Current earthquake casualty reduction measures are examined and recommendations made for needed changes. Key new approaches are outlined and a new framework for understanding casualty reduction measures presented. The framework considers both issues of demand for medical services and supply within primary, secondary and tertiary prevention aspects of each. It is used to assess current measures against recent empirical data and to suggest changes that incorporate new data and methods. Issues include the management of emergency medical services, messages for individual protective actions and assumptions about the nature of injuries. Research has tended to consider primarily the demand side of earthquake injury prevention, focusing on the injured rather than the uninjured. Case series investigations have tended to be descriptive rather than analytical and be undertaken from a clinical rather than an epidemiological perspective, documenting medical aspects of earthquake injuries. Linking these injuries to the risk factors associated with them has not been as systematically studied. Proposed here is an approach for casualty reduction research to fill knowledge gaps. It includes steps to integrate future casualty data and assessment efforts into casualty modeling and into ongoing earthquake policy formation.

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