Problems associated with medical disaster care. Preparations in a large Southern California area.

In the organization for dealing with medical disaster, the region is in an intermediary position, between the State Disaster Office and the operational areas. Regional functions are largely those of coordinating the activities of the areas, and are based upon directives and plans from the state level. The regional medical chief is a member of the staff of the Civil Defense coordinator and must advise him in all matters related to the health of the people, including medical and casualty care, hospitalization, public health, sanitation, preventive medicine and the special problems of biological, chemical and radiation hazards. Coordination with the other Civil Defense services is necessary. The basic medical plan is to give emergency care in the first aid stations and then evacuate casualties to hospitals when and how the situation permits. Regional function is to obtain personnel, supply, equipment and hospitalization support when required. Dispersal of danger zone populations to support areas creates many medical and public health problems among the displaced people and the residents. Survival of the nation requires altered concepts of casualty management. The least injured who have the greatest productive potential should have the highest treatment priority. Short, lifesaving surgical procedures must have precedence over long, complicated operations. No plan is any better than the individual doctors, nurses and other personnel who will put it into operation.