The EMS system and disaster planning: some observations.

Disaster planning, one of the 15 essential components of the Emergency Medical Service System Act of 1973, should be the culmination of the establishment of other components. Regions have gone to varying lengths to describe disaster plans but how realistic the plans are is questionable. New York has planned for multiple casualty incidents (MCI) to care for victims of fires, explosions, structural collapses and major transportation incidents. The irrational emotional response in mass disasters conflicts with the rational disaster plans written by health planners. Drills of disaster plans are not realistic. One solution is to designate the next serious incident, such as a fire or traffic accident, a major MCI. The ability to handle an MCI is probably the best measure of an EMS system's effectiveness.