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More than 4 million people worldwide have lost their lives and hundreds of millions have suffered due to natural and man-made disasters during the past 30 years. The dollars lost in damages and reconstruction costs are staggering. Hundreds of billions have gone to rebuild the infrastructure and to replace the personal property damaged or lost as a result of these disasters. Ongoing assistance may be required many years after the disasters to sustain and reconstruct the lives of those affected.


Disaster medicine and prevention is a system of study and medical practice encompassing the disciplines of emergency medicine and public health. The multidisciplinary nature of disaster planning and response has traditionally resulted in various definitions of disasters and events that cause mass casualties. Some commonality in terminology has evolved in the organizational aspects of emergency medical disaster response:


  • Austere medicine: Medicine practiced on-location without the amenities provided by an organized medical system. Austere medicine is often practiced in temporary shelters, with quite limited equipment. The goal is to provide temporary “fixes” to restore functionality or save life.
  • Disaster: Any event that overwhelms the emergency medical system resources available at a given time in a given jurisdiction. This may be a city/county, a region, a state, or even a country.
  • Incident Command System (ICS) and Incident Management System (IMS): Initially used by the military and fire departments. ICS has evolved over the past two decades into the current disaster management tools of choice for disaster command, operations, planning, logistics, and finance from the federal to local level.
  • Multiple (or Mass) Casualty Incident (MCI): Any event that causes a large number of individuals to become ill or injured. Sometimes called Multiple Victim Incident (MVI).
  • Medical disaster: Any event that causes a large number of individuals to become ill or injured and overwhelms the medical system resources available at a given time in a given jurisdiction.
  • Mutual aid: Agreements between neighboring communities to provide support and assistance in the event of a disaster.
  • National Response Framework (NRF): This is the current evolution of the US government national response plan. The ability for augmenting flexibility continues to be the driving force for the current version of the NRF. National or federal framework for coordinating the population and infrastructure of our nation including federal, state, local, tribal, and private sector resources in the event of a disaster.
  • Mitigation: Critical foundation in the effort to reduce the loss of life and property from natural and/or man-made disasters by avoiding or lessening the impact of a disaster and providing value to the public by creating safer communities. Mitigation seeks to fix the cycle of disaster damage, reconstruction, and repeated damage. These activities or actions, in most cases, will have a long-term sustained effect.


Disasters follow a pattern of development and have a distinguishable life cycle of various durations. This sequence of events has been termed the disaster life cycle (Figure 4–1). Disaster ...

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