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.

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.

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

During a wide-reaching catastrophic public health emergency or disaster, existing surge capacity plans may not be sufficient to enable health care providers to continue to adhere to normal treatment procedures and follow usual standards of care. This is a particular concern for emergencies that may severely strain resources across a large geographic area, such as a pandemic influenza or the detonation of a nuclear device. Under these circumstances, it may be impossible to provide care according to the standards of care used in non-disaster situations, and, under the most extreme circumstances, it may not even be possible to provide basic life sustaining interventions to all patients who need them. Although recent efforts to address these concerns have accomplished a tremendous amount in just a few years, a great deal remains to be done in even the most advanced plan. This workshop summary highlights the extensive work that is already occurring across the nation. Specifically, the book draws attention to existing federal, state, and local policies and protocols for crisis standards of care; discusses current barriers to increased provider and community engagement; relays examples of existing interstate collaborations; and presents workshop participants' ideas, comments, concerns, and potential solutions to some of the most difficult challenges.

Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.

Although many books have been published on the application of GIS in emergency management and disaster response, this is the first one to bring together a comprehensive discussion of the critical role GIS plays in hospital and healthcare emergency management and disaster response. Illustrating a wide range of practical applications, GIS in Hospital