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Availability v Need

Herbert L. Abrams, MD

JAMA. 1984;252(5):653-658.

Abstract
In defining capacity to "survive" a massive nuclear exchange, it is important to assess the medical resources that will be available in the post-nuclear war world. Approximately 80% of these resources—hospital beds and personnel, blood, drugs, and medical supplies—will have been destroyed, since they are located in or near the densely populated areas that constitute primary targets of attack. Casualty estimates published by federal agencies, together with data from the Hiroshima-Nagasaki experience, suggest the numbers and types of injuries that will afflict the US population. With a probable 48,000 surviving physicians to treat 32 million casualties, there will be one physician for every 663 patients. Of the trauma and burn victims, approximately 55% will require hospitalization; this will mean 64 patients for each available hospital bed. Data from recent wars have been utilized to determine the trauma-related blood requirements in the post-nuclear war world. Of the 64 million units of whole blood needed, only 14,000 will be available. Other medical resources will be in equally short supply. This disparity between need and availability indicates the difficulty of developing a meaningful medical response for the surviving injured.

(JAMA 1984;252:653-658)

Author Affiliations
From the Department of Radiology, Harvard Medical School, and Brigham and Women's Hospital, Boston.

Footnotes
Reprint requests to Department of Radiology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115 (Dr Abrams).

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