What A Disaster! The Hydrofluoric Acid Leak in Gumi City in 2012: Lessons What We Have Earned From Review of the Past Hospital’s Disaster Response

Abstract

Objective: This study aimed to analyze the characteristics of hydrogen fluoride–exposed patients (HFEPs) treated at an emergency department (ED) at a local university hospital, and to review the hospital's disaster response according to staff, stuff, space, and system (4Ss).Method: This is retrospective observational chart review and descriptive study included 199 HFEPs among 2628 of total ED patient who visited a local university emergency medical center for treatment between September 27 and October 20, 2012, following an HF leak at the Hub Globe factory in Gumi City, Republic of Korea. Descriptive results concerning 4Ss were obtained from interview with ED specialist staff physician on duty during the study period. According to the criteria of the American Burn Association, patients requiring burn center referral were assigned to the major burn group (MBG) as severe condition. Result: During the first 24 h after the accident, 161 (80.9%) HFEPs were treated in the ED. Among the 55 (27.6%) patients in the MBG, 8 (4% of the HFEPs) came to the ED during the acute phase (within the first 8 h after the leak began). During the acute phase, the ED was staffed with three doctors and three nurses. Among the total 2628 patients in the ED during the study period, 262 (9.97%) patients, including 167 (83.92%) of the 199 HFEPs, were there during the subacute phase, defined as the 24 h after the acute phase. During the subacute phase, the ED staff consisted of six doctors and 10 nurses. No concepts according to 4Ss that allowed for the expansion of ED space with securing disaster reserve beds or an increase in manpower with duty time adjustments or duty relocation for ED working personnel were in place as well as reinforcement of logistics such as antidote or PPE or disaster related measures of administration department or decontamination zone setup or decontamination or disaster related diagnostic testing measures or unification and management of the entrances and exits of hospital or implementation of previously designated disaster triage.Conclusion: Hospital disaster response was insufficient for all aspects of 4Ss. Detailed guidance for hospital disaster management plan establishment is required.