Abstract
Mass disastersare events which overwhelm, damage or destroy local Emergency Medical Services (EMS) systems, and therefore need the response of a State or National Disaster Medical System (NDMS). Natural mass disasters include major earthquakes, floods, hurricanes and fires. Manmade mass disasters include major fires, industrial accidents, wars, and nuclear accidents. Mass disasters must be distinguished from “multicasualty incidents” (MCI), such as major transportation accidents, which the local EMS system should be able to handle, if necessary, with the assistance of surrounding (regional) EMS systems. Endemic-epidemic disasters (e.g., droughts, famines, infectious diseases, and refugee problems) are catastrophes which deserve separate considerations, as they require ongoing political-economic solutions.

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