Disaster Preparedness

Disaster medicine is the union of disaster management and emergency medicine, to create a more formalized specialty and to further identify the integration of medicine in the overall disaster preparedness and response system. Disaster defined by the United Nations Disaster Management Training Programme is a serious disruption of the functioning of a society causing widespread human, material, or environmental losses, which exceed the ability of the affected society to cope using only its own resources (UNDMTP, 2002). Almost always, disasters, either natural or manmade, strike without warning and leave little lead time for preparedness at prehospital and hospital levels.

It is known that all disasters follow a cyclical pattern, the disaster cycle, otherwise known as the four phases of Emergency Management: preparedness, response, recovery, and mitigation/prevention (Ciottone, 2006). Preparedness encompasses making the community aware of circumstances that have potential for disaster formation and empowering them to cope effectively. It also includes planning and training individuals to identify resources that may be used in times of disaster. Response occurs at the impact of the disaster and represents a time when immediate assistance can save lives. This includes the basic elements of search/rescue, triage and initial stabilization, as well as definitive medical care. The coordination and collaboration of emergency medical teams, public health agencies, and governmental agencies initiates the recovery phase through reconstruction, and it also implies the return of normalcy within the society. Lastly, the mitigation phase refers to the ability to reduce the devastating   effects of disaster before the actual event through education and prevention teachings.  Essentially, mitigation is the “lessons learned” from previous disasters and also serves as a driving force for preparedness initiatives. Within this disaster cycle, emergency medicine specialists play a vital role in all four phases, but they have the most influence during preparedness and response. When disaster strikes, emergency medicines main role is to care for the injured. Depending on the severity of the event that has occurred, it may result in varying injuries and disease patterns. This becomes most important during disaster triage, which involves the task of assigning patients into treatment categories based on predicted survivability. During these times of disaster, health care workers are always faced with increasing ethical challenges in providing sensible care to patients in these types of circumstances. It is important for personnel to maintain ethical reasoning and balance in a field of scarce resources.

In October 2012, Hurricane Sandy was churning in the ocean, predicted as one of the largest storms in the Atlantic Ocean.  When it hit land, it was only a category two hurricane, but ended up causing much destruction around the New Jersey shore and New York City.  Many New York City hospitals had activated their disaster preparedness plan and were ready for the worst.  Despite extensive preparations, New York University had to evacuate around 300 patients after a loss of power and failed generators.  In times like this, the uncertainty and chaos can over come many individuals, but NYU’s disaster preparedness team handled the evacuation smoothly, transporting all patients to near by hospitals.  NYU officials successfully coordinated and collaborated with many individuals.  Disaster plans built on the four phases of emergency management can make certain that the organization will stay functional during times of disaster and emergency to provide sound medical care.  Drills and training allow hospital workers to understand and learn procedures that may be necessary during a time of emergency.  A disaster preparedness plan should be simple and easy to execute.  Active disaster preparedness will often lessen the burden of chaos during the initial effects. Using guides published by the different government and public health agencies along with the incorporation of a wide specialty team can often help to imbibe new ideas, plans, and effective training. Threats will always be present, but with adequate planning, practice, and mitigation, disaster preparedness can minimize mortality. Effectiveness in disaster management is molded by the coordination of many individuals, teams, and organizations with stronger disaster preparedness and management skills. Disaster preparedness and management provides a way to draw organization out of chaos while providing efficient patient care.

References:

Ciottone, G. (2006). Disaster Medicine. Philadelphia: Mosby.

United Nations Disaster Management Training Programme (2002, August).United Nations Disaster Management Training Programme. Retrieved April 3, 2013, from

http://ocha.unog.ch/drptoolkit/PreparednessTools/Coordination/role%20and%20responsibilities%20of%20UNDMT.pdf