1
BACKGROUND
In recent years, the disaster situation has changed complicatedly, containing
many uncertain factors. The fact that disasters occurs without warning, occurs very
suddenly increased the number of victims should be cured, transportation
always exceeds the capacity of the health sector response. To restrict to a
minimum the loss of life and material caused by the disaster, the need for
coordinated action of many forces, media synchronization, in which modern health
sector had an important role. The military zone hospital (MZH) was a general
hospital had specialist (type B), located on the strategic areas of the country,
performing tasks of treatment for soldiers and people in the area. There is
particularly important role in emergency medical response when disaster strikes.
But so far, there was no unified model, RRVMD by the military zone hospitals
was difficult. Therefore, we conducted this research subject to the following
objectives:
1. Status of receiving, rescue victims of mass disasters from military zone
hospitals in the period of 2007-2012.
2. Modeling, deployment experimental exercises and evaluate results of
model organization RRVMD in Hospital 4, Military Zone 4, in 2012-2013.
* New contributions on the practical science of the thesis:
- Has been described real operating condition, capacity of RRVMD of
military zone hospitals (MZH): There was adequate staffing organization by
decision; There are facilities, fully equipped, convenient infrastructure for
RRMVD; Have established the Steering Committee, annually implemented plan
RRMVD; In 6 years (2007-2012) the hospital had 1-2 times receiving, rescue
mass victims; Capable of sorting from 50-100 victims/hour, receiving treatment
from 30-60 victims/hour, maximum deployment 4-10 surgical teams, often held 5-
6 mobile health groups available assignment of a task; Ability to rescue specialist
early for the victims of disaster and responsive, effective for the second disaster.
- Has been developed and successfully tested model RRMVD of MZH:
Depending on the size, characteristics and extent of each type of disaster can be

- Geographically, regions, geography, population
1.1.3. Disaster situation in the world and Vietnam
1.1.3.1. Disaster situation in the world
Catastrophic events in the world were coming complicated and growing
rapidly. In 10 years (2002-2011), there are 3.942 worldwide natural disasters,
including floods accounted for 1.793 cases, whirlwind accounted for 1.022
3
cases The disaster caused by people common as: fire, terrorism, war, industrial
accidents, traffic accidents In 10 years (2002-2011), there were 2.622 disasters
caused by humans, killing 82.609 people and affected up to 152.900 people life,
loss of 38.112 million dollars.
1.1.3.2. Disaster situation in Vietnam
From 2003 - 2012, there were 103 big natural disasters killed 7.748 people
and 6.740 people injured, the loss of material wealth estimated thousand billions.
In Vietnam disaster caused by humans was diverse, complex and increasingly
more serious. Many disasters cause huge losses of life and materials, only traffic
accidents in 10 years (2003-2012) had 36.409 cases occurred, killing 9849 people
and 38.064 people injured.
1.2. The work of emergency medical response to disasters
- In the world: the system for emergency medical response in disasters was
organized to two trends: There were separated organizations outside the health
system or in health system sector.
- In Vietnam: based on the medical establishment to civilian and military
organize searching, rescue, treatment victims due to the line of treatment system.
1.3. Model of receiving, rescue victims of mass disasters in hospital
1.3.1. Situation of ability RRMVD in hospital
Hospitals can deploy RRMVD, depending on the severity of the disaster as
well as the number and structure of victim injury. However, hospitals have no
standard and full model for deployment RRMVD effective and systematic.
1.3.2. RRMVD model of some hospitals through rehearsal

2.1.2. Material Research
- The legal documents relating to the care and protection of people's health,
the combined military and civilian medical response to an emergency condition.
- The document of the situation and the damage caused by the disaster in the
world and in Vietnam, the period from 2002 - 2012
- The document summarizes the work RRVM disaster and the results of a
number of hospitals.
- The statistical reports on infrastructure, staffing organizations, media
equipment, qualifications and professional competence of MZH.
2.1.3. Study sites
At 7 military zone hospitals, organizations 2 experimental maneuvers
(BMT-13 and NA-NĐ13) in the province of Nghe An.
5
2.1.5. Research time
- Phase 1, describes the current status surveys: from 07 2011-06/2012.
- Phase 2, experimental exercises: from 7/2012 - 12/2013.
2.2. Methodology
2.2.1. Study Design
Research describes across, the retrospective study combined quantitative
and qualitative research and intervention by experimental maneuvers.
2.2.2. Sample sizes and sampling studies
2.2.2.1. Sample sizes and sampling baseline study
- All 7 military zone hospitals of the army
- 84 leaders, commander of the military zone hospitals
- 50 experts in: medicine, military medicine, military, logistics
2.2.2.2. Sample sizes and sampling intervention studies
- Intervention model: choose intentionally Hospital 4 - Military Zone 4
- The entire staff of 110 employees in H4/MZ4
- 61 turns of experts selected for interviews, opinions (1
st

