0071643192.pdf

EMS AND DISASTER MEDICINE

Classic terminology:

■ May be further divided into internal(within the hospital) and external
(outside the hospital grounds)
■ Are often classified by level (see Table 20.4)

Newer nomenclature:Potential injury-creating event (PICE; see Table 20.5)

■ A new term created to eliminate the confusion over the word “disaster”
■ Describes an event based on the following three modifiers:
■ Potential for additional victims
■ Whether the local resourcesare overwhelmed and need augmentation
or reconstitution
■ Extent of geographic involvement(local to international)
■ The PICE stage predicts the need for outside aid.

Disaster Preparedness

The Joint Commission on Accreditation of Health Care Organizations
(JCACO) requires all hospitals to have a written plan for both internal and
external disasters and to perform practice drills twice yearly.

A disaster plan must have:

■ Flexibility
■ Structure, such as normal daily operating procedures
■ Coordination with adjacent community areas
■ Input from EMS, police, medical community, and local government
■ Media liaison
■ Four phases: Mitigation, preparedness, response (activation, implementation),
recovery (see Table 20.6)
■ Must address both internal and external event response

TABLE 20.4. Disaster Classification

LEVEL PROJECTEDNEED RESPONSETIME

I Local resources only Hours

II Regional resources, which may take up to 1 day Up to 1 day

III Statewide or federal assistance required Up to 3 days

TABLE 20.5. Potential Injury-Creating Event Classification

AB C

POTENTIAL FOR STATE OFLOCAL EXTENT OFGEOGRAPHIC

PICE STAGE FURTHERVICTIMS?RESOURCES?INVOLVEMENT

0 No=static Controlled (=ok) Local

I Yes =dynamic Disrupted Regional

II Paralyzed National

III International

PICE classification: Four stages,

0—III, based on potential for

further victims, state of local

resources, and extent of

geographic involvement

JCAHO phases of disaster

preparedness: Mitigation,

preparedness, response,

implementation

Classic disaster terminology:

Three levels, based on

projected need for resources