In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed more than 90% of the city.

The purpose of this study was to assess the status of the rescue, evacuation, and transportation of the casualties during the early stages following the earthquake.

A cross-sectional study of 185 casualties who were transferred to and hospitalized in the university hospital during the first week period following the earthquake was conducted. Information regarding different places of settlement after being removed from the rubble, initial medical care, and the means of transportation was obtained by reviewing medical records and interviewing the victims.

The mean value of the duration of times taken for the first rescuers to reach the scene and remove the casualties from the rubble was 1.7 ±2.7 and 0.9 ±1.1 hours, respectively. Sixty-nine (37.7%) of the patients stayed within the area immediately surrounding their home for average times of 8 ±10 hours. The majority of casualties (57.6%) were transferred manually to a first place of settlement; 45.8% were taken to a second place of settlement using blankets. Of the patients studied, 159 (85.9%) did not receive any basic medical care at the first place and intravenous fluid therapy was the most common treatment provided for 24 (13%) patients at the second place of settlement. Patients received medical care at the first place of settlement for a mean time of 16.8 ±13.5 hours after escaping the rubble.

These findings indicate that the emergency medical service system in Bam was destroyed and not able to respond adequately. In order to reduce the negative effects of such disasters in the future, there is an essential need for a comprehensive disaster management plan and improvement of hospital structures, healthcare facilities, and communication between the different governmental departments for better coordination and planning.