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Volume 30, Issue 3

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On Wednesday, April 22, 1992, the 461-year old city of Guadalajara, Mexico, experienced a series of ten massive explosions occurring in the heart of the downtown Reforma district.

The explosions began at 10:30 a.m. (12:30 p.m. EDT) and continued for two hours. Five hours after the initial explosion, a second large explosion occurred about three miles from the Reforma site. The blasts measured 7.1 and 7.0 on the Richter scale at the University of Mexico in Mexico City some 200 miles away.

The blast blew open the streets and carved an enormous 9 mile ditch down the middle of Avenida Gante measuring 80 feet wide and 25 feet deep. Approximately 1,000 buildings were collapsed, destroyed or heavily damaged.

Drs. James Dugal, and Gail Anderson, led their team of physicians, the American Medical Search and Rescue Team based in Atlanta, Georgia, to the explosion disaster site in Guadalajara, Mexico.
The team was requested by the Jalisco Government and the University Autonomous of Guadalajara (UAG) Medical School to evaluate the search and rescue efforts, the medical needs of the trauma hospitals and consultation on “Crush Syndrome.”

Initial reports by the Mexican Government and confirmed by team member Al Nixon of the Atlanta Red Cross said at least 2,000 people were injured, 200 people were killed and over 20,000 were left homeless. Damages of building were estimated to be at $300 million.

Upon arriving to Guadalajara, the team, “hit the ground running.” One hour after arriving on Friday, Dr. Dugal and the rescue team were peering into a massive crater in what used to be the street, assisting in the digging for survivors of one of the worst industrial accidents in Mexican history.

The team began assisting in the search and rescue effort which would last the entire night. The methods of the rescuers were limited due to the lack of specialized equipment. Shovels and picks would break under the weight of the layers of concrete. The feelings of “helplessness” would be suppressed for a short time when the rescue team would discover a potential survivor.

The next morning, Drs. Dugal and Anderson met with Dr. Jesus Castillo, Director of the Program of Medicine for UAG Medical School and Dr. Leone Solis, Director of UAG Medical School.

Dr. Castillo was responsible for the Disaster Field Hospital and the triage of the injured to the trauma hospitals. Dr. Solis was responsible for hospital coordination of trauma patients. Dr. Castillo also coordinated the rescue effort during the 1988 Mexico City Earthquake.

Dr. Castillo briefed Drs. Dugal and Anderson on the status of the search and rescue effort and the medical needs of the hospitals. The UAG medical school had provided physicians, nurses, medical supplies, food and clothing for over 10,000 injured or homeless in the disaster area.

Dr. Castillo commented that the supplies provided such as tetanus toxoid, general antibiotics and orthopedic supplies were being consumed at a rapid rate. Not only were they treating patients at the field hospital from the explosion but the physicians were treating patients with daily problems such as hypertension, diabetes, seizures and general pediatric complaints.

While Drs. Dugal and Anderson were participating in the treatment of patients in the field and the trauma hospitals with “Crush Syndrome,” they created a “wish list” of critically needed medical items.
Orthopedic supplies, Antibiotics, Intravenous fluids, Central Venous Lines, Swan Ganz lines and Tetanus Toxoid were considered immediate needs and the request was sent back to Atlanta, Georgia, American Medical Search and Rescue Team headquarters.

The final evaluation of “lives saved” by the rapid response medical team may not be immediately apparent. The impact of the efforts of Drs. Dugal and Anderson combating “Crush Syndrome” and assisting in the rebuilding of the Emergency Medical System infrastructure will be noted for years.


This unique domestic and international medical disaster rescue team has filled a void in disaster response since its conception in 1984.

The Atlanta, Georgia based team rapidly deploys highly trained and experienced Emergency Medicine Physicians in a matter of hours to a disaster site to evaluate and assist in every facet of medical management.

The philosophy of the organization is that Emergency Physicians are the best choice in a disaster situation because they are trained to triage, diagnose and manage multiple patients with life threatening injuries. They practice this every day in their hospital Emergency Departments.

Prior to a mission the physicians are fully briefed on the type of the disaster, local geography, climate, culture and the existing medical services.
A needs assessment team is dispatched to the disaster site to evaluate:

1. The severity of the disaster site.
2. The type of injuries to the residents.
3. The damage to the existing Emergency Medical System and Hospitals.
4. Search and rescue manpower and supply needs.
5. Disaster site triage area manpower and supply needs.
6. Hospital equipment needs in the post-disaster phase.
7. Evaluation of “Crush Syndrome.”
The needs assessment and manpower survey reports are relayed back to the Incident Command Center in Atlanta and the appropriate items are obtained.

Members of the American Medical Search and Rescue Team have been deployed on nine successful missions around the world since 1984.

Dr. James Dugal, FACEP, is a Board Certified Emergency Physician who along with Dr. Gail Anderson, FACEP, led the American Medical Search & Rescue Team to Guadalajara. Drs. Dugal and Anderson have lead their rescue team to assist in the 1985 Mexico City Earthquake, the 1987 El Salvador Earthquake, the 1988 Armenian Earthquake and the 1991 Panama Earthquake.

This article adapted from Vol. 5 #3.