**4.1 Role and place of the medical forces and resources for MPIP**

### *4.1.1 Emergency care system (ECS)*

Usually the signals for victims of an accident or disaster are received by the medical director (manager) of the emergency room and emergency hospitals as medical institution from ECS. Firstly, emergency medical care center (EMCC) as a front line of health system is informed by Unified rescue and emergency number 112. The teams of EMCC are the first to go to the place and take place of the scene of the EDS as event [7–10, 14, 16–18, 27].

In large-scale disasters, the EMCC teams are not enough to provide the necessary amount of medical care to those in need. This requires in advance formation, preparation and equipment additional teams of staff of medical institutions for their inclusion in the provision of medical care. In addition to these medical teams for the population, especially in earthquake-prone areas or areas with chemical sites in anticipation of numerous medical losses, emergency hospital medical teams and emergency military teams can be used. These are medical formations built on a functional principle with opportunities to provide emergency qualified therapeutic and surgical care for vital indications [7, 14, 16–18, 27].

## *4.1.2 Hospitals*

The main tasks of the hospitals in EDS are the provision of medical care and treatment of the victims and hygienic and anti-epidemic provision of the affected regions, and by order of the chairman of the respective commission (district, municipal) and neighboring regions [7].

The network of health facilities and their infrastructure must be ready to provide timely emergency and specialized medical care to the population in emergency and disaster situations [2, 7–9, 16–18, 27].

Knowledge of the factors that can lead to damage to health or endanger the lives of people in EDS allows them to predict the medical consequences, to clarify ways to combat them, to take the necessary preventive measures to limit the medical consequences, to organizing emergency medical measures and eliminating the consequences of emergencies [7, 8].

The hospitals provide the necessary human and material-technical resources, create an effective organization and keep in constant readiness the forces for immediate action in EDS [2, 8].

Before the occurrence of the disaster, the head of the medical institution – hospital must make a comprehensive assessment of the condition and the ability of the health institution to work in such a situation. During this period, the action plan for the EDS and the work of the medical institution for the medical provision of the population of the respective territorial unit must be developed, in accordance with the plan of the Ministry of Health [2, 8, 16–18, 27].

The plan is developed in different variants depending on the expected nature and severity of the medical losses and includes the following [7, 8]:


**61**

*Medical Provision of the Population within an Outbreak of a Traumatic Defeat an Earthquake…*

3.Necessary medical teams and formations for rendering emergency and urgent

4.Creation of an appropriate structure (restructuring) of the bed base of the

5.Organizational scheme for providing medical care at the site of the lesion,

The Regional Health Inspectorates (RHI) are developing a work plan for the Hygiene and Epidemiological Provision and Inspectorate in the disaster area. It must be in accordance with the plan for conducting rescue and other urgent works

In case of disasters, the director of RHI clarifies the place and nature of the event, then organizes and conducts research and control of environmental hygiene parameters in the affected areas, in industrial and other sites in terms of toxic substances, dust, noise, vibration, microclimate, radiation and other harmful factors. This activity is carried out by pre-formed and trained anti-epidemic teams of RHI

The main task of the RHI is the organization and implementation of disinfection, disinsection, deratization and control of the degassing and decontamination

The number and nature of foodstuffs affected by the disaster, the type and quantity and the nature of the damage must be clarified, and enhanced sanitary control must be organized over all foodstuffs in the disaster area. This requires organizing and conducting intensive laboratory control over the affected catering

Based on the conclusions of the analysis, the RHI prescribes measures for compliance with hygiene standards and requirements for all factors of the working environment. After conducting a control for hygienic efficiency of the conducted measures, a conclusion is given for safe working conditions with a view to resuming

The relevant clinics from the Multidisciplinary Hospital for Active Treatment (MPHAT) and Hospital for Emergency Medicine, as well as the clinical departments of surgery, orthopedics and traumatology, resuscitation and anesthesiology in the district, regional and municipal hospitals are used as a base. If necessary, the bed capacity of the same hospitals is used. In some cases, staff and facilities from other surgical units (ophthalmology, maxillofacial surgery, etc.) of hospitals can be used. This allows in EDS for a short time and without significant difficulties to be included in the organizational scheme of medical care. About 60% of the inpatients can be discharged and a specialized bed stock can be released for the needs of the victims. For work in a trauma center, if necessary, medical teams (trauma, surgical, etc.) are formed on a functional principle, without seriously violating the readiness of these wards for admission and treatment of victims. These teams must arrive at the scene no later than one hour after the emergency medical teams. At this time, the medical situation, the scope of work and the

activities in the affected areas after the normalization of the situation [8].

