Disaster Medicine: Public Health Preparedness for Natural Disasters

The phases of emergency management are mitigation, preparedness, response, and recovery. Optimal disaster response requires knowledge and understanding of the US disaster response structure. In a disaster, the local government is the first to start a response. It initiates the incident command system, activates the local emergency management plan, sets up an emergency operations center (EOC), and activates mutual aid agreements as needed. Assistance from the state and federal governments may be requested. Hospitals respond using the hospital incident command system. The incident commander declares a hospital emergency, sets up an EOC, and uses the predisaster hazard vulnerability analysis tool to choose the incident action plan specific to the hazard. Principles of the crisis standard of care are used in disaster response when health care needs overwhelm available resources. Alert systems are critical to inform personnel and the public about weather conditions, evacuation orders, and closures of roads and health care facilities. Family physicians can play an important role during disaster response, including patient notification and immediate discharge or transfer of patients with less serious acute conditions from the hospital and emergency department to free beds.