Unconscious patients with either upper airway obstruction or inhalation injury or any patients with correctable hypovolemia resulting from hemorrhage or burns would be especially likely to benefit from early medical intervention. Safar, studying the 1980 earthquake in Italy, concluded that 25% to 50% of victims who were injured and died slowly could have been saved if life-saving first aid had been rendered immediately (114).

Data from the 1976 earthquake in Guatemala (115,116), the 1985 Mexico City earthquake (29), the 1988 Armenian earthquake (33), and the 1992 earthquake in Egypt (86) showed that injured people usually seek emergency medical attention only during the first 3 to 5 days following the earthquake, after which hospital case-mix patterns return almost to normal. From Day 6 onward, the need for emergency medical attention declined rapidly and the majority of the wounded required only ambulatory medical attention--indicating that specialized field hospitals that arrive 1 week or more after an earthquake are generally too late to help during the emergency phase. Following the 1992 earthquake in Egypt, nearly 70% of all patients with earthquake-related injuries were admitted within the first 36 hours after this earthquake (86).