The New Protocol: Bringing the Hospital to the Scene

Summary: On October 4th, 2024, the New Taipei City Fire Department received a call about a middle-aged man trapped under a large stone weighing approximately 2 tons following a landslide. The landslide was triggered by heavy rains from Typhoon Krathon, which struck Taiwan. The local fire squad was initially dispatched to free the man, but was unsuccessful. As time passed, firefighters grew increasingly concerned about the man’s medical condition due to prolonged entrapment. “Special Medical Response unit” was then activated, implementing a new protocol developed by the New Taipei City Fire Department. This protocol involves collaboration between trained medical professionals and firefighters to provide advanced medical support during complex rescues. A key feature is the deployment of a specialized medical team directly to the scene, including surgeons, emergency physicians, nurses, and paramedics. Aside from standard prehospital management, this team can deliver on-site advanced medical care, such as administering blood transfusions and managing pain with controlled medications. In extreme cases, they are also trained to perform field amputations to expedite evacuation. This two-tier response involves dispatching an ambulance to transport the medical team, while a mobile surgical truck collects medications and blood products from a contracted hospital before heading to the site as quickly as possible. In this particular case, upon arrival, the medical team administered tranexamic acid to control bleeding and managed the patient’s pain with tramadol. They also coordinated with the receiving hospital to prepare the trauma team in advance. The team monitored the patient’s condition throughout the rescue, and once successfully evacuated, he was transported to a level-one trauma center for further treatment. The patient was later diagnosed with crush injuries and rhabdomyolysis. This case highlights the critical role of advanced emergency protocols in enhancing patient outcomes during complex rescue operations.