Peyman Saberian - Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.Tehran Emergency Medical Service Center, Tehran, Iran.
Pir-Hossein Kolivand - Pre-Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.. National Emergency Medical Service Organization, Tehran, Iran.
Parisa Hasani-Sharamin - Tehran Emergency Medical Service Center, Tehran, Iran.
Fatemeh Dadashi - Tehran Emergency Medical Service Center, Tehran, Iran.
Amir Reza Farhoud - Joint Reconstruction Research Center, Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Introduction: The earthquake is one of the most natural catastrophic crises that can cause a lot of casualties. Considering an earthquake-prone country, Iran is ranked as one of the world's most dangerous countries Objective: In this article, we describe the actions taken by emergency medical service (EMS) after theearthquake in Kermanshah, Varzaghan, and Bam and compared the strengths and weaknesses of theemergency response program and the limitations and challenges of this system in dealing with these major crises.Method: This study is a cross-sectional study that compares some of the information and findings related to three earthquakes that occurred in Iran, including Bam, Varzaghan and Sarpol-e-Zahab earthquakes. The data reported in the present article is descriptive and is based on various independent sources such as National Emergency Operation Center, Local Emergency Operations Center (EOC), the EMS of the country, the World Health Organization, the United Nations, the statistics website, the Forensic Data website, the International Institute of Seismology and Earthquake Engineering, conferences and personal interviews. To ensure the credibility of the information, the authors reported data that had been verified by two or more sources.Results: The characteristics of the geographic area of the ۳ earthquakes has been described. Post-earthquake response activities were described in details in subheadings including rapid warning and response, surge capacity plan, rapid response teams, emergency medical teams, increasing the capacity of health facilities, increasing transfer capacity, and handling, transportation and distribution of injuries.Conclusion: In the recent earthquake, had been occurred in Sarpol-e-Zahab, the health response of the country was largely satisfactory. The existence of structures such as EOC at various levels, the unified incident command system, emergency operations plan, and Medical Care Monitoring Center are among the most important reasons for satisfactory performance.

Civil Defense; Earthquakes; Emergency Medical Services; Patient Transfer; Surge Capacity