According to the World Health Organization (WHO), catastrophe is a sudden ecological phenomenon of sufficient magnitude to require outside help. In prehospital care, catastrophe is a situation in which the needs of care exceed the material and human resources immediately available, requiring extraordinary and coordinated measures to maintain the basic or minimum quality of care. It is an imbalance between the resources available and the expendable resources, so that the greater the imbalance, the more serious the consequences will be for the victims of the event. The catastrophe implies an environmental involvement which is harmful tosupplies, communication, transport and access to the site. Accidents with multiple victims present an imbalance between available resources and needs, and despite that, can beefficiently attendedas long as the protocol operational doctrine is adopted. As a parameter of magnitude, we consider accident with multiple victims those events with more than five serious victims.
The attendance to accidents with these characteristics is a challenge in which the prehospital care services and the hospitals come across frequently. Daily in our country, accidents of the most varied types happenwith a number of victims exceeding five. In the face of these situations, there is an inability of the services to deal withthem, thus, the need to train, frequently, the professionals directly involved inthese emergencies. In a recent WHO survey, only 50% of countries planned a budget in the health sector to reduce risk and prepare for emergencies. Although only 11% of people exposed to natural hazards live in developing countries, they account for more than 53% of global deaths due to natural disasters, showing that investment and the promotion of coordinated actions and training of professionals greatly reduce deaths in disasters. According to WHO itself, data from 2008 showed that 321 natural disasters killed approximately 236,000 people, causing financial losses of billions. The best effort, that is, the best care for the most serious victim should give way to the concept of the best care for the greatest possible number of victims.
Therefore, three basic principles in the care of these situations are essential: sorting, treatment and transportation. In order to these three basic principles to be fully met, there must be command, communication and control, essential points for the service success.
Concerned about this scenario, the Pan American Trauma Society developed the course "Advanced Medical Response in Disasters", which is being taught in our country in partnership with SBAIT. It is an eight hour theoretical course , that covers the following topics: management and command system in disasters situation; ABC of disaster response; decontamination; radioactive, biological and chemical agents; explosion and crushing injuries; psychological response in disasters; in addition to SAMU's actions in disaster response.
Each student receives the book "Advanced Disaster Medical Response Manual", by Dr. Susan Briggs and Dr. Raul Coimbra, Distribuna Editorial, colored, with 163 pages, serving as a bibliographic basis for the course.