| What is Emergency Management? To some, it is a disciple, to others, a process. I look at emergency management as a process, under the elected leadership, where communities manage complex emergencies and disasters. It is that ability to manage these events that separates emergency management from respond organizations. Fire, Law Enforcement, EMS, even Public Works are the subject matter experts in their fields. But they rarely work daily as teams in dealing with complex events. Nor do they generally work with the elected leadership of a community in their daily responses. Emergency Management (EM) is based on the concept of local disaster management supported by higher levels of Government to include State and Federal assistance when needed. EM recognizes that disasters are cyclic through phases. Those phases include preparing for disasters through training, exercises, planning, and public education to name a few preparedness activities. If disaster occurs, responding to the event and managing the immediate effects on the community. After the emergency phase has passed, often even during, recovery begins, the task of returning a community to the pre-disaster state that may take years. Reducing or eliminating impacts of hazards is a constant goal of EM though mitigation programs. A new phase of prevention has taken a more prominent role in the U.S. after September 11, 2001. From terrorism to disease outbreaks, prevention can involve intelligence, surveillance and detection, and even vaccinations. The job of Emergency Management is to improve the outcome of a disaster. These outcomes can be measured in lives saved, fewer injuries, reduced damages, decreased disruptions, shorter recovery time, to name a few. If we do not improve the outcome of a disaster, then we have failed. Warning Basics the event must be detected. nthe decision to warn the public must be made. nthe public must receive and understand the warning. nthe public must have somewhere safe to go to or action to take nthe public must act.
Unless we improve the outcome of an event, the system has failed |
• The public has a right to knowledge - so that they can
make an informed choice - on how to respond to
threats to their community. | Sometimes the obvious is the best response, over the years, these truths have kept me focused on the mission. With everything that can go wrong going wrong, usually at the same time, it helps to remember what's important and what's not. The Rules - Meet the needs of the
disaster survivors
- Take care of the responders
- See rule 1.
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There is always much more that needs to be done, but these standing orders make sure you get started on the basics. Standing Orders Reestablish Communication with Areas Impacted 2.Initiate Search and Rescue /Security 3.Meet Basic Human Needs - 1.Medical
- 2.Water
- 3.Food
- 4.Shelter
- Emergency Fuel
- 5.Ice is a distant
sixth (Unless its really hot)
4.Restore Critical Infrastructure 5.Open Schools
/ Local Businesses 6.Begin the Recovery
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While this seems an over simplification of a disaster, it helps when everything is needed yesterday and you have run out of options. There is also a big difference between needs and wants. Many times we get wrapped up over the public wants (money, ice, etc) and needs (shelter, water, basic medical care, etc.) Evacuation Basics - •Threat
- Protective Action Required
- Decision
- Warning
- Evacuation
- Sheltering
- Re-entry
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If you order an evacuation, start planning for the re-entry. What conditions will be required for the return of the residents. Disaster Response - Cost-effective
- Free of mistakes
- Timely
Pick One |
| Disaster Operating Environment - New Players in Unfamiliar Roles
- Heavy Information Demands
- Politically Sensitive Issues
- Changing Requirements
- Rapid Decisions
- Degraded Communications
- Unforeseen Consequences
- Public Affairs Priorities
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Then there is always the question of what is a disaster... How to Tell a Disaster From an Emergency
Disaster Emergency |
I Use a Sledgehammer It rarely pays to be subtle. It’s better to have too much than
not enough. Push resources into the affected
area. Don’t wait for requests. A quick and overwhelming response
is better than a well-planned and well thought out response. If you wait until you have all the
facts, it becomes harder to change the outcome.
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From Jim Shultz, Director, DEEP Center (Center
for Disaster and Extreme Event Preparedness), University of Miami
Key
Points on Disaster Behavioral Health
for
Emergency Management Professionals
Disaster behavioral health
deals with optimal health human functioning within family, community,
and occupational roles during extreme events (Shultz et al., 2003).
Psychosocial Consequences of Disasters
(Shultz et al., 2006):
1) Widespread.
The psychological “footprint” of disaster is much larger than the
medical “footprint.” Translation: More people are impacted
psychologically than are harmed physically.
2) Spectrum of severity.
Fear and distress is common among persons exposed to disasters but most
regain function rapidly without need for intervention. This is good
news—resilience is the most likely outcome. However, a subset of
survivors are distressed to the point of changing behavior such as
surging on hospitals and points of distribution. A smaller percentage
develop psychiatric disorders including PTSD, depression, and anxiety
disorders.
3)
Range of duration.
Some survivors will experience psychological impact long after the
disaster event is over. This is because the “forces of harm” that
provoke psychological reactions include not only exposure to hazards
(usually brief), and also loss and change (usually
long-lasting).
4)
Related to the nature of the disaster.
