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February 5, 1992

Physicians and Disaster Preparedness

Author Affiliations

Department of Health and Human Services Washington, DC

JAMA. 1992;267(5):654-655. doi:10.1001/jama.1992.03480050058020

To the Editor.  —I was delighted to see the focus on national planning for medical response to major disasters and emergencies.1 However, in reading the article, I was disappointed to discover that Drs Pretto and Safar failed to recognize the important distinction between traditional, everyday emergency medical services (EMS) response and catastrophic mass casualty response.In fact, they completely ignored the National Disaster Medical System (NDMS), its current operational plans and arrangements, and its rapidly increasing medical response capabilities.Although EMS deal with everyday emergencies, a disaster, by definition, is an occurrence that overwhelms available personnel and other resources. To assume that concentrations of personnel and technology will occur rapidly following an incident producing tens of thousands of seriously injured or ill victims is impractical and unrealistic and creates false expections.Given the vast geographic area of our nation, the multiple major metropolitan concentrations of our population, the wide