Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

Chapter 3. Responding to a Disaster
Phases of Response
There are four basic phases of response to a disaster. They are:
1. Preparedness (including prevention and planning).
2. Actual response to the event.
3. Mitigation.
4. Recovery (short- and long-term) and critique.
Preparedness
Although we usually cannot predict disasters, we can control them through prevention and
planning efforts. Prevention through preparedness is probably the most important phase of
response in emergency management. During the preparedness phase, governments,
organizations, and individuals develop plans to save lives, minimize disaster damage, and
enhance disaster response. Preparedness efforts include preparedness and evacuation planning;
emergency exercises and training; warning systems; emergency communication systems; public
information and education; and development of resource inventories, personnel contact lists, and
mutual aid agreements.
Physicians participate in preparedness and prevention in many different ways, including:
immunization programs, dietary advice, health education, and safety precautions and planning.
As participants in an emergency action plan, physicians need to help formulate ways of
preventing incidents from occurring or limiting the consequences from an incident that has
already occurred. Physicians need to know what will be expected of their hospital in the case of a
potential infectious disease outbreak. They should also be prepared with the knowledge and
resources needed to help identify the etiology of a problem and to provide timely treatment.
In the case of acts of terrorism, law enforcement plays the lead role in prevention, although
physicians are often called upon to lend their expertise in an effort to identify the impact that
various scenarios would or could have on the health of the community. Part of prevention
consists of participating in a pre-established medical surveillance network of communities that
will alert public health and safety officials of suspicious trends. A communications network of
pediatricians, school nurses, freestanding pediatric walk-in clinics, and pediatric emergency
departments should be formed.
Plans to share information within the Health Insurance Portability and Accountability Act
(HIPAA) guidelines need to be developed and implemented so that patterns of illness can be
tracked and investigated. An information-sharing network like this can provide invaluable data
and assistance to public health and safety officials that will help them to make informed
decisions about evacuations, quarantines, and any other planned responses to a biological or
chemical incident. Law enforcement officials may also ask physicians to advise them on how
best to educate and create awareness in school personnel and parent organizations without
causing panic or mass hysteria.
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