Generally, across all types of disasters, the degree of psychological
impact is directly related to the magnitude, intensity, duration, and
geographic scope of the disaster. As one key finding, human-generated
intentional disasters such as terrorism produce severe psychiatric
outcomes in a higher proportion of exposed persons than do natural
disasters (Norris et al., 2002).
Effective Emergency Management is also effective behavioral health
support and intervention.
Strong scientific evidence exists for the psychological benefits of
interventions that create or restore safety, calming, connectedness,
self-efficacy, and hope for disaster survivors (Hobfall, et al., in
press). Effective emergency management includes (Fugate, 2006):
1)
Establish communications
2)
Secure the area (first 12 hours) and establish a “presence”
3)
Search
4)
Stabilize and restore basic needs (first 72 hours)
5)
Reestablish infrastructure and “normal” operations
These actions are directed toward the disaster-affected
community at large (not usually delivered one-on-one). These actions
rapidly and efficiently reestablish safety, security, presence, basic
needs, and critical services—with powerful psychological benefit. Also,
these actions are outcomes-driven.
Predictors of Serious Psychological Impact
Pre-Disaster Risk Factors
Lack of personal and family preparedness
Poverty and lack of financial resources
Lack of social support (lack of family and friendship
resources)
Previous traumatic exposure (abuse, combat, assault, severe
accident, life-threatening illness)
Previous psychiatric or substance abuse diagnosis
Lifespan risks (young children, single parent status, frail
elderly)
Special needs and disabilities that may limit ability to
respond to warnings, evacuate, engage in self-care
Disaster Event Phase Exposures
Personal experience of threat of death or severe bodily harm
Witnessing harm to others or death
Physical harm to self
Physical harm or death of loved one, close friend, or
co-worker/teammate/buddy--bereavement
Exposure to grotesque scenes
Exposure to noxious agents
Post-Disaster Risk Factors
Ongoing threats
Severe destruction
Disruption of basic needs and services
Multiple losses (home, work, children’s schools)
Stress Signs--Common Fear and Distress
Reactions in Disasters
Physical: Fight-or-flight response (increased heart rate,
respirations, BP, adrenalin “rush”)
Emotional: Fear, terror, anger, irritability, overwhelm,
hopelessness, helplessness
Cognitive: Decreased concentration, decision-making &
problem-solving ability, memory problems
Behavioral: Changes in sleep and diet, decline in performance,
increased substance use
Social: Withdrawal, isolation, difficulty giving or
receiving support, hostility
Spiritual: Increased reliance on faith or crisis of faith,
cynicism
Evidence-based Early Psychosocial Intervention
Psychological First Aid
(PFA) represents the current cutting edge. Use national PFA models
developed by experts in the field (National Center for PTSD/National
Center for Child Traumatic Stress model is becoming the standard). The
NCPTSD PFA Operations Guide is available at
www.ncptsd.va.gov)
PFA is not only an individual level intervention. A great deal of PFA
is provided during mass response activities conducted by survivors
themselves and by arriving teams of first responders. DEEP
Center-defined outcomes that can be measured (systems approach to
PFA) (Shultz et al., 2006):
·
Restore SAFETY (remove from harm’s way, bring to safe place, provide
basic needs)
·
Reestablish FUNCTION (calm survivors, connect survivors to loved ones
and support personnel)
·
Empower ACTION (provide information for action, restore infrastructure,
guide first steps)
Use behavioral triage to distinguish persons needing referral for
psychiatric evaluation.
Psychological debriefing is generally not appropriate for survivors and
may be harmful in some circumstances. Excellent guidance on early
interventions is contained in: “Mental-Health Intervention for
Disasters: A National Center for PTSD Fact Sheet” available at
http://www.ncptsd.va.gov/facts/disasters/fs_treatment_disaster.html.
Resilience is the default
Resilience is “mastery against adversity” (Reissman, 2006). Most
people regain effective function. Many survivors experience
“post-traumatic growth”, becoming stronger through the disaster
experience.
The
focus of community-level and individual-level response is to make sure
that a disaster does not “throw off” the natural tendency toward
resilience. Since the default is having persons function in life as
well, healthy persons, the trick is to not let the traumatic event move
survivors away from resilience. Keys to resilience are the same as keys
to emergency management:
1)
Be prepared
2)
Decrease stressors
3)
Increase supports
4)
Engage in healthy lifestyle behaviors
5)
Build preparedness and response systems that promote items 1-4
In the post-impact phase, increase the focus on minimizing stressors and
restoring resources.
Disaster Response Professionals
Disaster response professionals experience stress reactions and may have
considerable impact from witnessing and responding to disaster events.
Excellent guidance for response professionals in contained in:
“Disaster Rescue and Response Workers: A National Center for PTSD Fact
Sheet” available at
http://www.ncptsd.va.gov/facts/disasters/fs_rescue_workers.html.
Updated 05/23/2008 | 
