Is there one optimal medical treatment and evacuation chain for all situations: "scoop-and-run" or "stay-and-play".

In 2006, the Ministry of Defense of the Netherlands initiated a targeted agenda program for the World Congress on Disaster and Emergency Medicine in Amsterdam in 2007 (15WCDEM). The issue to be discussed was if there is one "golden" treatment and evacuation system that is applicable for different military and civilian situations. And, if there is not such a system, which parameters are important to construct the most optimal system for each different situation. This issue is related to the applicability and evidence base of the standards of the North Atlantic Treaty Organization. A group of experts started a website discussion on the issue during December 2006. During the 15WCDEM, several other participants were active in the discussion. Using the different experiences and the outcome of the discussions, it was concluded that there is not one "golden" medical emergency system, there are no "golden" timelines, and no "golden" skills. A medical system should be flexible and be able to adjust on each specific, local situation. First responder and non-medical people with medical skills (first responders) are essential in the front line of the emergency medical systems. More research is needed on the medical techniques and skills that are most effective early in the treatment and evacuation systems. Lessons learned from the military system are relevant for the civilian emergency medical services and vice-versa. The World Association for Disaster and Emergency Medicine can be an important platform to share and exchange information between these two systems. The target of the platform should be to obtain a generic picture of the important elements in prehospital emergency medical care.