1. Introduction to Disasters Daniel Kollek, MD, CCFP(EM) Director, Centre for Excellence in Emergency Preparedness Associate Professor, Division of Emergency Medicine McMaster University

2. Disaster The Merriam-Webster dictionary definition of disaster is "a sudden or great misfortune." The Medical definition if a disaster is "when the destructive effects of an event overwhelm the ability of a given area or community to meet the demand for health care."

3. How have health care systems dealt with disaster in the past?

4. September 11, 2001- NYC

5. September, 2002 - Jerusalem

6. The new kid on the block

7. What kind of disasters might we face and how do we assess our risk?

8. Natural disaster

9. Natural Events Hurricane/Tornado Severe Thunderstorm Snowfall Blizzard Ice Storm Earthquake Tidal wave Drought Flood - external Wild fire Landslide Volcano Epidemic Extreme temperature

10. Technological disaster

11. Technological events Electrical failure Generator failure Transportation failure Fuel Shortage Natural gas failure Water failure Sewage failure Steam failure Structural damage Fire alarm failure Communications failure Medical gas failure Medical vacuum failure Info. systems failure Fire – internal Flood – internal Hazmat exposure – internal Supply failure

12. Man-made disasters Anthrax envelope - 2001

13. Human events MCI – Trauma MCI - Medical MCI – Hazmat Hazmat – external Terrorism – chemical Terrorism – biological Terrorism - radiological VIP situation Infant abduction Hostage situation Civil disturbance Labor action Forensic admission Bomb threat

14. For each event you must assess risk What is the probability of occurrence? What impact would it have? What is your preparedness?

15. How do we characterise disasters?

16. By settings (from local to global)

17. By timeline (from static to dynamic)

18. By Phase Planning & Mitigation

19. By Phase Disaster response

20. By Phase Recovery

21. There are common threads in most disasters

22. A disaster often has multiple patients

23. A disaster always has multiple players

24. The Players: Police Fire EMS Hospitals Volunteers Public health Elected officials Civil servants Utilities Transit Provincial / Federal agencies Media

25. Whatever the case….

26. What you need in a disaster Supplies Equipment Manpower A system to deliver this to you in a useful fashion Information Guidance Money and……..

27. Incident Management is the system

28. IMS is the system used for command and control of a disaster response

29. IM Systems have standard components

30. IM Systems have a standard command structure

31. Response guided by IMS will have a standard sequence of events

32. Do it right and you will become the…..