Table 3 Recommendations for future disaster medical transportation

1. Plan for long-distance evacuation

Medical facilities, including nursing homes, should have a plan for long-distance disaster-specific (over 100 km) evacuation. This plan should be practiced with full-scale exercises and when flaws are found, they should be evaluated and eliminated

2. Securement of transportation measures and designated hospitals

A disaster-specific evacuation plan should include the securement of transportation measures and designated hospitals where patients can be sent

3. Multiple communication measures

Healthcare facilities should have two or three independent communication measures such as a radio, satellite phone, amateur radio, and multi-channel access radio systems

4. Supervision by emergency physicians and disaster specialists

Hospital evacuation in disaster settings should be supervised by emergency physicians and be handled by disaster specialists who are accustomed to patient transportation on a daily basis

5. Dispatch of central governmental persons to the disaster site

Selected members of the central government should not stay in the central office waiting for information from the disaster site, but should go into the disaster site, get precise information, and make use of the information to formulate a governmental response

6. The presence of an emergency physician or disaster researcher in the central government

The presence and availability of an emergency physician or disaster researcher in the central government can greatly contribute to the governmental response, especially for disaster-specific medical transportation