Elsevier

Annals of Emergency Medicine

Volume 16, Issue 9, September 1987, Pages 1085-1091
Annals of Emergency Medicine

Special contribution
Catastrophic disasters and the design of disaster medical care systems

https://doi.org/10.1016/S0196-0644(87)80764-3Get rights and content

The National Disaster Medical System (NDMS) is aimed at medical care needs resulting from catastrophic earthquakes, which may cause thousands of deaths and injuries. Other geophysical events may cause great mortality, but leave few injured survivors. Weather incidents, technological disasters, and common mass casualty incidents cause much less mortality and morbidity. Catastrophic disasters overwhelm the local medical care system. Supplemental care is provided by disaster relief forces; this care should be adapted to prevalent types of injuries. Most care should be provided at the disaster scene through supplemental medical facilities, while some can be provided by evacuating patients to distant hospitals. Medical response teams capable of stabilizing, sorting, and holding victims should staff supplemental medical facilities. The NDMS program includes hospital facilities, evacuation assets, and medical response teams. The structure and capabilities of these elements are determined by the medical care needs of the catastrophic disaster situation.

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      By contrast, no significant difference in mortality was found between single vs multiple anatomical areas of injury (P = .115), however, the mortality increased significantly when the number of involved anatomical sites increased from 1 to 4 areas (P = .021). As we have all witnessed, the casualty burden from a massive earthquake is high [9]. The recent 2010 Haiti earthquake caused mortality in upward of 200 000 at the time of this study, compared with the 2008 Sichuan earthquake's estimated 69 227 deaths.

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    Presented at the UAEM/IRIEM Research Symposium on Environmental Emergencies in Clearwater Beach, Florida, February 1987.

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