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OCR for page 28
CARE OF CASUALTIES UNDER CONDITIONS
O F NATU RAL D ISASTER
It is apparent that the problems of care of disaster victims differ
from those of the care of individually injured persons in that they
are concerned with unexpected expansion of first aid, rescue,
communication, sorting, distribution, and medical care. No plan
for emergency care in disaster is likely to succeed unless it provides
for an orderly utilization of currently functioning facilities. For
this reason, emphasis should be placed on employment of all
elements of disaster services on a day-to-day basis so that they
will be functioning smoothly when the load of casualties suddenly
increases.
Because disasters occur repeatedly in this country and because
progress has been slow in solving problems of caring for mass
civilian casualties, medical problems encountered in disaster should
be under continued study and analysis by multi-disciplinary
groups. The need for integration of public resources in coping
Fitly material damage in disaster is apparent, but the community
role in handling human casualties is less well prescribed. The
Disaster Research Group of the Division of Anthropology of the
National Academy of Sciences-National Research Council, in its
extensive studies from 1951 to 1963 for the Office of Civil Defense,
and the Ohio State University Disaster Research Center, estab-
lished in 1963, have both concentrated on responses of local, state,
and federal agencies to the stresses imposed by unexpected disaster
with emphasis on behavioral and sociological problems. Efforts
of the American College of Surgeons to encourage members to
report on casualty care in disasters have added little. substantive
information on which to improve results. The Committee on Dis-
aster Medical Care of the American Medical Association has at-
tempted to identify potentials for improved care, but no national
action program has been implemented. An ad hoc Committee on
Disaster Medical Care of tile National Academy of Sciences-
National Research Council finds no evidence of effort by these
groups, or by independent workers or federal organizations, to-
ward pooling of resources to assemble substantial data or to
analyze medical management in a sufficient number of disasters
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of different types. In no single large disaster do we have precise
information on the causes of death, the numbers and types of
injuries of survivors, or the rewards of efficiency and the penalties
of inefficiency in rescue, first aid, transportation, and medical
care. A pattern exists in the organization and functions of the
Office of Emergency Planning of the Executive Once of the
President for gaining this type of information and for implementing
improvements in management and care that would result from its
analysis. Trained disaster specialists based at eight federal centers
throughout the nation move out at first warning to areas imperiled
by disaster. Oat the basis of their assessments, the President can
declare a major disaster; under the direction of the Office of
Emergency Planning 24 agencies would then be automatically au-
thorized to provide assistance. These are concerned mainly with
supplies, equipment, and personnel to clear debris; provide food,
medicine, and shelter; restore utilities; enforce law and order; and
render financial assistance and welfare services. Many communities
are unaware of the way to secure outside assistance in rescue,
first aid, and medical help available through the American Na-
tional Red Cross, the U. S. Public Health Service, civil defense
agencies, and field units of the Armed Forces. Better utilization
of these resources could be ensured if in each community or area
a recognized committee or council on emergency medical services
would assume the role of coordination of the efforts of these
agencies. Physicians thoroughly familiar with the missions of the
24 federal agencies and versed in local medical problems in disaster
should be included on the teams of trained disaster specialists of
the eight federal centers.
RECOMMENDATION
Development of a center to document and analyze types and numbers of
casualties in disasters, to identify by on-site medical observation prob-
lems encountered in caring for disaster victims, and to serve as a
national educational and advisory body to the public and the medical
profession in the orderly expansion of day-to-day emergency services to
meet the needs imposed by disaster or national emergency.
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Representative terms from entire chapter:
disaster victims
