Hospital disaster planners must plan for those disasters most likely to occur in their community. 27 Hospitals in Hawaii and along the Gulf coast of the United States should plan for hurricanes,2829 those in California should plan for earthquakes,30313 3 and 34 and those near chemical industries should have facilities for decontamination. Hospitals located near facilities using large amounts of hazardous materials are required by Title III of the Superfund Amendments and Reauthorization Act to participate in local emergency planning committees.35 Accidents at large transportation facilities, such as airports and harbors, and at festivals, stadiums, and amusement parks can generate large numbers of casualties.36 3!,38 and39 Various types of disasters are characterized by specific morbidity and mortality rate patterns, and thus health care requirements.40 Earthquakes cause many deaths and severe injuries.4 42 and 43 Hurricanes cause primarily property damage, with low numbers of deaths and predominantly minor injuries.28 Pulmonary irritation from fires or hazardous chemicals requires large supplies of oxygen, as the 1984 industrial accident in Bhopal, India, demonstrated. 44 The Tokyo sarin chemical weapon attack in 1995 required large quantities of the antidote atropine. 45 Fortunately, some disasters, such as hurricanes, may afford several days' lead time, and preparations for management can begin early.
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