Disaster Preparedness and Management

  • Lewis J. KaplanEmail author
  • Samuel Tisherman


Disaster preparation and management are responsibilities for everyone in a healthcare facility. Whether natural or man-made, disasters and crises stress all facility resources including staff. Due to the extraordinary needs that accompany a disaster, opportunities for process improvement as well as education and training are readily discovered during drills as well as after actual events. A worthy goal is to be so well prepared that the entire facility is ready to respond in an appropriately integrated fashion regardless of the magnitude of the need. This chapter identifies key areas of disaster preparedness that specifically impact critical care practice and preparation in and outside of the ICU.


Disaster Preparedness In-hospital violence Violent extremism Special response teams Law enforcement Critical care 


  1. 1.
    Threat and Hazard Identification and Risk Assessment (THIRA) and Stakeholder Preparedness Review (SPR) Guide. Comprehensive Preparedness Guide (CPG) 201. Department of Homeland Security Third Edition May 2018;; Accessed 2 May 2019.
  2. 2.
    Adashi EY, Gao H, Cohen LG. Hospital-based active shooter incidents. Sanctuary under fire. JAMA. 2015;313(12):1209–10.CrossRefGoogle Scholar
  3. 3.
    de Cauwer H, Somville F, Sabbe M, Mortelmans LJ. Hospitals: soft targets for terrorism? Prehosp Disaster Med. 2017;32(1):94–100.CrossRefGoogle Scholar
  4. 4.
    Attacks on Healthcare. World Health Organization. Accessed 2 May 2019.
  5. 5.
    Finucane DJ. Unhealthy complacency: the vulnerability of US hospitals to direct terrorist attacks. J Healthc Risk Manag. 2017;37(3):8–12.CrossRefGoogle Scholar
  6. 6.
    National Protection and Programs Directorate, Office of Infrastructure Protection. Security of soft targets and crowded places – Resource guide. April 2018; Accessed 2 May 2019.
  7. 7.
    US Department of Homeland Security soft targets and crowded places security plan overview. May 2018; Accessed 2 May 2019.
  8. 8.
    National Exercise Program. Accessed 2 May 2019.
  9. 9.
    Hesterman J. Deterring and mitigating attack. In: Fagel MJ, Hesterman J, editors. Soft targets and crisis management: what emergency planners and security professionals need to know. Boca Raton: CRC Press/Taylor and Francis Group; 2017; ebook Chapter 12.Google Scholar
  10. 10.
    American College of Surgeons. The Committee on Trauma. Accessed 2 May 2019.
  11. 11.
    Federal Emergency Management Agency. Incident command system resources. Accessed 2 May2019.
  12. 12.
    Hall TNT, McDonald A, Peleg K. Identifying factors that may influence decision-making related to the distribution of patients during a mass casualty incident. Disaster Med Public Health Prep. 2018;12(1):101–8.CrossRefGoogle Scholar
  13. 13.
    Cid VH, Mitz AR, Arnesen SJ. Keeping communications flowing during large-scale disasters: leveraging amateur radio innovations for disaster medicine. Disaster Med Public Health Prep. 2018;12(2):257–64.CrossRefGoogle Scholar
  14. 14.
    Ali K, Nguyen HX, Vien Q-T, Shah P, Chu Z. Disaster management using D2D communication with power transfer and clustering techniques. IEEE Access. 2018;6:14643–54.CrossRefGoogle Scholar
  15. 15.
    Mukherjee B, Wang S, Lu W, Neupane RL, Dunn D, Ren Y, et al. Flexible IoT security middleware for end-to-end cloud-fog communication. Futur Gener Comput Syst. 2018;87:688–703.CrossRefGoogle Scholar
  16. 16.
    Ranjan A, Panigrahi B, Rath HK, Misra P, Simha A, Sahu HB. A study on path loss model for UAV based urban disaster and emergency communication systems. IEEE Xplore. 2019;
  17. 17.
    Kuhls DA, Fildes JJ, Johnson M, Dort SD, Jacobs LM, Eastman AE, et al. Southern Nevada trauma system uses proven techniques to save lives after 1 October shooting. Bull Am Coll Surg. March 1, 2018; Accessed 2 May 2019.
  18. 18.
    Bachrach DG, Lewis K, Kim Y, Patel PC, Campion MC, Thatcher SMB. Transactive memory systems in context: a meta-analytic examination of contextual factors in transactive memory systems development and team performance. J Appl Psychol. 2019;104(3):464–93.CrossRefGoogle Scholar
  19. 19.
    Gerold KB. Hospital planning and response to an active shooter incident: preparing for the n=1. Anesthesiol Clin. 2019;37(1):161–70.CrossRefGoogle Scholar
  20. 20.
    Gordon TJ, Sharan Y, Florescu E. Potential measures for the predetection of terrorism. Technol Forecast Soc Chang. 2017;123:1–16.CrossRefGoogle Scholar
  21. 21.
    Pogrebnyakov N, Maldonado E. Didn’t roger that: social media message complexity and situational awareness of emergency responders. Int J Inf Manag. 2018;40:166–74.CrossRefGoogle Scholar
  22. 22.
    Kako M, Hammad K, Mitani S, Arbon P. Existing approaches to chemical, biological, radiological, and nuclear (CBRN) education and training for health professionals: findings from an integrative literature review. Prehosp Disaster Med. 2018;33(2):82–190.CrossRefGoogle Scholar
