Worldwide disaster medical response: an historical perspective.
OBJECTIVE
Disaster medicine and disaster medical response is a complex and evolving field that has existed for millennia. The objective of this article is to provide a brief review of significant milestones in the history of disaster medicine with emphasis on applicability to present and future structures for disaster medical response.


RESULTS
Disaster medical response is an historically necessary function in any society. These range from response to natural disasters, to the ravages of warfare, and most recently, to medical response after terrorist acts. Our current disaster response systems are largely predicated on military models derived over the last 200 yrs. Their hallmark is a structured and graded response system based on numbers of casualties. In general, all of these assume that there is an identifiable "ground zero" and then proceed with echelons of casualty retrieval and care that proceeds rearward to a hospital(s). In a civil response setting, most civilian models of disaster medical response similarly follow this military model. This historical approach may not be applicable to some threats such as bioterrorism. A "new" model of disaster medical response for this type of threat is still evolving. Using history to guide our future education and planning efforts is discussed.


CONCLUSIONS
We can learn much from an historical perspective that is still applicable to many current disaster medical threats. However, a new response model may be needed to address the threats of bioterrorism.
Dara
Saqib I
SI
Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Ashton
Rendell W
RW
Farmer
J Christopher
JC
Carlton
Paul K
PK
D004189:Disaster Planning / Q000266:history*; D004632:Emergency Medical Services / Q000266:history; D004635:Emergency Medicine / Q000266:history*; D004636:Emergency Service, Hospital / Q000266:history; D006078:Government Programs / Q000266:history; D006302:Health Services Research / Q000266:history; D049670:History, 17th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D049691:History, Medieval; D006801:Humans; D007390:International Agencies / Q000266:history; D038622:Internationality