**2. Medical provision of the population - goals, principles and tasks**

The medical provision of the population (MPP) is an element of activity of the health system especially due to EDS. In case of emergencies it is based as much as possible on the existing health care system and only with an organizational approach moves to a new mode of work with available staff and sources. MPP according to real practice, results of an epidemiological survey and documentary research is defined as a complex of interconnected organizational, medical and hygienic-anti-epidemic measures [7–10, 14].

**It seems that the Aim** of MPP is organized in a few groups of actions:


The occurrence of different types of traumatic defeat due to huge EDS, which are characterized by diverse in nature injuries and mass effect determine the main principles of MPP [1, 2, 7–10, 14, 15].

**The main Principles** of MPP due to contemporary scientific knowledge are collected in some main key points [1, 2, 7–10, 14–16]:

*Natural Hazards - Impacts, Adjustments and Resilience*

**Region Probability (low,** 

**moderate, high)**

*The earthquake risk assessment in Bulgaria by regions (sources: BAS).*

firmness but also readiness for effective operational response and good medical practices. The productive operational activities at each stage of the MPIP with responsible and expert risk health management in a dynamically changing environment at the EDS require mobile flexibility and maneuverability in the development of the plan and its implementation [2, 5–7]. The provision with sufficient resources and their maneuver contextually according to the specific EDS is the basis for a good organizational culture [7, 8] Essential step for rescuing and providing successful medical care to the affected population is a practical interaction with other emergency systems and organization [8, 9]. Coordination of the EDS activities on a large scale is a solid fundament principle for the correct direction of the actions [7–9]. In case of the destructive EDS with a serious territorial scope and severely affected

> **Power (low, moderate, high)**

Blagoevgrad High High Moderate Moderate High Burgas Low Low Low Moderate Moderate Varna Moderate Moderate Moderate High High Veliko Tarnovo High High Moderate Moderate Moderate **Vidin Low Low Low Low Low** Vratsa Low Moderate Low Moderate Moderate Gabrovo Moderate Moderate Low Moderate Low Dobrich High High Moderate Moderate Moderate Kardzhali Moderate Low Low Moderate Moderate Kyustendil Moderate Moderate Low Low Moderate Lovech Low Moderate Low Low Low **Montana Low Low Low Low Low** Pazardzhik High High Moderate Moderate Moderate Pernik Moderate Moderate Moderate High High Pleven Moderate Moderate Moderate Moderate High Plovdiv High High Moderate High High Razgrad Moderate Moderate Low Low Low Ruse High High Moderate High High Silistra High High Moderate Low Moderate Sliven Moderate Moderate Moderate Moderate Moderate Smolyan Moderate Moderate Low Low Low **Sofia-city High High High High High** Sofia Moderate Moderate Low Moderate Low Stara Zagora High High Moderate High Moderate Targovishte High Moderate Low Low Low Haskovo High High Moderate High High Shumen Moderate Moderate Low Moderate Moderate Yambol High Moderate Moderate Moderate Low

**Expected losses (low, moderate, high) People Finance Ecology**

**54**

**Table 1.**


For the correct understanding and optimization of the activities connected with EDS **the tasks** of the MPP are divided into three groups depending on the time for their implementation – before, during and after disaster strike [1, 2, 7–10, 14–18]:

1.Before a disaster occurs:

	- Deployment of the medical formations according to the operational plan, keeping them ready for work and protection.
	- Bringing the health risk management system into readiness.
	- Strengthening the medical provision (MP) system and teams and start MP of the evacuated population from epicenter, during transport to emergency room.

**57**

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

• Introduction of the formations in the center of defeat.

*Main interconnected components of successful medical provision of the population.*

• Organization and rendering of timely first medical aid in the center of

• Removal and evacuation of the victims for appropriate medical care and

• Continuous management and maneuver for the most appropriate use of the

Proper performance of these tasks is a prerequisite for providing in the shortest possible time the optimal amount of medical care to the largest possible number of victims [2, 7–11, 14, 16–18]. The good success of medical provision of the effected population is guaranteed with a clear goal, streamlined tasks and by following the

*Affecting large areas with mass destruction and mass loss* is a typical effect after hug magnitude earthquakes. A typical example of possible consequences in largemagnitude earthquakes is presented in **Figure 2** as number of victims and financial losses due to some of the most destructive earthquakes in XX century (**Figure 2**) [2–6]. Industrial sites, homes, hospitals, public buildings, utilities, underground and aboveground technical facilities, transport hubs, etc., are damaged or destroyed [2, 7–10, 13, 19–22]. This significantly impedes rescue operations, effective enough

• Conducting a forensic medical examination of the victims and their

• Provision of complex of hygienic and anti-epidemic measures.

**3. Earthquakes as an outbreak of traumatic damage: risks and** 

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

defeat.

**Figure 1.**

subsequent treatment.

medical forces and means.

**3.1 Mass destruction after earthquakes**

immediately after the earthquake occurs.

identification.

basic principles (**Figure 1**).

**consequences**

	- Medical reconnaissance.

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

#### **Figure 1.**

*Natural Hazards - Impacts, Adjustments and Resilience*

providing MPP.

1.Before a disaster occurs:

possible.

room.

3.After a disaster occurs:

• Medical reconnaissance.

7–10, 14–18]:

1.*Universality* of using of medical resources.

establishments until the final outcome.

prevention, diagnosis and treatment.

• Planning the activities of the health system for MPP.

• Creation of the medical and sanitary property.

• Constant and regular current hygienic control.

keeping them ready for work and protection.

• Bringing the health risk management system into readiness.

medical staff to starting and working into epicenter.

• Strengthening the epidemiological surveillance of the territory.

2.In case of threatening and an ongoing EDS:

2.*Maximum allowable economy* of using of available resources.

3.*Implementation of the medical evacuation* into a MPP activity.

4.To *use correctly* Unified rescue system with unified emergency number for

5.To use *unified doctrine* for rendering medical aid and treatment from the epicenter of defeat to the ends in the multi-profile and specialized medical

For the correct understanding and optimization of the activities connected with EDS **the tasks** of the MPP are divided into three groups depending on the time for their implementation – before, during and after disaster strike [1, 2,

• Study of the devastating effect of various factors in EDS and the means for

• Construction and maintenance of formations and resources of the MPP.

• Training, drills, workshops for preparing medical staff to react as better as

• Deployment of the medical formations according to the operational plan,

• Strengthening the medical provision (MP) system and teams and start MP of the evacuated population from epicenter, during transport to emergency

• Strengthening and targeting the operational and special preparation of

**56**

*Main interconnected components of successful medical provision of the population.*


Proper performance of these tasks is a prerequisite for providing in the shortest possible time the optimal amount of medical care to the largest possible number of victims [2, 7–11, 14, 16–18]. The good success of medical provision of the effected population is guaranteed with a clear goal, streamlined tasks and by following the basic principles (**Figure 1**).
