|Annals of the MBC - vol. 4 - n' I - March 1991
POSITION PAPER OF THE WORLD ASSOCIATION
FOR EMERGENCY AND DISASTER MEDICINE:
PRIORITIES IN MEDICAL RESPONSES TO DISASTERS
Emergency and disaster medical care
should hold a priority position in every nation's health care plan.
It is the responsibility of emergency health care providers at al levels (physicians,
nurses, ambulancemen, paramedics, administrators, and policy-making officials) to
establish a disaster response system within and as a part of a community's total emergency
response plan. This plan must be based on existing, documented research and f irsthand
experience, and should integrate the following principles:
- As the preliminary act in developing a coordinated medical
response to a disaster, the community as a whole must be well-prepared. Hence, all members
of the community available must be trained in the essentials of Life Supporting First Aid
(LSFA) including simple rescue techniques. This training must be re-inforced periodically
through the media and other mechanisms.
- Existing, local medical and paramedical personnel must be
identified and trained in the basics of field medical care so that emergency health care
providers will be available immediately from within the disaster zone.
- Fire, police, and other prehospital professionals should be
trained in basic rescue and engineering extrication techniques.
- A system for emergency transportation for victims,
responders, and essential equipment and supplies should be established and staffed by
personnel trained in Life Supporting prehospital medical techniques.
- Ongoing evaluations of local and regional disaster risks
coupled with structural hazard assessments should be conducted in order to better forecast
the types and scopes likely to be encountered for a given area. An essential component of
this program is the support and coordination of the active development of research models
which integrate types of natural and man-made disasters, injury patterns, and health care
resources which will be needed to care for victims.
- Staging areas within a zone in which there exists a
potential for a disaster to which victims, and pre-appointed, trained local medical,
paramedical, law enforcement, and emergency transport personnel automatically will
converge, must be pre-identified by local health care providers. Such areas need not be
contiguous with each other but must be well known by those likely to be involved. Such
staging areas will be made known to all, including the lay public, through public
educational campaigns. In the event of a disaster resulting in mass casualties, each of
these areas will be staffed by the assigned personnel preclesignated above, provided with
adequate communications equipment and operators, and supplied with those basic survival
and medical materials necessary for the provision of urgent care during the immediate
- Adequate communication capabilities are an essential
element of any disaster preparedness program, These must include multiple links to the
staging areas from regional command centers so that such centers may be kept apprised of
the health care needs of the affected area(s). Regional aid responses must be facilitated
and coordinated by such centers and they must remain informed of the needs of the area and
of all of the resources which may be brought to bear to assist in the operations.
- A disaster preparedness plan should be established,
exercised, and re-evaluated on a regular basis at the regional, state and provincial
- National health policy should include a coordinated,
interdisciplinary approach to mass casualty disaster preparedness and management including
defined roles and participation of both the military and volunteer aid agencies.
- An inventory should be established for cataloguing and
updating the many voluntary aid and mobile disaster units available world-wide. This
inventory should be made available to national and international health planners so that
each may be appropriately assessed and included as part of each nation's disaster plan.
- International relief agencies, national disaster response
teams, and international health organizations should work cooperatively to improve the
availability, capability, and effectiveness of international disaster efforts. Such
programs should be based on the past-performance of these responders as well' as the
specific needs of the disaster-affected area. A single coordinating agency should be
responsible for the deployment of all such assistance.
These principles are put forth by the
World Association for Emergency and Disaster Medicine in concert with the beginning of the
1990s, the United Nations'