++

Disasters have claimed millions of lives and cost billions of dollars worldwide in the past few decades. Recent examples of large-scale disasters include the terrorist attacks of September 11, 2001, the intentional distribution of anthrax in the U.S. in 2001, the 2004 Pacific Ocean tsunami, and the 2010 earthquake in Haiti. Emergency physicians frequently have extensive responsibilities for community and hospital-level disaster preparedness and response. This chapter discusses the definition of a disaster, disaster preparedness and planning, the hospital emergency operations plan, field disaster response, and the ED disaster response.

++

The World Health Organization defines a disaster as a sudden ecologic phenomenon of sufficient magnitude to require external assistance. A disaster is an event that overwhelms the resources of the region or location in which it occurs. Furthermore, a hospital disaster may similarly be defined as an event that overwhelms the resources of the receiving hospital. It is important to note that a hospital disaster may be of any size and is not limited to mass casualty incidents. A single patient who ingested an organic phosphorous pesticide may overwhelm the resources of a hospital if that hospital is not prepared to decontaminate external to the ED. A single patient with suspected smallpox or a single special patient (e.g., President of the U.S. or a celebrity) may draw so many resources from the ED that it affects the care of other patients.

++

Whether an event is a disaster further depends on the time of day, nature of the injuries, type of event, and the amount of preparation time before the arrival of patients. The ED “surge capacity” (ability of the ED to care for more patients than is typical) may be severely limited by hospital overcrowding.

++

When it appears that the normal procedures of an ED may be interrupted by an event, there must be policies and procedures in place to activate a disaster response, direct the mobilization of personnel and equipment, and permit the rapid triage, assessment, stabilization, and definitive care of victims.

++

Types of Disasters

++

Disasters are subdivided into several categories (Table 6-1). External disasters occur at locations that are physically separate from the hospital (e.g., transportation accident, industrial accident). An internal disaster is an event that occurs within the confines of the hospital (e.g., bomb scare, laboratory accident involving radiologic agents, power failure, fire, etc.). Disasters can be both internal and external (e.g., earthquake with mass casualties as well as damage to the internal hospital). Natural disasters are discussed in 6348648, Chemical Agents in Chapter 9, and bioterrorism in Chapter 10.

++
Table Graphic Jump Location
Table 6-1 Types of Disasters 

Want access to your institution's subscription?

Sign in to your MyAccess Account while you are actively authenticated on this website via your institution (you will be able to tell by looking in the top right corner of any page – if you see your institution’s name, you are authenticated). You will then be able to access your institute’s content/subscription for 90 days from any location, after which you must repeat this process for continued access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess account, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessMedicine Full Site: One-Year Subscription

Connect to the full suite of AccessMedicine content and resources including more than 250 examination and procedural videos, patient safety modules, an extensive drug database, Q&A, Case Files, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessMedicine

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.