Disaster Planning and the EM Physician

by Bob Stuntz

Today we have our first post from Bryan Wexler, MD.  Bryan is currently a fellow in Disaster Medicine and Emergency Management.  Check out his bio on our guest author page.  He also incidentally holds the title as the real most interesting man in the world.  Being a disaster medicine specialist, Dr. Wexler is going to tell us all about the world of disasters, how to prepare for them, and what we all need to know in future posts.  But first, an intro…

In wake of Hurricane Sandy and the immense devastation caused, states of emergency were issued and many were left homeless or without power.

For those involved in disaster planning and response the responsibilities are understood to a large extent.   However the question remains, “What does this mean for the average Emergency Medicine physician?”

One cannot prepare for every potential event and permutation, which is why an “All-Hazards” approach, with emphasis on general concepts over specific individual nuances and annexes on more likely events, is favored.  

As we have seen with the closing of New York University Langone Medical Center, among others following the hurricane, preparation is crucial not only for the facility itself, but also the nearby hospitals receiving an additional influx of patients.  While evacuation of a facility might be the cause of inadequate preparation or failure of plans, or might seem like an admission of defeat, ultimately it is a testament to an understanding of the safety of patients and staff.  Having good evacuation plans as well as mutual aid agreements with nearby facilities is important for continuation of care despite an adverse situation. 

The Emergency Department is essentially the front line of the hospital, and the physician its de facto leader.  With constant, well-documented problems of overcrowding, the Emergency Department has become adept at compensating and composing quick solutions to keep things running as smoothly as possible.  However, in a true disaster where resources are overwhelmed, these attempts may be inadequate.  As such, it is imperative to be familiar with ones hospital disaster plan, resources available in times of crisis, and the incident command system. 

Having a plan in place is just the beginning. Understanding the potentially far-reaching implications of events or loss of certain utilities is crucial in development of a good disaster response plan.  True preparedness also requires frequent testing of systems in order to discover and improve on inherent weaknesses as well as provide familiarity with the plan for when it is needed.

In future posts, we will go into detail about the specific components of a disaster plan and disaster management.  

Italie, Leanne; Marchione, Marilynn.  “NYU Hospital Evacuation: Hurricane Sandy Power Failure Moves More Than 200 Patients.”  The Huffington Post.  10 Oct 2012.  15 Nov 2012 http://www.huffingtonpost.com/2012/10/30/nyu-hospital-evacuation-hurricane-sandy_n_2044026.html.  

Koenig KL, Schultz CH. Koenig and Schultz’s Disaster Medicine: Comprehensive Principles and Practices. New York, NY: Cambridge University Press, American College of Emergency Physicians; 2010. eds.