The goal of most EMS is to provide treatment to those in need of urgent medical care, with the purpose of satisfactorily treating the problem, or arranging for timely removal of the patient to the next point of definitive care. Earthquakes are among the most destructive types of natural disasters, striking suddenly with no accurate method of prediction or warning, thereby taking a heavy toll on life, injury and property. The damage created affects all aspects of the community - transportation, telecommunication, and infrastructure and can easily overwhelm local health services, damage clinics, hospitals and render them useless.

To review the pertinent literature and to analyze the information in order to set practical guidelines for EMS work in earthquakes with a community-based approach.

Survival of casualties extricated from under the rubble depends upon early medical interventions by emergency teams on site. EMS needs to strive for: • early arrival • early qualified treatment • Earthquakes differ from other disasters, where the system is intact.: early transport and definitive care. • They present a vast number of patients • problems concerning availability of medical personnel, • accessibility to patients, means of transportation & communication.

A routine national community-based approach will strengthen the ability to provide early response in both daily and disastrous events, improving both morbidity and mortality rates. Possibly no immediate definitive care.