During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.

Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.

Disasters and Public Health: Planning and Response, Second Edition, examines the critical intersection between emergency management and public health. It provides a succinct overview of the actions that may be taken before, during, and after a major public health emergency or disaster to reduce morbidity and mortality. Five all-new chapters at the beginning of the book describe how policy and law drive program structures and strategies leading to the establishment and maintenance of preparedness capabilities. New topics covered in this edition include disaster behavioral health, which is often the most expensive and longest-term recovery challenge in a public health emergency, and community resilience, a valuable resource upon which most emergency programs and responses depend. The balance of the book provides an in-depth review of preparedness, response, and recovery challenges for 15 public health threats. These chapters also provide lessons learned from responses to each threat, giving users a well-rounded introduction to public health preparedness and response that is rooted in experience and practice. Contains seven new chapters that cover law, vulnerable populations, behavioral health, community resilience, preparedness capabilities, emerging and re-emerging infectious diseases, and foodborne threats Provides clinical updates by new MD co-author Includes innovative preparedness approaches and lessons learned from current and historic public health and medical responses that enhance clarity and provide valuable examples to readers Presents increased international content and case studies for a global perspective on public health

The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations draws from a broad spectrum of expertise-including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication-to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.

The most comprehensive resource of its kind, Ciottone's Disaster Medicine, 2nd Edition, thoroughly covers isolated domestic events as well as global disasters and humanitarian crises. Dr. Gregory Ciottone and more than 200 worldwide authorities share their knowledge and expertise on the preparation, assessment, and management of both natural and man-made disasters, including terrorist attacks and the threat of biological warfare. Part 1 offers an A-to-Z resource for every aspect of disaster medicine and management, while Part 2 features an exhaustive compilation of every conceivable disaster event, organized to facilitate quick reference in a real-time setting. Quickly grasp key concepts, including identification of risks, organizational preparedness, equipment planning, disaster education and training, and more advanced concepts such as disaster risk reduction, tactical EMS, hazard vulnerability analysis, impact of disaster on children, and more. Understand the chemical and biologic weapons known to exist today, as well as how to best manage possible future events and scenarios for which there is no precedent. Be prepared for man-made disasters with new sections that include Topics Unique to Terrorist Events and High-Threat Disaster Response and Operational Medicine (covering tactical and military medicine). Get a concise overview of lessons learned by the responders to recent disasters such as the earthquake in Haiti, Hurricane Sandy, the 2014 Ebola outbreak, and active shooter events like Sandy Hook, CT and Aurora, CO. Learn about the latest technologies such as the use of social media in disaster response and mobile disaster applications. Ensure that everyone on your team is up-to-date with timely topics, thanks to new chapters on disaster nursing, crisis leadership, medical simulation in disaster preparedness, disaster and climate change, and the role of non-governmental agencies (NGOs) in disaster response - a critical topic for those responding to humanitarian needs overseas. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.

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