Emergency Medical Care in the Underground Environment

Abstract

Underground medical care is required in certain instances where patients sustain life or limb threatening injuries or illness while in the underground environment. This most often occurs during deep mining operations, both coal and non-coal, and during recreational caving activities. Additional situations such as industrial tunneling, underground repositories and storage areas and building collapses, such as might occur in a natural disaster or in terroristic activities might also occasion the need for such care. The U.S. mining industry suffered 102 fatal accidents with 250 total permanent disabilities during 1980. In 1983 there were 70 fatalities and in 1984, 124 miners died because of mining accidents. Analysis of accident reports indicate that 25–50% of these injuries may have been ameliorated by timely delivery of physician and paramedic based care in the underground environment. From 1967–1975, 187 recorded caving accidents resulted in 33 deaths among 311 victims. It is unclear how many of these fatalities or injuries could have been prevented or ameliorated by rapid delivery of physician and paramedic based underground medical care.

US emergency and disaster response in the past, present, and future: The multi‐faceted role of emergency health care

“…Emergency medicine physicians and paramedics established early sophisticated pre-hospital medical care teams for unusual nonhospital environments such as deep mines, caves, and structural failures, 28 and widespread earthquake building collapse, 29 tactical law enforcement support, 30 and Urban Search and Rescue Medical Teams. 31 DMATs 32 were first developed in the 1980s as part of the National Disaster Medical System managed by DHHS in partnership with the Federal Emergency Management Agency (FEMA), VA, and the Department of Defense.…”

Medical Aspects of Urban Heavy Rescue

“…Medically trained personnel should be integrated into the rescue team to provide medical care at die scene of extrication rather dian waiting for die victim to be extricated and brought to a safe area for treatment. 3 The need for medical care at the site of extrication rests on die premise that die medical literature is replete with case scenarios in which patients in collapsed structures are found and initially appear well, only to deteriorate rapidly following their extrication and recovery. The tremendous time and effort expended in searching for, reaching, and extricating die entombed victim only to have that victim die shortly after extrication or later as the result of a potentially preventable complication is unacceptable.…”