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  <head>
    <title>074-01 Mechanistic foundations, classification, normal variation, and clinical presentation</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Foundations of austere and disaster medicine">
      <outline text="Core framing">
        <outline text="Ordinary physiology under constrained resources"/>
        <outline text="Greatest justified benefit, with individual dignity"/>
        <outline text="Scarcity changes priorities, not reasoning"/>
      </outline>
      <outline text="Defining events and settings">
        <outline text="Mass-casualty incident: needs exceed available resources"/>
        <outline text="Disaster: community function beyond local capacity">
          <outline text="Sudden or slowly evolving"/>
        </outline>
        <outline text="Impact set by vulnerability and exposure"/>
        <outline text="Remote, rural, resource-limited overlap">
          <outline text="Not interchangeable; local expertise matters"/>
        </outline>
        <outline text="Cycle: mitigation, preparedness, response, recovery">
          <outline text="Prevention often saves more than heroic response"/>
          <outline text="Recovery lasts years"/>
        </outline>
      </outline>
      <outline text="Triage under uncertainty">
        <outline text="Sort by urgency, benefit, resources"/>
        <outline text="Mass casualty favours likely survivors"/>
        <outline text="Shared protocol, not assumed colour terms"/>
        <outline text="Rapid initial assessment, detail sacrificed">
          <outline text="Airway, haemorrhage control, antidote change category"/>
          <outline text="Children need age-adjusted physiology"/>
        </outline>
        <outline text="Dynamic: retriage as conditions change">
          <outline text="Labels attached, legible, timed"/>
          <outline text="Over-triage consumes, under-triage delays"/>
        </outline>
        <outline text="Expectant does not mean no care">
          <outline text="Analgesia, warmth, presence remain obligations"/>
        </outline>
      </outline>
      <outline text="Command, zones, and communication">
        <outline text="Incident command roles">
          <outline text="Clinical expertise informs, not replaces"/>
          <outline text="Span of control limits direction"/>
        </outline>
        <outline text="Redundant communication methods"/>
        <outline text="Hot, warm, cold zones">
          <outline text="Scene safety precedes patient contact"/>
        </outline>
        <outline text="Distribute by capability and capacity"/>
        <outline text="Hospital internal surge plans"/>
        <outline text="Honest, consistent public messaging">
          <outline text="Rumours fill information gaps"/>
        </outline>
      </outline>
      <outline text="Injury patterns by mechanism">
        <outline text="Blast: primary to quaternary injury">
          <outline text="Tympanic rupture does not predict lung injury"/>
        </outline>
        <outline text="Chemical: route, persistence, latency, toxidrome">
          <outline text="Decontamination as urgent as antidote"/>
          <outline text="Undirected washing not universally safe"/>
        </outline>
        <outline text="Radiological: contamination versus irradiation">
          <outline text="Irradiated only patient does not expose staff"/>
          <outline text="Life-threatening trauma before decontamination"/>
        </outline>
        <outline text="Biological: unusual clusters and syndromes">
          <outline text="Natural and deliberate look identical early"/>
        </outline>
        <outline text="Crush: necrosis, hyperkalaemia, kidney injury">
          <outline text="Deterioration after release of compression"/>
          <outline text="Treat before extrication, avoid potassium"/>
        </outline>
        <outline text="Burns: airway oedema, circumferential risk">
          <outline text="Hypothermia common despite burns"/>
        </outline>
        <outline text="Floods, earthquakes, wildfire"/>
      </outline>
      <outline text="Austere physiology and environment">
        <outline text="Haemorrhage control and tourniquets">
          <outline text="Record tourniquet time, keep it visible"/>
          <outline text="Permissive low pressure not in brain injury"/>
        </outline>
        <outline text="Hypothermia worsens coagulation and shock"/>
        <outline text="Hyperthermia needs rapid cooling"/>
        <outline text="Altitude hypoxaemia and acclimatisation">
          <outline text="Descent and oxygen definitive"/>
        </outline>
        <outline text="Diving illness and gas embolism">
          <outline text="Flying after diving can precipitate symptoms"/>
        </outline>
      </outline>
      <outline text="Infrastructure-dependent disease">
        <outline text="Power failure disrupts oxygen, dialysis, cold">
          <outline text="Registries and backup plans preserving privacy"/>
          <outline text="Generator exhaust carbon-monoxide risk"/>
        </outline>
        <outline text="Displacement: crowding, malnutrition, violence">
          <outline text="Water, sanitation, shelter as core interventions"/>
        </outline>
        <outline text="Chronic disease interruption causes crises">
          <outline text="Formulary and continuity records in preparedness"/>
        </outline>
      </outline>
      <outline text="Cultural and local knowledge">
        <outline text="Communities know geography and evacuation"/>
        <outline text="Bypassing local leadership causes harm"/>
        <outline text="Language access and cultural safety build trust">
          <outline text="Historical mistreatment justifies suspicion"/>
        </outline>
        <outline text="Essential versus customary care"/>
      </outline>
    </outline>
  </body>
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