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Mass casualty preparedness pays off (e.g., prepositioned medical kits, aid agreements among countries, responders with knowledge of the local language, etc.), Poncelet said, and more preparedness is clearly needed. For large disasters, global standards should be established for mass casualty and fatality management. Hanfling cited two existing frameworks, which may serve as additional resources: the UN International Search and Rescue Guidelines classification system for international search and rescue teams and the Virtual Onsite Operational Command Center for team response registration and selection. Furthermore, models such as the IHR could serve as a potential blueprint for developing a crisis standards of care framework. There will be no global solution, however, before there are local solutions. Through this workshop, and subsequent workshop summary, the hope was expressed that a broader dialog would be initiated to stimulate additional efforts and Crisis Standards of Care concept development within the individual nation and larger international community. For example, while these issues were not discussed in detail at the workshop, it is important to address these moving forward: Is there a need for classification, criteria and standards for medical teams who arrive at the scene? What standards can be put in place for standard operating procedures, education, training, drills, equipment, response systems, international relief, and assessment?

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