2.3. Errors and remedies
- Form design research to ensure adequate information, unified
- Conduct a pre-test, complete toolkit
- Choose enumerators, supervisors are experienced staff
- Organization of adequate training and close supervision
2.4. Methods of analysis and data processing
- Clean form before accessing computer
- Data processing using Excel 2007 software, SPSS 13.0.
2.5. Research organization
- Investigate, analysis the situation in 7 hospitals under the form
- Organizing two rehearsals corresponding to 2 plans were built.
2.6. Limitation of the thesis
- No research on: equipment, drugs, facilities, materials
- No evaluation of the ability of each forces participating in a specific way
- Not given model for each type of disaster
- No deep research on the treatment, ensure logistics
2.7. Ethical aspects of research
- The study subjects entirely voluntary
- The information only used for research purposes and to ensure security.
7
Chapter 3
RESEARCH RESULTS
3.1. Current status and operational capacity of RRVMD of MZH
3.1.1. The task, organization forces.
- Hospitals type B, general hospitals with specialist; With a payroll of 270
employees, was organized into six departments, 7surgical, 7 Internal Departments
and 6 Para clinical Departments.
- MZH had 7 tasks, including: "Ready combat, combat service and meet
emergency medical situations such as natural disasters, catastrophes" .
3.1.2. The number of employees(E) and number of beds(B)

2
)
500 500 400 1500 800 500 1250
Extra beds (bed) 100 50 100 150 100 120 120
- Each hospital had from 3-7 operating rooms, when emergency medical
response can deploy more from 2-4 operating rooms. Each hospital can deploy
more from 50 – 150 B enough to properly cure the disaster 1 to level 2.
8
- The research hospitals were equipped with basically for examination,
diagnosis and treatment of patients, but the number was small, some just a single
type should not be a transfer available on mobile military medical team.
- All research hospitals had mobile equipment and materials as artificial
respiration apparatus, anesthetic machine, operating tables, mobile X-ray all type
of cars to transport patients but not enough quantity to meet if disaster happened.
- All hospitals were not equipped with the tools of preventing biological
weapons, chemical, nuclear, such as sanitation treatment systems, test facilities
and tools of personal protection, respirator protection, DDA car
3.1.4. The situation of receiving and rescue of hospitals in 6 years (2007-2012)
- Number of hospital surgery was not the same, the difference between the
hospitals quite large (2043-7981 cases per year). Individual hospitals have
relatively stable, the next year always higher.
- The targets were exceeded professional regulations: bed utilization rate
reached 116.9% - 184.0%; The rate of illness from 68.2% - 82.8%; The number of
examination/day highest from 190-1471 people/day; The number of
emergency/day highest from 14-140 people/day.
3.1.5. Current status of the organization and the ability to deploy properly and
heal victims of the mass Hospital Research
Table 3:13: The receiving ready, rescue victims of mass in research hospitals
Content
H11

Hospital
Victims
sort/hour
(people)
Operation
(cases)
Motivated
surgical team
(team)
Victims
RR/hour(peopl
e)
H110 50 10 5 50
H9 50 6 5 50
H7 100 8 5 50
H4 50 6 6 50
H17 100 6 5 60
H7A 50 4 5 30
H121 100 6 6 60
The hospital research can be classified from 50-100 victims/hour and
received treatment from 30-60 victims/hour. Regularly held 5-6 emergency groups
and can deploy 4-10 surgical team.
- 56.5% - 66.7% opinions of experts and staff that MZH only meet a part
mission of RRVMD, due to the lack of planning (53.6% - 57.5%); No RRVMD
model (65.0% - 71.4%); lack of practical training RRVMD (67.5% - 81.0%).
- Only 29.8% - 32.7% suggested that the practical ability of medical staff
had good capability in rescue emergency victims of disaster.
3.2. Building RRVMD model in MZH
3.2.1. Basic on model building
- Functions and tasks of military zone hospitals

and limited mortality disabled.
* Content model: Depending on the specific situation, organizations can deploy
RRVMD model as the following options:
11
Area field
Chart 3.2: Diagram deployed forces in place disaster
+ At the disaster site (at the field: hold a mobility medical teams (MMT)
capable of first treatment that the core is basic treatment surgical team(BTST)
enhanced sort and deliver group, maneuver quickly to the disaster field, parts was
organizing according to diagram 3.2.
+ At the hospital:
If number of victims was moderate, not continuous, can use examination
part to receive and sorting, emergency (if any), write patient records and put the
victim in the clinical with professional treatment.
First aid area
Commander
board
Death body
place
Nơi để tử thi
Delivery mild
victims
Emergency area
Delivery severe,
moderate victims
area
Sorting severe,
moderate victims area
Sorting mild victims
area

