The Kobe earthquake: the system response. A disaster report from Japan.

The Great Hanshin earthquake on 17 January 1995 caused a complete disruption of both the communications and transportation systems which, as a result, severely hampered a prompt and timely system response. The survival rate of the extricated victims was 80.4% on the first day, and 1892 victims were extricated with an overall survival rate of 40%. Very few patients were transported to hospitals outside the disaster area on the first day of the disaster. The power supply was quickly reestablished, however, it took a long time for the water supply to return to normal and this factor played a major role in limiting the clinical activities of the damaged hospitals. Crush syndrome was the most prominent medical syndrome necessitating critical care after the Kobe earthquake. The Japanese Association for Acute Medicine has since made eight new proposals for emergency medicine during mass-disasters that will hopefully improve the survival of patients in any future disasters.