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February 5, 1992

Physicians and Disaster Preparedness-Reply

Author Affiliations

International Resuscitation Research Center University of Pittsburgh (Pa)

JAMA. 1992;267(5):655. doi:10.1001/jama.1992.03480050058022

In Reply.  —Our article was not a study in itself but a review of disaster medicine research with recommendations based on this review for an improved US NDMS. These may also lead to improvements in everyday, communitywide EMS.Dr Mason writes about us ignoring the current plans for NDMS. These may be secret since the published plans are civil defense and not EMS oriented. He talks about "triage," which we feel should be part of every disaster medical response, with physicians selecting the "appropriate level of care with available resources." Our main concerns with the present unwieldy NDMS are the prolonged response times, the large teams of nontraumatologists, and the lack of citizen involvement. Mason's comments fail to address the failure of all public agencies over the past 30 years to institute a nationwide citizen, life-supporting, first-aid-training program. This is the first link in the EMS life-support chain and