Introduction to Disasters

Daniel Kollek, MD, CCFP(EM)Director, Centre for Excellence in Emergency PreparednessAssociate Professor, Division of Emergency MedicineMcMaster University

Disaster

• The Merriam-Webster dictionary definition of disaster is "a sudden or great misfortune."

• The Medical definition if a disaster is "when the destructive effects of an event overwhelm the ability of a given area or community to meet the demand for health care."

How have health care systems

dealt with disaster in the past?

September 11, 2001- NYC

September, 2002 - Jerusalem

The new kid on the block

What kind of disasters

might we face and how do we assess our risk?

Natural disaster

Natural Events

• Hurricane/Tornado• Severe

Thunderstorm• Snowfall• Blizzard• Ice Storm• Earthquake• Tidal wave

• Drought• Flood - external• Wild fire• Landslide• Volcano• Epidemic• Extreme

temperature

Technological disaster

Technological events

• Electrical failure• Generator failure• Transportation

failure• Fuel Shortage• Natural gas failure• Water failure• Sewage failure• Steam failure• Structural damage

• Fire alarm failure• Communications failure• Medical gas failure• Medical vacuum failure• Info. systems failure• Fire – internal• Flood – internal• Hazmat exposure –

internal• Supply failure

Man-made disasters

Anthrax envelope - 2001

Human events

• MCI – Trauma• MCI - Medical• MCI – Hazmat• Hazmat – external• Terrorism – chemical• Terrorism – biological• Terrorism -

radiological

• VIP situation• Infant abduction• Hostage situation• Civil disturbance• Labor action• Forensic admission• Bomb threat

For each event you must assess risk

• What is the probability of occurrence?

• What impact would it have?

• What is your preparedness?

How do we characterise disasters?

By settings (from local to global)

By timeline (from static to dynamic)

By Phase

Planning & Mitigation

By Phase

Disaster response

By Phase

Recovery

There are common threads in most disasters

A disaster often has multiple patients

A disaster always has multiple players

The Players:

• Police• Fire• EMS• Hospitals• Volunteers• Public health

• Elected officials• Civil servants• Utilities• Transit• Provincial / Federal

agencies• Media

Whatever the case….

What you need in a disaster

• Supplies

• Equipment

• Manpower

A system to deliver this to you in a useful fashion

• Information

• Guidance

• Money

and……..

Incident Managementis the system

IMS is the system

used for command

and control of a disaster

response

IM Systems have

standard components

IM Systems have a

standard command structure

Response guided by IMS

will have a standard sequence of events

Do it right and you will become

the…..