  23. 23.
    Therkorn J, Drewry D, Pilholski T, Shaw-Saliba K, Bova G, Maragakis LL, et al. Impact of air-handling system exhaust failure on dissemination pattern of simulant pathogen particles in a clinical biocontainment unit. Indoor Air. 2018;29(1):143–55.CrossRefGoogle Scholar
  24. 24.
    Buehler JW, Caum J, Alles SJ. Public health and the Pope’s visit to Philadelphia, 2015. Health Secur. 2017;15(5):548. Scholar
  25. 25.
    Paras E, Butler M, Maguire BF, Scarfone R. Emergency preparedness for a mass gathering: the 2015 papal visit to Philadelphia. Disaster Med Public Health Prep. 2017;11(2):267–76.CrossRefGoogle Scholar
  26. 26.
    Geiderman JM, Malik S, McCarthy J, Jagoda A. The care of VIPs in the emergency department: triage, treatment and ethics. Am J Emerg Med. 2018;36(10):881–1885.CrossRefGoogle Scholar
  27. 27.
    Kearns RD, Conlon KM, Valenta AL, Lord GC, Cairns CB, Holmes JH, et al. Disaster planning: the basics of creating a burn mass casualty disaster plan for a burn center. J Burn Care Res. 2014;35:e1–e13.CrossRefGoogle Scholar
  28. 28.
    Toerper MF, Kelen GD, Sauer LM, Bayram JD. Hospital surge capacity: a web-based simulation tool for emergency planners. Disaster Med Public Health Prep. 2018;12(4):513–22.CrossRefGoogle Scholar
  29. 29.
    Kelen GD, Tronosco R, Trebach J, Levin S, Cole G, Delaney CD, et al. Effect of reverse triage on creation of surge capacity in a pediatric hospital. JAMA Pediatr. 2017;171(4):e164829.CrossRefGoogle Scholar
  30. 30.
    King MA, Kissoon N. Triage during pandemics: difficult choices when business as usual is not an ethically defensible position. Crit Care Med. 2016;44(9):1793–5.CrossRefGoogle Scholar
  31. 31.
    Blanch L, Abillama FF, Amin P, Christian M, Joynt GM, Myburgh J, et al. Triage decisions for ICU admission: report from the task force of the World Federation of Societies of intensive and critical care medicine. J Crit Care. 2016;36:301–5.CrossRefGoogle Scholar
  32. 32.
    Sawyer JR. Hospitals and terrorism: the realities; the future; mitigating risks. J Healthc Prot Manage. 2013;29(2):1–8.PubMedGoogle Scholar
  33. 33.
    United Hatzalah of Israel. Accessed 2 May 2019.
  34. 34.
    National Association of Blood Bikes. Accessed 2 May 2019.
  35. 35.
    King MA, Dorfman MV, Einav S, Niven AS, Kissoon N, Grissom CK. Evacuation of intensive care units during disaster: learning from the hurricane Sandy experience. Disaster Med Public Health Prep. 2016;10:20–7.CrossRefGoogle Scholar
  36. 36.
    Farra S, Miller ET, Gneuhs M, Timm N, Li G, Simon A, Brady W. Evacuation performance evaluation tool. Am J Disaster Med. 2016;11(2):131–6.CrossRefGoogle Scholar
  37. 37.
    Martin N, Pascual JL, Crowe D, Toevs C, Cereda MF, Mikkelsen M, Kaplan LJ. Comfort at the crossroads: service, therapy and emotional support animals in the ICU and at the end-of-life. J Trauma Acute Care Surg. 2018;84(6):978–84.CrossRefGoogle Scholar
  38. 38.
    Waxman DA, Chan EW, Pillemer F, Smith TWJ, Abir M, Nelson C. Assessing and improving hospital mass-casualty preparedness: a no-notice exercise. Prehosp Disaster Med. 2017;32(6):662–6.CrossRefGoogle Scholar
  39. 39.
    Fernandez-Moure J, Pascual L, Martin ND, Rodgers H, Kaplan LJ. Emergency response team in and outside of medicine – structurally crafted to be worlds apart. J Trauma Acute Care Surg. 2019;86(1):134–40.CrossRefGoogle Scholar
  40. 40.
    Zakhary BM, Kam LM, Kaufman BS, Felner K. The utility of high-fidelity simulation for training critical care fellows in the management of extracorporeal membrane oxygenation emergencies: a randomized controlled trial. Crit Care Med. 2016;45(8):1367–73.CrossRefGoogle Scholar
  41. 41.
    Toups ZO, Hamilton WA, Alharthi SA. Playing at planning: game design patterns from disaster response practice. CHI PLAY ‘16;
  42. 42.
    Debacker M, Utterbeeck FV, Ullrich C, Dhondt E, Hubloue I. SIMEDIS: a discrete-event simulation model for testing responses to mass casualty incidents. J Med Syst. 2016;40:273.CrossRefGoogle Scholar
  43. 43.
    Smith SW, Jamin CT, Malik S, Abrukin L, Tupchong KM, Portelli I, et al. Freestanding emergency critical care during the aftermath of hurricane Sandy: implications for disaster preparedness and response. Disaster Med Public Health Prep. 2016;10:496–502.CrossRefGoogle Scholar
  44. 44.
    Schell CO, Warnberg MG, Hvarfner A, Hoog A, Baker U, Castegren M, Baker T. The global need for essential emergency and critical care. Crit Care. 2018;22:284.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Perelman School of Medicine, University of Pennsylvania, Department of Surgery, Division of Trauma, Surgical Critical Care and Emergency SurgeryPhiladelphiaUSA
  2. 2.Corporal Michael J Crescenz VA Medical CenterSurgical Services, Section of Surgical Critical CarePhiladelphiaUSA
  3. 3.University of Maryland School of MedicineR Adams Cowley Shock Trauma CenterBaltimoreUSA

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