Introduction
Emergency medical services should be prepared during all disaster management phases, including preparedness, mutilation, response, recovery, and reconstruction. Emergency medicine plays a significant role in life-saving care and effective management after a disaster. Emergency medical services can coordinate with governmental agencies, non-governmental agencies, public health services, and hospitals to provide effective support and care.
What Is a Disaster?
A disaster is a tragic event that interferes with the normal function of the area or a community and causes destruction, harm, and suffering. It can occur from natural forces or by human activities. Disasters can include floods, wildfires, earthquakes, storms, volcanic eruptions, tsunamis, technological accidents, epidemics, and terrorism. These events can damage infrastructure, displacement of people, loss of lives, and affect the socio-economic situation. Management of this disaster involves non-governmental organizations, government agencies, emergency services, and community members.
What Is Disaster Management?
Disaster management is the coordinated and systemic approach taken by communities, organizations, and governments to prepare, respond, recover, and mitigate the results of disasters. Whether the disaster is man-made or natural, children are affected most, and the main focus should be to protect the children. Apart from these, the main goal of disaster management should be to save lives, protect the environment, and minimize the psychological and socio-economic impacts of disasters. The phases of disaster management involve:
-
Preparedness: This phase is undertaken before the occurrence of the disaster. This improves the ability to respond to the disaster effectively. This involves developing an emergency plan, assessing risks, performing early warning systems, stockpiling necessary equipment and supplies, training personnel, and creating public awareness campaigns. Some relief items include tarpaulins, blankets, purifying tablets, water carriers, and shelter materials.
-
Mitigation: This is the phase that is involved in reducing and removing the risks and vulnerabilities that can be due to disasters. This involves land-use planning, reinforcing infrastructure, building codes, constructing barriers, and implementing hazard-resistant designs.
-
Response: This phase occurs right after the occurrence of the disaster. This involves rescue operations, providing temporary shelter, emergency medical assistance, and distributing food and water.
-
Recovery: This phase is mainly concentrated after the crisis has taken place and should aim at restoring the affected parts of the disaster. This should include assessment of the damage, infrastructure repair, debris removal, supporting affected businesses, providing financial assistance, restoring essential services, and facilitating social and psychological recovery.
-
Reconstruction: This phase is included in a large-scale disaster that involves long-term reconstruction of the affected areas. This can include the construction of schools, housing, and hospitals, and also measures should be taken to prevent future disasters.
What Is the Role of Emergency Medicine in Disaster Preparedness?
The role of emergency medicine in disaster preparedness includes:
-
Training and Education: This is an important step in disaster preparedness. Training and education should be given to the healthcare providers, which can improve their knowledge and skills in areas of mass casualty management, triage (assessment to determine the urgency for the treatment), and emergency procedures. Apart from these, it can also help in calculating risk and identifying potential hazards. Training should be given in psychological first aid to support individuals with trauma, grief, and distress.
-
Development of Performance Metrics: This helps in the selection of patients for prehospital rapid sequence intubation to improve ventilation and oxygenation and to protect them from aspiration, ground or air transportation, and out-of-hospital cardiac arrest patients.
-
Establishment of MOUs (Memoranda of Understanding): An MOU between the agencies can play a significant role in disaster preparedness, response, and recovery. MOUs can occur between government agencies, emergency management organizations, non-governmental agencies, law enforcement agencies, and healthcare providers.
-
Planning for Liability and Licensure Issues: The medical emergency system should construct agreements that should address the licensure along with medical malpractices, compensation, and occupational health coverage for workers. Emergency medical services are the front-line providers in disaster management; therefore, they should be provided with safety along with protection. Methods such as improving sleep, providing personal protective equipment (PPE), and administration of immunoprophylaxis or chemoprophylaxis should be provided.
What Is the Role of Emergency Medicine in Disaster Response?
The response activities have five phases, which involve recognizing an event, notification of the disaster, mobilization, disaster response, and demobilization.
-
Participating in Unified Command Leadership: Emergency medical services should involve command leadership in taking care of sick and injured patients. This can improve efficiency and effectiveness.
-
Triage: Triage is a process of assessing the patients to determine the urgency of the treatment. This process should involve quick assessment and an assortment of patients in order to receive treatment. The main objective should involve the effective use of limited resources and to save as many lives as possible. Emergency medical services should help in categorizing the patient who requires acute medical care. The two techniques that are commonly used are START (simple triage and rapid treatment) and SALT (sort, assess, life-saving intervention, and treatment and transport).
-
Improving the Standard Protocols: Emergency medical services should have the flexibility to use procedures and medications that are out of their reach, especially during acute disaster events where there is difficulty in accessing healthcare facilities, transport, or infrastructure damage. Therefore, emergency medical services should have more access to new medications, antivirals, and vaccines in case of slow emerging situations such as pandemic influenza (outbreak of influenza virus).
-
Involving In Community Response Roles: Emergency medical services should expand their role in community services and can be a part of Medical Reserve Corps (MRC) and community emergency response teams (CERTs). CERTs help in training citizens and volunteers to assist the victims during the disaster, and MRCs provide health services and assist emergency health care providers to provide care to people with fewer injuries. Emergency medical services should also get involved in community education programs on cardiopulmonary resuscitation (CPR), first aid, and automated external defibrillation (AEDs).
-
Involving In National Response Roles: Emergency medical services should also expand their roles in national services and can be a part of the disaster medical assistance team (DMAT), which helps in providing equipment and supplies. These services also help in the transportation of patients to unaffected areas.
Conclusion
The success of disaster management depends on coordinated efforts of governmental and non-governmental agencies, military rescue, search rescue, law enforcement, public health services, public utilities, emergency medical services, and hospitals. The role of the emergency department in disaster management is multiphase. In every phase, the emergency medical system should provide planning, specialized training and education, and coordination.