*DOI: http://dx.doi.org/10.5772/intechopen.94259*

medical institution if necessary.

*4.1.3 Regional health inspectorates (RHI)*

of the regional and municipal commission [7, 8].

on the territory of the disaster [7, 16–18, 27].

establishments and food industry establishments.

regular operation of the affected sites [7].

**4.2 Organization of MPIP**

*4.2.1 Surgical and trauma care*

medical aid, as well as inpatient medical care.

during transportation and in the medical institution.

*Medical Provision of the Population within an Outbreak of a Traumatic Defeat an Earthquake… DOI: http://dx.doi.org/10.5772/intechopen.94259*


#### *4.1.3 Regional health inspectorates (RHI)*

*Natural Hazards - Impacts, Adjustments and Resilience*

*4.1.1 Emergency care system (ECS)*

the EDS as event [7–10, 14, 16–18, 27].

municipal) and neighboring regions [7].

and disaster situations [2, 7–9, 16–18, 27].

consequences of emergencies [7, 8].

Ministry of Health [2, 8, 16–18, 27].

rendering medical aid to the victims.

diate action in EDS [2, 8].

hospital.

*4.1.2 Hospitals*

**4. Health risk management: essential principles**

and surgical care for vital indications [7, 14, 16–18, 27].

**4.1 Role and place of the medical forces and resources for MPIP**

Usually the signals for victims of an accident or disaster are received by the medical director (manager) of the emergency room and emergency hospitals as medical institution from ECS. Firstly, emergency medical care center (EMCC) as a front line of health system is informed by Unified rescue and emergency number 112. The teams of EMCC are the first to go to the place and take place of the scene of

In large-scale disasters, the EMCC teams are not enough to provide the necessary amount of medical care to those in need. This requires in advance formation, preparation and equipment additional teams of staff of medical institutions for their inclusion in the provision of medical care. In addition to these medical teams for the population, especially in earthquake-prone areas or areas with chemical sites in anticipation of numerous medical losses, emergency hospital medical teams and emergency military teams can be used. These are medical formations built on a functional principle with opportunities to provide emergency qualified therapeutic

The main tasks of the hospitals in EDS are the provision of medical care and treatment of the victims and hygienic and anti-epidemic provision of the affected regions, and by order of the chairman of the respective commission (district,

The network of health facilities and their infrastructure must be ready to provide timely emergency and specialized medical care to the population in emergency

Knowledge of the factors that can lead to damage to health or endanger the lives of people in EDS allows them to predict the medical consequences, to clarify ways to combat them, to take the necessary preventive measures to limit the medical consequences, to organizing emergency medical measures and eliminating the

The hospitals provide the necessary human and material-technical resources, create an effective organization and keep in constant readiness the forces for imme-

The plan is developed in different variants depending on the expected nature

1.Creation and maintenance of a system for notification of the employees of the

2.Calculation of the medical losses and of the necessary forces and means for

and severity of the medical losses and includes the following [7, 8]:

Before the occurrence of the disaster, the head of the medical institution – hospital must make a comprehensive assessment of the condition and the ability of the health institution to work in such a situation. During this period, the action plan for the EDS and the work of the medical institution for the medical provision of the population of the respective territorial unit must be developed, in accordance with the plan of the

**60**

The Regional Health Inspectorates (RHI) are developing a work plan for the Hygiene and Epidemiological Provision and Inspectorate in the disaster area. It must be in accordance with the plan for conducting rescue and other urgent works of the regional and municipal commission [7, 8].

In case of disasters, the director of RHI clarifies the place and nature of the event, then organizes and conducts research and control of environmental hygiene parameters in the affected areas, in industrial and other sites in terms of toxic substances, dust, noise, vibration, microclimate, radiation and other harmful factors. This activity is carried out by pre-formed and trained anti-epidemic teams of RHI on the territory of the disaster [7, 16–18, 27].

The main task of the RHI is the organization and implementation of disinfection, disinsection, deratization and control of the degassing and decontamination activities in the affected areas after the normalization of the situation [8].

The number and nature of foodstuffs affected by the disaster, the type and quantity and the nature of the damage must be clarified, and enhanced sanitary control must be organized over all foodstuffs in the disaster area. This requires organizing and conducting intensive laboratory control over the affected catering establishments and food industry establishments.

Based on the conclusions of the analysis, the RHI prescribes measures for compliance with hygiene standards and requirements for all factors of the working environment. After conducting a control for hygienic efficiency of the conducted measures, a conclusion is given for safe working conditions with a view to resuming regular operation of the affected sites [7].
