Disaster Medical Services
Reaffirmed by the ACEP Board of Directors March 1997; October 2006; and April 2012
Revised and approved by the ACEP Board of Directors June 2000
Originally approved by the ACEP Board of Directors June 1985
The American College of Emergency Physicians (ACEP) believes that emergency physicians should assume a primary role in the medical aspects of disaster planning, management, and patient care. Because the provision of effective disaster medical services requires prior training or experience, emergency physicians should pursue training that will enable them to fulfill this responsibility.
A medical disaster occurs when the destructive effects of natural or man-made forces overwhelm the ability of a given area or community to meet the demand for health care.
Disaster planning, testing, and response are multidisciplinary activities that require cooperative interaction. Each agency or individual contributes unique capabilities, perspectives, and experiences. Within this context, emergency physicians share the responsibility for ensuring an effective and well-integrated disaster response.
Emergency medical services and disaster medical services share the goal of optimal acute health care; however, in achieving that goal, the two systems use different approaches. Emergency medical services routinely direct maximal resources to a small number of individuals, while disaster medical services are designed to direct limited resources to the greatest number of individuals. Disasters involving the intentional or accidental release of biological, chemical, radiological, or nuclear agents present an extremely difficult community planning and response challenge. In addition, they may produce a far greater number of secondary casualties and deaths than conventional disasters. Because the medical control of emergency medical services is within the domain of emergency medicine, it remains the responsibility of emergency physicians to provide both direct patient care and medical control of out-of-hospital emergency medical services during disasters.
Improvement of established disaster management methods requires the integration of data from research and experience. Emergency physicians must use their skills in organization, education, and research to incorporate these improvements as new concepts and technologies emerge.
Where local, regional, and national disaster networks exist, emergency physicians should participate in strengthening them. Where they are not yet functional, emergency physicians should assist in planning and implementing them.