Fire. Flood. Explosion. Tidal wave. Radiological incident. Civil
disturbance. Poisonous gas leak. Auditorium grandstand collapse. Aircraft crash.
Train crash. Earthquake.
The potential for a mass casualty incident lies anywhere large numbers of
people can and do gather. Every community faces this risk and must be prepared
for disaster, taking into account that disaster casualties might exceed the
capacity of hospitals in the immediate vicinity.
Hospitals, communities and emergency managers also should plan for the
possibility that a disaster may even destroy a local hospital, complicating care
of current patients and creating additional disaster victims. A disaster often
requires outside help, and communities should be prepared for this contingency.
Considerations include mass casualty triage, coordinated casualty flow, logistic
and personnel support, and transfer of casualties to supporting hospitals. Every
hospital should be able to access resources beyond its own immediate area to
supplement its own operations.
General Aviation to the Rescue
General aviation aircraft are a valuable component of any disaster contingency
plan. Disasters devastate the transportation infrastructure, sometimes causing
fissures in roadways, covering large areas with debris and inhibiting ground
transportation. Aircraft therefore provide the best -- and sometimes the only --
General aviation aircraft are those that do not fall into the military,
commercial airline or corporate categories. General aviation resources enjoyed
some recognition in the years following the 1962 Cuban Missile Crisis. The
nation at that time experienced a renewed interest in civil defense and national
emergency preparedness. The U.S. Office of Civil Defense, the U.S. Civil
Aviation Authority and the U.S. Air Force coordinated plans to use general
aviation aircraft for emergency purposes.
General aviation aircraft reportedly airlifted medical supplies, food and
personnel into earthquake-stricken areas following California's tremendous 1989
earthquake. This type of disaster response has a name: State and Regional
Disaster Airlift, or SARDA.
SARDA has existed in some form for quite a while. So long as airplanes have
flown, pilots have been willing to help disaster victims. SARDA organizations
are use available general aviation resources to facilitate speedier transport of
emergency medical supplies, food, personnel and patients; as well as to conduct
airborne reconnaissance. Aerial operations are not limited by rubble-strewn
traffic lanes, destroyed bridges or localized fires.
The FAA currently provides the only guidance in effect for SARDA (Advisory
Circular 00-7D). The material serves only to guide and is not a regulation or
statute. The FAA published its most recent version of that circular in September
California, Illinois and Texas have SARDA plans. Most other states rely on
the Civil Air Patrol for aviation disaster response.
Civil Air Patrol: Valuable Resource
Pilots and aircraft owners formed the Civil Air Patrol on Dec. 1, 1941, to
assist in the impending World War II effort. CAP during that period flew
numerous missions, including tow target, military transport, courier duties,
border patrol and anti-submarine patrol. CAP efforts currently cover three
areas: emergency services, aerospace education and cadet training.
CAP emergency services consist of search and rescue and disaster relief. CAP
survives as the official, non-combatant auxiliary of the United States Air Force
-- the only official civilian auxiliary of any branch of the U.S. armed forces.
CAP is the emergency services organization of general aviation.
Current Response Protocol
If a major disaster were to occur today, most communities would call on the U.S.
military - the only groups now capable of launching a response of this
magnitude. Military involvement, however, creates a new set of problems.
It takes time for the military to mobilize. During the Persian Gulf War, many
medical units were deployed overseas. In peacetime, most units are staffed at
one-half their manning tables or less. They are then filled, if necessary, by
calling reserves or by drafting from military hospitals. This mobilization takes
weeks and requires a presidential declaration.
Another significant issue: Who will pay for the military response? Some
states have been in litigation for years arguing over who will pay for services
rendered when the military had responded. This creates the need for an
alternative to military involvement. The alternative I propose: Plan and provide
for a total civilian response.
'Disaster Circus' Comes to Town
As a Lt. Colonel in the Civil Air Patrol, specializing in disaster planning, I
set about to create a model plan for such a civilian response.
After three years of research, I developed a model disaster response plan
entitled "Civil Aeromedical Staging Facility," or CASF. I nicknamed
the plan "Disaster Circus" because it uses temporary structures and
requires air mobility.
CASF would employ general aviation aircraft, including helicopters, to
facilitate immediate access to a temporary medical unit. Aircraft would
transport a temporary structure for use as an emergency medical facility that
would be staffed by a team of medical volunteers, including EMTs, paramedics,
nurses and physicians. A board-certified emergency room physician would be in
charge of the CASF, which would provide speedy relief to many a distressed
community. What's more, CASF would save more lives.
Various state agencies would develop the facility, based on the potential
needs of their constituency. The state's emergency preparedness agency, the
state medical authorities, the state aviation authorities and the local Civil
Air Patrol wing should be involved.
When the governor declares a state of emergency, the facility would mobilize.
Helicopters and fixed-wing aircraft would transport the facility into the
disaster area upon request from the state. The team would stabilize the injured
and airlift them to supporting hospitals outside the disaster area. When no
longer needed, the unit would dismantle the temporary facility and return to its
Under this plan, the Civil Air Patrol would provide aircraft, aircrews,
support bases, mission coordinators and communications. Equipment would be
obtained from a variety of sources -- among them military surplus, donations or
outright purchase. All equipment must be air-transportable.
My CASF plan, comprised of 12 chapters and including six annexes, provides
for facilities of 100 beds, 300 beds, 600 beds and 1,000 beds, as well as the
- Equipment lists
- Equipment and facility configurations
- Set-up and structure schedules
- Generator power grid
If implemented, the plan would aid the people of any community that has
experienced a disaster. It also would provide an opportunity for emergency
organizations to work together in the face of disaster, without having to wait
for a federal declaration or military mobilization. The plan also is
sufficiently flexible to allow for customization to meet the needs of specific
The key, under any circumstances, is appropriate planning before a disaster