The Hyatt Regency skywalk collapse: an EMS-based disaster response.

The Hyatt Regency skywalk collapse (July 17, 1981) provided the emergency medical services system of Kansas City, Missouri, with its greatest challenge ever. Utilizing an EMS-based, centralized, city-wide disaster plan, the rescue operation encountered 113 dead and 188 multiply traumatized patients. The rescue operation could be divided into three areas: initial response, onset triage, and delayed extrication. Success of the operation was credited to several factors, including the centralized urban location of the collapse, short patient transport times, centralized ambulance dispatch, availability of ALS vehicles and personnel to the scene, and mutual aid response. Short-comings of the rescue that became apparent on critical review of the response included poor communications at the scene, lack of physician bystander control, and the need for identification of key personnel at the site. Success in responding to the health care needs of a disaster included a flexible and well-organized disaster response plan as well as the support of a health care system capable of picking up the pieces of the psychological aftermath.