Role of the Family Doctor in Disaster and Emergency Medicine

Abstract

It is an honorable experience to be invited to address you today and to extend the warmest regards to you from your colleagues in New Zealand. You will be excused if it is difficult to find our two small Islands on the map, for we are tucked down in the South Pacific with a small population or just over 3 million, and you would be excused for asking what can a general practitioner or family physician contribute to an International Seminar attended by so many recognized experts in the field of trauma management. The contribution I offer to you today follows a study tour I made 2 years ago as the Wolfson Travelling Fellow in Emergency Care (3) of major trauma management in many European countries and in the United States, I also want to tell you a little about our involvement in New Zealand, as family or general practitioners in prehospital intensive care (4). The vital message that I brought back to my colleagues in New Zealand following an investigation of emergency care in other countries was that competent life support must be established within minutes of injury and delivered by a skilled team consisting of both medical and paramedical personnel. The message was important to my country because we are faced with more than our share of natural disasters. We have a scattered population with vast distances between our hospitals, and we have one of the highest motor vehicle fatal accident rates in the world. A breakdown of 900 deaths in New South Wales in Australia showed that for every 15-min delay in establishing competent, on site resuscitation, the number dying at the accident scene doubled. Some countries I visited in 1975 had, unfortunately, very little skilled medical involvement in the emergency situation outside the hospital environment, and, no matter how well paramedics were trained, the total quality of care was, in my view, always of a higher standard when doctors worked on site as a team with paramedic ambulance staff. For this reason, it is a delight to return to West Germany to see again the highest standard of emergency care delivery and to reexamine your BINZ Transporter Ambulances and helicopter rescue services. In using machinery of such quality, you have equated the cost of its provision with the value of human life saved.