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Are We Prepared?

Ernesto A. Pretto, Jr, MD; Peter Safar, MD

JAMA. 1991;266(9):1259-1262.

Abstract
Preparing for a resuscitation response to mass disasters, such as major earthquakes or industrial disasters, requires revisions of present local, regional, and national disaster plans. These should include the following: (1) life-supporting first aid and basic rescue capability of the lay public; (2) advanced trauma life support and advanced (heavy) rescue capability brought quickly to the scene from local and surrounding (regional) emergency medical services systems; and (3) trauma hospitals sending medical resuscitation teams to, and receiving casualties from, the disaster scene for resuscitative surgery and definitive care. Local and regional everyday emergency medical services systems would respond first. The armed forces should help, at least for transport and security. We propose that the National Disaster Medical System replace its civil defense model with an emergency medical services model, designed to mobilize rapid support for local emergency medical services systems from regional, state, and national resources. Coordination should be by one federal agency, such as the Federal Emergency Management Agency, which, however, needs to focus more on resuscitation through physician input.

(JAMA. 1991;266:1259-1262)

Author Affiliations
From the International Resuscitation Research Center (Disaster Reanimatology Study Group), the Department of Anesthesiology and Critical Care Medicine, and Presbyterian University Hospital, University of Pittsburgh (Pa) School of Medicine.

Footnotes
Presented in part at the Sixth Congress of the World Association for Emergency and Disaster Medicine (Club of Mainz), Hong Kong, September 12, 1989.

Reprint requests to University of Pittsburgh, International Resuscitation Research Center, 3434 Fifth Ave, Pittsburgh, PA 15260 (Dr Pretto).

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