Doctors And Firefighters Explain What Went Wrong In Hospitals On The Night Of The Tragic Itaewon Emergency

South Korea is mourning the tragic passing of 154 people following a fatal crowd surge in Itaewon, Seoul.

On October 29, a large number of people were caught in a narrow alley next to the Hamilton Hotel. With no space for people to move, things quickly devolved into a state of emergency as the pressure, which experts claim can even be strong enough to bend steel in such situations, led people to suffocate and go into cardiac arrest.

According to witnesses and survivors, the crowd surge was caused by “forceful pushing,” reportedly instigated by individuals who found themselves on the upper end of the sloped alley.

The crowd surge resulted in 132 injured in addition to the casualties, leaving hospitals nearby completely overrun. ER doctors who spoke to The Korea Herald explained that, for hospitals near areas known for their nightlife, weekends are often particularly busy. This spelled out a big problem for the night of October 29.

ERs are busier during weekends, so this likely happened when they were already dealing with a heavy workload.

— Dr. Ha Sang Ook, head of Hallym University Medical Center’s emergency department

The issue was that the victims weren’t normal patients—they were CPR patients. According to a firefighter who was on the scene, most hospitals aren’t generally equipped to handle large numbers of patients who require CPR. After all, these tend to be the minority of cases, according to Dr. Ha Sang Ook.

These weren’t mildly injured patients. They were CPR patients. There aren’t many hospitals that can accommodate dozens of such patients at once… In a situation like this, patients are scattered across different hospitals so that no single hospital carries a disproportionate load.

— Firefighter

First responders have a system that allows them to see capacity levels in nearby hospitals in real time, so the victims of the crowd surge were taken to multiple different hospitals. Yet, there were so many that the hospitals were quickly swamped. The reason for this is not simply due to space issues, but rather that one cardiac arrest patient alone requires a team of at least four medical workers, meaning three patients would require the entire ER team.

If multiple cardiac arrest patients arrive simultaneously, then one ER cannot handle it.

— Dr. Ha Sang Ook

Dr. Ha Sang Ook stated that chest compressions in CPR must be “administered for 20 to 30 minutes, before deciding if the patient is untreatable” and that “it’s definitely not a one-person job.” 

A firefighter from the Yongsan fire department who was on call that night stated that first responders faced a delay in rescuing the victims due to the chaos on the scene. This hampered medical workers’ attempts to help the victims once they got to the hospital because, as Dr. Heo Tag explains, it only takes one or two minutes for someone to lose consciousness from asphyxia, while the limit for cardiac arrest resuscitation delay is four.

Additionally, victims of the crowd surge require far more than CPR, as they suffered extreme compression for up to two hours, something that leads to internal bleeding and organ damage. This can cause victims’ stomachs to swell up, which is something that a doctor who was on call that night reported seeing.

I could feel their stomach swell up as I did CPR on them. I’m not talking about just one patient. But I could see that in a lot of the people who were hurt, and people who were already dead.

— Doctor in Itaewon speaking to YTN

Read further about what doctors and firefighters on the scene recounted of their attempts to rescue the victims right here.

Korean Doctors At The Scene Recalls The Horror of The Crowd Surge And Desperate Rescue Attempts