The national disaster medical system: past, present, and suggestions for the future.
This article reviews the history and structure of the National Disaster Medical System (NDMS), with an emphasis on its definitive care component. NDMS's capacity to handle very large mass casualty events, such as those included in the National Planning Scenarios, is examined. Following Hurricane Katrina, Congress called for a reevaluation of NDMS. In that context, we make three key suggestions to improve NDMS's capacity to respond to large mass casualty disasters: (1) increase the level of engagement by the private (i.e., nonfederal) healthcare system in preparedness and response efforts; (2) increase the reliance on regional hospital collaborative networks as part of the backbone of the NDMS system; and (3) develop additional, alternative patient transportation systems, linked to the overall NDMS patient tracking effort, to decrease the sole reliance on DoD long-haul air transport in medical evacuation.
Franco
Crystal
C
Center for Biosecurity of the University of Pittsburgh Medical Center, Baltimore, Maryland 21202, USA. cfranco@upmc-biosecurity.org
Toner
Eric
E
Waldhorn
Richard
R
Inglesby
Thomas V
TV
O'Toole
Tara
T
D004189:Disaster Planning / Q000379:methods / Q000458:organization & administration* / Q000639:trends; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration* / Q000639:trends; D016304:Hospitals, Private; D006801:Humans; D054527:Mass Casualty Incidents; D014187:Transportation of Patients; D014481:United States; D014483:United States Dept. of Health and Human Services