Adj. A/P Rahul Goswami

FACEM, EMDM, PGCAeroRT

• Bali bombing 2002

• Masters Disaster Medicine

• Philippines: Super-typhoon Haiyan

• Nepal: Earthquake

• MIMMS

My XP

Definition of a disaster

• Defined in terms of the ability of a service to cope with the number of casualties

• Involves police, fire and health services (sometimes military) to varying degrees depending on the incident

Classification of a disaster

• Simple or compound

• Natural or man made

• Industrial

• Transport

• Sporting or mass gathering

• War or terrorism

• Compensated or Uncompensated

Simple or compound?

Simple or compound?

General Approach

• Prevention / Mitigation

• Preparedness

• Response

• Recovery

• Staff

• Stuff

• Space or structure

• System

• Integrated all-hazards response

• Helmuth Von Moltke

Science of Surge

General Approach

• Prevention / Mitigation

• Preparedness

• Response

• Under

• Over

General Approach

• Prevention / Mitigation

• Preparedness

• Response

• Recovery

• Infrastructure is just part of it

• Sanitation and basic services

• Children / Govt. / Business

• Medicine

• Chronic health conditions

• Psychological recovery can take months or years

• Infectious disease?

Recovery

• Command and Control

• Safety

• Communications

• Assessment

• Triage, Treatment & Transport

System

ETHANE

Incident siteOuter cordon

Inner cordon

Incident site

CSC

JSECSRC

What is ED’s Response?

• Preparation of facilities and staff

• Evacuation of stable patients

• Rapid, high-volume turnover of mass casualties

• Return to normal activities

• Dispatch Site Team or DMAT

• Staff a mobile hospital

Not amateur hour

In Summation

• Just a matter of time

• Plan… … but know your plan will fail

• Systems save lives but flexibility is key

• EDs are masters of chaos – this is a virtue