(HF)
The remaining
forces of hospital
13
Size, staffing: Decision No. 20/QĐ-TM 02/01/2009 Chief of General Staff
of the Vietnam People's Army.
3.2.3. 2 Results through two empirical rehearsals in Hospital 4 - MZ4
3.2.3.1. Rehearsals BMT-12 on 7/2012 (In accordance with option 2)
- Preparatory work;
+ Establish committees: a steering committee, organizing committee,
building committee documents, assisting part, part to ensure
+ Component in the exercise forces: Forces in hospital staff and
coordination.
+ Prepare assumption victims: cases structure like a disaster have occurred,
have more situations poisoning victims.
- Organization of practice exercises and assessment model results:
+ Coordinate with MZ Hygienic team deployed MZ sanitary treatment
+ Deployment MMT arrived the field: the core is first aid team enhanced
delivering group (including 1- 2 nurse practitioners).
+ Deployment HF as basic organizational model of military medical sector.
Table 3:24: Results of deployment hospital field model to RRVMD
Parts
Form
deployment
Content
deployment
Maneuver
time
Time
deployment

7,47
± 3,17
Diagnosis
Result
Corre
ct
SL 46 62 40 148
% 83,6 88,6 88,9 87,1
Wron
g
SL 9 8 5 22
% 16,4 11,4 11,1 12,9
Time
The earliest 10 8 10
Latest 23 20 21
Average 13,8 ± 1,8 12,5 ± 1,6 13 ± 1,7
Time to sort out a victim at least 4 minutes, maximum 18 minutes, with an
average of 6,81 ± 3,15 (min) to 7,63 ± 3,25 (min). Time moving to departments
earliest 8 minutes, latest 23 minutes, on average from 12,5 ± 1,6 to 13,8 ± 1,8
(min). There were 22/170 victims (12,9%) not diagnosed correctly when moving.
Table 3:26: Results hygienic treatment for victims contamination at MZHF
Content
Quantity
victim
Time for 1 sanitary victim(minute)
Minimum
Maximum Average
Victims must be off 8 7 19 12,15 ± 4,27
Victims can walk, bath 13 7 23 11,35 ± 5,61
15

31 93,9 2 6,1 0 0
Perform tasks surgical HSR
33 100 0 0 0 0
Organization and staffing RRVMD
30 90,9 3 9,1 0 0
Evaluate the ability to complete
tasks similar situation
33 100 0 0 0 0
Most (90.9% - 100%) expert reviews of good evaluations all parts of the
content. Only one reviews (3.0%) that should be added: "The RR part should
16
contract with the delivery team so close to transport injured victims immediately
after sorting to help improve circulation quick follow order of priority". 2
comments (6.1%) that required additional content for sanitary station: "It should
work synergistically with internal delivery team for victims must be off".3
comments (9.1%) said that: "It should increase the number of people to transport
victims when the victim receives so many at the same time, there must be
provisions for collecting specific types of preventive stretcher, to ensure sufficient
quantities needed for transporting victims to avoid wasting time".
3.2.3.2. Rehearsals NA-ND13, June/2013 (In accordance with option 1)
- Preparation: similar to BMT-12 drills, but no force participation Hygienic
team and implemented under option 2.
+ Prepare assumption victims: victims cases structure like a disaster have
occurred, however no victims poisoned.
- Organization of practice exercises and assessment model results:
Table 3:30: Results of deployment preparation force in the field and
hospitals
Parts
Form Content
Maneuver

Content Phase I Phase II Phase III Total
The number of victims 10 25 20 55
Time for a
victim
classificatio
n(min)
Maximum 16 14 15
Minimum 3 3 3
Average
6,63
± 2,25
5,81
± 2,17
5,47
± 2,15
6,15
± 2,35
Diagnostic
Results
Correct
Quantity 10 24 20 54
% 100 96 100 98,2
Wrong
Quantity 1 0 1
% 0 4 0 1,8
Time
transport to
clinics
(min)
Earliest 5 8 7

Qu % Qu % Qu %
Perform tasks RR part
27 96,4 1 3,6 0 -
Perform tasks ASRS part
28 100 0 - 0 -
Organization staffing and force
of RRVMD
26 92,9 2 7,1 0 -
Evaluate the ability to complete
tasks when similar situations
occur
28 100 0 - 0 -
Most (92.9%-100%) experts opinion on the forces of organization so good
and also the mission of RRVMD. Only 2 reviews (7.1%) said that: "It should add
up the number of people to transport victims in many cases the victim receives
many at a time, there must be some indication for internal transport forces to
make job easier ".
19
Chapter 4
DISCUSSION
4.1. On the capacity of RRVMD of MZH
One of the important tasks for the MZH such as: when disaster strikes, mass
casualties, then under the leadership of Commanders of military Regions and the
Steering Committee remedial disaster. Rescue forces were mobilized, deployed to
search and rescue, sorting and transporting victims as directed by the medical
establishment to medical facilities. The victim is promptly treated to reduce to the
lowest mortality, disability caused by the disaster. In some hospital researched
were general hospitals with specialist will be the receiving place, rescue for bulk
victim request.
Although the number of patients MZH was huge now and always

