In accordance with the 1973 Emergency Medical Services Systems Act in the United States, one of the 15 functions to be performed by every EMS (Emergency Medical Services) system is disaster planning. The predicate of success in remediating such a macrosystem challenge as regional disaster planning requires the consensus of multidisciplinary health care and public safety human resources prior to the effective cataloging of physical resources. As the emergency physician is the medical leader of EMS system design and implementation, it is important that he explore newly developing disaster planning methodologies to facilitate consensus disaster planning.

Important modifications in ambulance design were suggested and introduced by Safar in 1965 and in 1971. However, most of these modifications have not reached the developing countries. The present “ambulance” in these countries are low ceiling and carry no equipment or trained personnel. They could be better defined as “taxis for horizontal transportation.” Recently, we have been able to introduce onto the market of these countries, a new ambulance that is competitive in price and adapted to the availability of materials, equipment, and personnel.

ACLS for cardiac arrest consists of basic life support, which includes mouth-to-mouth breathing and external chest compression; management of the airway with adjunctive equipment including intubation and ventilator support with supplemental oxygen; recognition of specific cardiac dysrhythmias and appropriate emergency therapy; electrical defibrillation and cardioversion; techniques for placement of intravenous lines; diagnosis of and therapy for acidbase abnormalities with particular emphasis on respiratory and metabolic acidosis; drug therapy during the pre-arrest phase, the cardiac arrest itself, and the period following resuscitation; and stabilization, to prevent cardio-respiratory arrest, and during the post-resuscitation period. In 1975, the American Heart Association developed an ACLS Training Program in which cognitive knowledge is presented at lectures and practical skills are taught and tested at several performance stations.

In 1979, Eisenberg et al. evaluated the survival rate after an out-of-hospital cardiac arrest in a population of approximately half a million people. It was concluded that the survival rate definitely depended on the time before the initiation of cardiopulmonary resuscitation (CPR) and the time the definitive care was received. Both were equally important. The time limits found were four minutes for initiation of CPR and eight minutes for definitive care.

Disaster relief and the spirit of volunteerism have been inextricably interwoven with the design and development of Red Cross societies around the world. The American Red Cross is one of 131 members of an international federation of national Red Cross and Red Crescent societies, the League of Red Cross Societies. Societies are chartered by their own governments and conduct programs in the fields of health, welfare, and safety in accordance with each nation's needs.

Under the auspices of the Organization for Civil Defence, the Netherlands Red Cross and the National Union for Lifesaving and First Aid “The Orange Cross”, a training course in First Aid under Disaster Conditions was started in 1979.

This training course is meant for laymen, who, after having obtained their First Aid certificate, will participate in the medical care of disaster victims. The contents of the training course are discussed. In order to obtain a clear insight into the training course, attention is also paid to the Medical Disaster Relief Organization.

St. Helens is one of a group of high volcanic peaks that dominate the Cascade Range between northern California and southern British Columbia, Canada. The distribution is in a band that roughly parallels the coastline of the so-called “Ring of Fire,” a near circular array of volcanoes located on islands, peninsulas and the margins of continents that rim the Pacific Ocean.

On November 23rd, 1980 at 7:34 p.m. a violent earthquake, 6 on the Richter scale, hit the South of Italy, at precisely the Regions of Campania and Basilicata. The shock lasted 80 seconds, causing death and destruction.

Basilicata, one of Italy's Southern Regions, has already been hit by several other earthquakes in the past, which seriously damaged its population and territory. It is a most mountainous region, with the only exception being a very small plain stretching towards the sea.

Planning of earthquake disaster prevention is of great concern in Japan, since we have frequently been subjected to serious damage due to severe earthquakes. The medical treatment after a disastrous earthquake is undoubtedly one of the most serious items to be considered.

The countermeasures against earthquake disasters, in relation to medical treatment, may be divided into two categories; a) prevention of damage to medical facilities and instruments, b) planning for emergency and disaster medicine. This paper introduces the countermeasures against earthquake disasters in relation to medical treatment in Japan.

Every new earthquake disaster revives the idea of earthquake prediction, the idea which was considered a few decades ago as a fantasy scientific endeavor. However, recent technical and scientific developments, as well as some social and economic pressures, have created a quite different atmosphere. Earthquake prediction has become a serious scientific activity combining the efforts and results of many disciplines, particularly those of the earth sciences. The principal purpose of earthquake prediction is to reduce the vulnerability of the population living within an earthquake prone region. For this reason, scientific disciplines other than seismology and geology are also involved; they include those dealing with various aspects of human response and environment.

Health planning for disasters builds on an awareness of ways in which the disaster affects health and on anticipation of tasks to be performed by the health sector.

In view of the possibility of an earthquake of significant magnitude in Israel, and in the absence of previous earthquake experience, published data of earthquake health effects were studied, such as causes of death and injury, casualty rates and factors influencing these, distribution of injuries and their severity, effect on health care facilities and on physical, social and psychological environments. Implications of the studied data were applied to relevant conditions in Israel and to an earthquake there. A predisaster vulnerability assessment was thus obtained, pointing to the nature, size, and space and time distribution of tasks the health sector would be expected to perform should an earthquake occur in Israel.

On the basis of this assessment some recommendations for the preparation and preparedness of the health sector for such an occurrence are submitted.

On the night of April 11, 1984, the cyclone “Kamisy” struck the northern part of Madagascar. Because of the alarming reports from the disaster area, the League of Red Cross and Red Crescent Societies decided to send a disaster stand-by team. The results of the survey of the disaster area and the medical assistance are discussed. Attention is also given to the objectives of the disaster stand-by team.

The Falkland Islands conflict in the South Atlantic once again drew attention to the paramount importance of making adequate plans for the treatment of the sick and wounded, and their subsequent removal from the battle area. The pages of history are littered with accounts of battles, and in some cases wars, being lost because of the inadequate or non-existent plans made to give logistic medical support to the fighting units

Data on resuscitation potentials immediately following major earthquakes are lacking. Published reports have been unrevealing. Retrospective interviews of surviving eyewit esses might be more revealing. The epicenter of the last major Peruvian earthquake of May 30, 1970, was off the coast, but the damage included most of central Peru including the Andean Range. A total of 80,000 people were killed, including the entire population of Yungay (25,000), buried alive by several m of an ice-mud-rock avalanche which broke off Mt. Huascaran (22,000ft.). There, resuscitation potential was zero. In nearby Huaras (pop. 30,000, alt. 12,000 ft.), 15,000 died, 90% of houses were destroyed. Interviews with lay survivors gave unclear reports.