the immediate response was funded by The General Hospital of the Chinese People’s Armed Police Forces. The request to the medical team came through 2 h after the earthquake, and the team arrived at Yaan People’s Hospital with medicine and equipment 14 h later. This paper describes the team’s experience during the immediate aftermath of the earthquake and the following 8 days.

Implementation of telemedicine services in the earthquake disaster relief: the best medical experts provide direct medical service to the affected people

To sum up the experience and significance of the remote medical consultation system used by the PLA General Hospital in 4/20 Sichuan Lushan earthquake medical rescue in 2013. After the Lushan earthquake in April 20, 2013, the expert medical rescue team of the PLA General Hospital immediately took the wireless portable telemedicine system to the converge hospital which had received many wounds in earthquake and had been connected with other hospitals, medical rescue teams and rescue ambulances to open the remote medical consultation system for disaster services including intensive care, emergency treatment, orthopedics, cerebral surgery, hepatobiliary surgery, obstetrics, gynecology and other related professional remote assistance services. The experts put forward the diagnosis and treatment for victims and had a benign interaction between the experts in disaster site and rear experts, as a result improved the ability of treatment of the disaster expert medical team. The PLA General Hospital treated more than 110 patients by remote medical consultation system in the Lushan earthquake and achieved real-time HD consultation and on-site operation guide. The using of remote medical consultation system achieved the connection between multimedia communication system and medical information system of the hospital and the interconnection of video, audio, data and medical services among each united hospitals, which can provide the significant experience of using remote medical consultation system in our disaster medical rescue activities.

Discussion about health assessment and epidemic prevention mode for China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake

To discuss health assessment and epidemic prevention in earthquake rescue, to establish emergency health and epidemic prevention mode for the national earthquake emergency medical rescue team scientifically, and to provide references and consultations for emergency hygiene and epidemic prevention measures in disaster medicine. China National Earthquake Disaster Emergency Search and Rescue Team gathered and evaluated environment, food, drinking water and other health related information around more than 2000 earthquake victims in Baoxing County, Shuangshi Town and Qingren Township from 20th April 2013 to 27th by using methods such as field epidemiological investigations. The national earthquake emergency medical rescue team spread comprehensive evaluation focusing on the local epidemics, find out the starting point of epidemic prevention, and then built reporting system in disaster area. The team also formulated the emergency detection system of food and drinking water and carried out health education. After the golden 72 hours, by comprehensive evaluation the establishment of early response in disaster area and spreading epidemic prevention, this team achieved the full coverage of three in the earthquake area, the resettlement of residents and families in that area and gradually formed a disaster medical rescue hygiene and epidemic prevention mode.

Surviving 6 days in a crevasse

In August, 2012, a 70-year-old-man fell 10 m into a crevasse (10 m depth, 1 m width) while crossing a glacier alone at 3000 m in the Austrian Alps. He was immediately wet up to his waist and gloves with no possibility of self-rescue. He was healthy, fi t, and was not taking any medication. He had a history of two leg fractures many years ago but otherwise an uneventful medical history. He had hiking equipment including gloves, hat, and some food, but was without specifi c glacier equipment such as crampons, iceaxe, and rope. In the crevasse there was some visible daylight and he sat down on his backpack. There was no cellular network coverage and his mobile phone battery was soon depleted. On the basis of the distance to the closest mountain huts he estimated that hikers could have been in his vicinity between 1000 h and 1600 h daily, during which time he periodically shouted for help. To conserve body heat he covered himself with rescue foil (200 cm by 135 cm) (fi gure). He rationed his food to a few biscuits and one row of chocolate daily (800 kJ per day), and drank water dripping from the ice, but he became increasingly thirsty. He reported that he had lost hope of survival on the fourth day, but resisted panicking. On the sixth day, hikers heard his call and a medical helicopter and rescue team were mobilised. Our patient was winched up from the crevasse and fl own to a local hospital. On assessment, his Glasgow-coma-scale score was 15, heart-rate 85 per min in sinus rhythm, blood pressure 120/70 mm Hg, body-core temperature meas ured epitympanically 33·5°C, serum sodium 130 mmol/L, creatinine 173·3 μmol/L, urea 90·4 mmol/L, creatine kinase 2·942 U/L, myoglobin 2·013 μg/L, uric acid 1058·7 μmol/L, glucose 8·9 mmol/L, Lancet 2013; 381: 506

Vehicle Accident Automatic Detection and Remote Alarm Device

&lt;p&gt;The Rapid growth of technology and infrastructure has made our lives more easy . The advent of technology has also increased the traffic hazards and the road accident take place frequently which causes huge loss of life and property because of the poor emergency facilities. Our project will provide an optimum solution to this draw back. An accelerometer can be used in a car alarm application so that dangerous driving can be detected . It can be used as a crash or rollover detector of the vehicle during and after a crash. With signals from an accelerometer, a severe accident can be recognized. According to this project when a vehicle meets with an accident immediately Vibration sensor will detect the signal or if a car rolls over, an Micro electro mechanical system(MEMS) sensor will detects the signal and sends it to ARM controller. Microcontroller sends the alert message through the GSM MODEM including the location to police control room or a rescue team. So the police can immediately trace the location through the GPS MODEM, after receiving the information. Then after conforming the location necessary action will be taken. If the person meets with a small accident or if there is no serious threat to anyone`s life, then the alert message can be terminated by the driver by a switch provided in order to avoid wasting the valuable time of the medical rescue team.&lt;/p&gt; &lt;p&gt;This paper is useful in detecting the accident precisely by means of both vibration sensor and Micro electro Mechanical system(MEMS) or accelerometer. As there is a scope for improvement and as a future implementation we can add a wireless webcam for capturing the images which will help in providing driver`s assistance.&lt;/p&gt; &lt;p&gt;Keywords - Accident ,Automatic Detection, Micro electro Mechanical system , Remote Alarm Device, Vehicle&lt;/p&gt;

Monitoring Road Accidents using Sensors and providing Medical Facilities

The main objective of this paper is to detect an accident in which immediately help is required to driver and driver is not in position to inform any medical rescue team. In this kind of situation there is a need to develop such system which should inform automatically to medical rescue team that some accidents have taken place along with geo-graphical location. This paper proposed a method using various sensors for monitoring accidents and providing on spot medical facility.

Comparison of Two Large Earthquakes: The 2008 Sichuan Earthquake and the 2011 East Japan Earthquake

Between August 15th and 19th, 2011, eight 5th-year medical students from the Keio University School of Medicine had the opportunity to visit the Peking University School of Medicine and hold a discussion session titled "What is the most effective way to educate people for survival in an acute disaster situation (before the mental health care stage)?" During the session, we discussed the following six points: basic information regarding the Sichuan Earthquake and the East Japan Earthquake, differences in preparedness for earthquakes, government actions, acceptance of medical rescue teams, earthquake-induced secondary effects, and media restrictions. Although comparison of the two earthquakes was not simple, we concluded that three major points should be emphasized to facilitate the most effective course of disaster planning and action. First, all relevant agencies should formulate emergency plans and should supply information regarding the emergency to the general public and health professionals on a normal basis. Second, each citizen should be educated and trained in how to minimize the risks from earthquake-induced secondary effects. Finally, the central government should establish a single headquarters responsible for command, control, and coordination during a natural disaster emergency and should centralize all powers in this single authority. We hope this discussion may be of some use in future natural disasters in China, Japan, and worldwide.