Establishment of good communications is critical in any disaster or mass-casualty situation. Past experience, however, has shown that this essential function is difficult to achieve for a variety of reasons. Telephones frequently become inoperative due to switchboard overload and damage to telephone lines and other equipment. A major goal should be full utilization of all possible communications resources, including citizens' band groups, cellular phones, blackboards, E mail, intercoms, closed-circuit television, short-wave radio and radio-equipped individuals of all kinds, runners, and even messenger and courier services.

Interhospital communication may be necessary because of shortages of supplies, such as blood or intravenous fluids; certain equipment, such as incubators or surgical instruments; or personnel, such as nurses, x-ray technicians, respiratory therapists, or physicians. When a hospital is overloaded, it may be desirable to transfer patients to a prearranged receiving hospital. Unfortunately, interhospital communications may present a weak link in the community's disaster response. After one Los Angeles earthquake in 1971, 67 percent of hospitals had difficulty with interhospital communications. —

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