In addition, most hospitals have plans to ensure health in unexpected
situations such as: have executive Steering Committee met in medical disaster;
plans to meet health in disaster; has been prepared to meet the health care plan for
each type of disaster, most especially hospitals are organized BTST, rescue teams,
military maneuver, rescue specialist and training, and additional test equipment
regularly should be able to respond quickly when there is an emergency situation.
4.2. About the RRVMD model in MZH
4.2.1. In principle RRVMD of MZH
In terms of hospital professional activities regularly, have collected a large
capacity victims in a time, to avoid the unnecessary disturbance and upset the
rhythm of the scientific work, the entire hospital board on the other hand create the
best conditions for the maximum concentration of manpower, facilities in
RRVMD and avoid other consequences related to emergency medical response,
such as task often hampered regular hospital, infecting victim when poisoned,
radioactive, infectious So RRVMD principles of MZH (hospital B) based on the
principles:
- Ensure regular professional activities of the hospital.
- Make the most of the facilities, vehicles, equipment and forces available
technical staff of the hospital.
- RRVMD based on the principle of rescue transport in lines, according to
regional military and civilian combined.
- Good organization and effective work RRVMD to reduce lowest mortality,
disability for the victims.
21
- Coordinate combines maximum strength of the forces in the area,
especially to coordinate with local health workforce, good performance combining
military and civilian medical care in the emergency response to disaster for
receiving victims rescue and overcome the consequences of the disaster.
Principles RRVMD of MZH must be comprehensive, high planned, timely
and always demonstrated a deep humanity with the ultimate objective is to

and retraining staff of the hospital management of organizational capacity,
22
commanders, operating in situations RRCMD, team training staff technical
proficiency level of mass emergency when a disaster occurs.
With the experimental rehearsal RRVMD of hospital 4 have presented a
number of process modeling and how to implement, other hospital the same line
can refer and use as appropriate: On the level of disaster : MZH may meet with
disaster levels 1 to level 2, the highest efficiency level disaster 2. Means that it can
receive and rescue 51 to 200 victims.
The disaster near hospitals, regional hospitals may receive victims directly
from the hospital to the disaster site if within 40 km, convenient transportation,
hospitals need to be implemented under the option 1 as follows: at field used
MMT a strong team, flexibility for receiving emergency, sorting, transporting to
MZH. At the hospital with moderate number of victims, not continuous, just
enhance forces for the examination part or organize a part close to the examination
department is ready enough for picking up, sorting and transporting victims
personnel in the department of the hospital.
If disaster distance far of 40 km, transportation difficulties, not directly
move the victim to a hospital, should be implemented in accordance with option 2
as follows: at the field still use the MMT but compact because at the field, there
were other forces work together to perform tasks in place disaster. In hospital
separate a part with fully equipped forces have separate payroll to establish
hospital field- basic hospital for MMT in order to RRVMD as soon as possible.
CONCLUSION
Through researching situation and the possibilities of receive, rescue mass
victims of the military zone hospitals from 2007 - 2012 and the intervention study
by experimental maneuvers in Hospital 4 - Military Zone 4 (2012 - 2013), we
draw the following conclusions:
1. Situation and capacity of RRVMD in MZH period 2007-2012:
- The hospital has adequate staffing organization by decision. The payroll

sorting groups - ensuring escort compact, maneuverable; Tasked to the field to
search, sorting, transport and rescue victims to the back
+ Field hospital disaster response, deploying far disaster site by 10-15 km, to
be the basic hospital for MMT.
+ Force's remaining of MZH do routine tasks but to narrow the mission and
scope of the rescue.
* Results after two rehearsals under two experimental options:
24
- The model was considered reasonable, realistic, feasible, easy to
implement. Two plans laid out properly with the actual ability of the current MZH,
close to the disaster situation that may occur in the future.
- 90.9% - 92.9% of respondents rated experts on organization, staffing, use
of force in 2 options was reasonable. 100% expert opinion evaluation model was
built, MZH capable of completing tasks when similar situations.
RECOMMENDATIONS
From the research results achieved, propose some recommendations below:
1. Department of Defense annual budget spent large enough to facilitate the
rehearsed in the model applied to MZH response to the disaster scenario happens
in the future.
2. Having a plan training human resources, expanding the scope of
professional, equipment to enhance MZH may rescue specialist for the victims.
3. Although modeling and studied the plan was very basic, but the disaster
was not predictable completely and accurately. So we need to have the following
specific research to effectively respond to each type of disaster that may occur in
the future.