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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:

1. 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.
2. 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.
3. Fire, police, and other prehospital professionals should be trained in basic rescue and engineering extrication techniques.
4. 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.
5. 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.
6. 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 post-disaster period.
7. 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.
8. A disaster preparedness plan should be established, exercised, and re-evaluated on a regular basis at the regional, state and provincial levels.
9. 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.
10. 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.
11. 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'