Designation of a new training model of a local disaster medical system with tabletop exercises.

BACKGROUND A new model of a local disaster medical system (LDMS) was proposed through the consensus method of expert panel meetings for county governments in Taiwan. This LDMS model adopts a local emergency medical response system (EMRS) for dealing with daily accidents as a basic structure by expanding its roles and functions. The objective of this study was to determine the feasibility of the new LDMS model by evaluating its initial phase response to simulated disasters using tabletop exercises. METHODS Two tabletop exercises were held after the responders of the LDMS were trained according to the new model. Forty and 42 participants respectively joined the 2 tabletop exercises, which simulated an earthquake causing 400 casualties in 6 different locations in order to apply the new LDMS model. The outcome measurements of the tabletop exercises were the mean accuracy rate of victim triage and disposition, and medical interventions. RESULTS About 92% of victims were correctly triaged, and 88% had a correct disposition. Moreover, around 86% of all victims received adequate medical interventions. All victims were dispatched to appropriate facilities or treatment areas within 45 min. CONCLUSION The new EMRS-oriented model of this LDMS can respond quickly, efficiently, and adequately to the initial phase of a disaster during tabletop exercises. Further clinical investigations are required to prove the efficacy of the new LDMS model in real disasters or in full-scale drills.