Introduction:Disaster is a collective responsibility requiring coordinated response from all parts of society. This theme focused on coordination and management issues in a diverse range of scenarios.Methods:Details of the methods used are provided in the preceding paper. The chairs moderated all presentations and produced a summary that was presented to an assembly of all of the delegates. Although the main points developed in Themes 1 and 4 were different from each other (as reported in the Results section), their implementation was similar. Therefore, the chairs of both groups presided over one workshop that resulted in the generation of a set of Action Plans that then were reported to the collective group of all delegates.Results:The main points developed during the presentations and discussions included: (1) the need for evidence-based assessments and planning, (2) the need for a shift in focus to health-sector readiness, (3) empowerment of survivors, (4) provision of relief for the caregivers, (5) address the incentives and disincentives to attain readiness, (6) engage in joint preparation, response, and training, (7) focus on prevention and mitigation of the damage from events, and (8) improve media relations. There exists a need for institutionalization of processes for learning from experiences obtained from disasters.Discussion:Action plans presented include: (1) creation of an Information and Data Clearinghouse on Disaster Management, (2) identification of incentives and disincentives for readiness and develop strategies and interventions, and (3) act on lessons learned from evidence-based research and practical experience.Conclusions:There is an urgent need to proactively establish coordination and management procedures in advance of any crisis. A number of important insights for improvement in coordination and management during disasters emerged.
In Japan, different triage tags have been developed and used by different organizations including the Japan Medical Association, Japan Self-Defense Force, fire departments, etc. There have been growing calls to unify these tags as the current situation can lead to confusion in case of a major disaster that involves many relief organizations.The organization of triage tags has been examined by the Study Society, and on 26 February, 1996, a report was issued on the Standardization of Triage. Factors that have prevented the standardization of triage tags include: 1) Different kinds and scales of disaster were envisioned when the tags were invented; and 2) Some tags are good for specific types of disasters, but others are not.Our proposal for the study assumes that multiple relief organizations are involved in a large-scale disaster, and that the tag is used in different types of disasters. Standardization will: 1) Promote the concept of triage; 2) Accurately determine the number of patients who need treatment, including those with minor injuries; and 3) Promote the sharing of information. Triage is not simply the act of putting a triage tag on a patient. We must better understand the true meaning and importance of triage. Keywords: disasters; Japan; standardization; tags; triage E-mail: nino@nms.ac.jp Russia that have resulted injuries to >3,000 people. The leading causes of the injuries were related to exposures to chlorine and ammonia as well as phosphororganic compounds. This situation has resulted in the establishment of a well-organized, national system of emergency relief under the auspices of Russian government. Management of the Medical After-Effects of Chemical Accidents in RussiaThe main coordinating services for the provision of relief services in chemical accidents in Russia are EMER-COM of Russia and ARCDM "Zaschita" of Ministry of Public Health of Russia. These agencies are responsible for the provision of medical relief after chemical accidents, and for management at the federal, regional, and territorial levels. Sixty-nine Russian Federation territorial centres for Disaster Medicine have been formed. They include specialized toxicological teams for rendering prehospital medical assistance and toxicological centres for rendering specialized medical care to the injured. On the territorial level, a system of management and planning for chemically hazardous enterprises includes: 1) estimate of medical after-effects at the level of an enterprise; 2) estimates of man power and resources of medical assistance required to provide it at the prehospital stage; and 3) coordination and interaction of departments of Ministry of Defence and other departments for relief operations. The present system allows the provision of effective, timely medical care to the injured in chemical accidents in Russia and carries out evacuation of those who have received initial care in the toxicological centres. This system may be proposed for study and use in different countries of the world to manage medical relief in chemical a...
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