Emergency Medicine Concepts and Principles - Research Paper Example

?Emergency Medicine Concepts and Principles Introduction There are various concepts and principles which define emergency medicine. Some of these concepts shall be discussed below, with a primary focus on the emergency management in Australia. Aims: This study aims: 1. To establish a comprehensive understanding of the various principles and concepts which are governing emergency management, mostly emergency management practices in Australia. 2. To help this student in gaining a complete assessment of the present emergency principles and systems in Australia. 3. To assist the student in establishing informed research and analytical skills in the evaluation of available materials applicable to this study. 4. To assist this student in the development and the implementation of efficient emergency management processes in the future. Objectives: The objectives of this study include the following: 1. To present the various concepts and principles which govern the practice of emergency management in Australia. 2. To establish a comprehensive understanding of the various principles of emergency management by describing, explaining, and analysing the following: what emergencies and disasters are; the impact of emergencies and emergency management; emergency prevention; the prepared community command control; the human factor; and emergency laws and other pertinent legal processes. 3. To reflect on the various elements of emergency management with the end goal of gaining a more profound and a bigger perspective of emergency management. Accidents, emergencies, disasters, catastrophes, and calamities defined Accidents – Accidents are unexpected incidents which often cause equally unexpected effects. These incidents usually impact on a minimal group of people, in some instances, it may impact on one person only. It can also cause some damage to physical structures, as well as cause injuries and losses of human life. Accidents may include: automobile-related accidents, lightning strikes, falls from stairs or heights, burns from fires, cuts and scrapes after tumbles or trips (SConsultnet, n.d). In Australia, latest figures indicate that data on automobile-related accidents have now increased in terms of prevalence; deaths related to these incidents have also increased in recent years. Emergencies – Emergencies, on the other hand are events which usually threaten public health, safety, and welfare (Department of Environmental Management, n.d). These incidents differ from each other in terms of size, location, and their causes, as well as impact; however, despite these considerations, they usually all impact negatively on the environment. Emergencies are also considered as unexpected events which impact negatively on the lives and properties of people, and eventually they prompt the use of community emergency and routine responses as well as procedures (Emergency Management Institute, n.d). Examples for emergencies include: forest fires, outbreaks of diseases, road blocking landslides, and floods covering towns and farms (Central Coast Center Independent Living, n.d). In Australia, in the two landslides which occurred from 1939 to 2007, about 28 individuals were killed and 101 other individuals significantly impacted (CRED, 2007). Wildfires numbering 28 were seen from 1939 to 2007, this caused the death of 300 people, and caused damages amounting to about 1.2 million US dollars (CRED, 2007). Disasters – Disasters are “a condition or situation of significant destruction, disruption and/or distress to a community” (Emergency Management Australia (2004, p. ix). In a similar vein, the United Nations (1992) consider disasters to be incidents which seriously interrupt the normal activities of society as they cause significant human and environmental losses – more than what can normally be handled by the community resources. Beachley (2005) enumerated the following as disasters: floods, extreme range of temperatures, epidemics, multiple car crashes, and environmental contamination through chemical agents. In Australia, there were 46 floods (1939 to 2007) killing close to 200 individuals and causing damage totalling about 3 million US dollars (CRED, 2007). There were four disasters involving extreme temperatures from 1939 to 2007 and deaths from these incidents totalled about 400 people, affecting 4.5 million individuals (Charles Sturt University, 2001). There were ten droughts from 1939 to 2007 in Australia and 600 were recorded killed, with close to 13 million people affected (CRED, 2007). Catastrophes – Catastrophes are defined as events which disturb normal societal functions; and they often lead to massive breakdowns in the daily activities of the community (Quarantelli, 1994). More often than not, individuals affected by catastrophes are left at a loss on whom to turn to for assistance (Quarantelli, 1994). Hurricane Katrina which hit the US in 2005 is an example of a catastrophe. This hurricane’s impact was so extensive that it shut down community structures, government functions, and prevented the entry of aid into areas affected (Quarantelli, 2006). In Australia, the Newcastle Earthquake in 1989 is considered a catastrophe as as it registered damage close to 4 billion dollars. Cyclone Darwin also caused damages amounting to billions of dollars, and including the Sydney hailstorm, the Brisbane fires, and the Victorian bushfires, these incidents caused damages amounting to billions of dollars (Insurance Council of Australia, n.d). Types of emergencies/disaster 1. Man-made – These types of disasters basically speak for themselves – they are initiated by man and its impact is credited to man’s actions. They include wars, technical difficulties and failures, transportation disasters, incidents which involve biological or chemical elements, terrorism, military-rebel encounters, bombings, and other forms of civic disturbances (Department of Environmental Management, n.d). These are usually intentionally or may be accidentally caused by man’s acts of omission or commission 2. Natural – These incidents are caused by nature and its normal environmental progression. They include hurricanes, earthquakes, blizzards, volcanic eruptions, typhoons, hail, epidemics, and slow-rising floods, among others (Maurer and Smith, 2005). These incidents are caused by nature and its normal interactions and manifestations. Human actions do not impact on how these incidents arise. The impact of these natural disasters may however be increased due to human activities. Man’s actions which include pollute may exacerbate the impact of floods and typhoons which prevent the natural drainage of waters into rivers and into the oceans. Denudation of forests may also increase the impact of typhoons and storms, thereby causing landslides. Over-use of chlorofluorocarbons (CFC) also exacerbates the impact of the sun on our planet causing global warming and the destruction of our ozone layer. Hazards (natural, man-made) defined Hazards – Hazards actually refer to the potential of an event or activity causing a negative impact or harm to humans or to larger communities (Health and Safety Executive, n.d). These may refer to biological hazards which come in the form of bacteria and viruses; chemical hazards which often have physical and toxic qualities; ergonomic hazards which are caused by repetitive activities and improper work resources; physical hazards which may come in the form of radiation and magnetic fields; psychological hazards which may come in the form of workplace stress; and safety hazards which may come in the form of workplace slippage, heavy equipment dangers, and equipment malfunctions (Canadian Centre Occupational Health and Safety, 2009). In Australia, the Charles Sturt University (2001) enumerate the following as major natural hazards: 1. Bushfires – Southeast Australia vulnerable to wildfires especially during summer season and periods of drought. 2. Floods – Floods often endanger Southern Queensland, as well as northern New South Wales, and Southeastern Victoria during the wet season 3. Heatwaves – Heatwaves often cause many deaths and many people to have heatstroke during the summer months. A record of 400 deaths has been seen in Australia due to heatwaves. 4. Droughts – These droughts occur usually once in every three to ten years and they cause economic difficulties for many people in the region. 5. Cyclones – These cyclones usually start at the north, and then cross towards the north eastern and north Western regions of the Australian coastlines, atleast six times in one year. 6. Earthquakes – These earthquakes are felt usually an average of once in every 15 months and at a magnitude of 5.5 on the Richter scale. 7. Tsunamis – These tsunamis are caused by earthquakes which occur usually at sea. Numerous incidents have already been seen throughout the years of these tsunamis impacting on coastlines and coastal communities. Risks defined Risks – Risks basically refer to the possibility that an unfavourable event would happen. This unfavourable event is often caused by a hazard unfolding at work or with the use of products created by work (Everson, 2003). It also refers to the possibility of a hazard later developing into an accident or a more significant incident. A risk may be expressed as follows: the risk of developing liver cirrhosis from alcohol drinking may be stated as: alcoholic drinkers are 5 times more likely to die of liver cirrhosis than non-alcoholics. (Canadian Centre for Occupational Health and Safety, 2009). Impact of emergencies/disasters and why emergency management Effects on people 1. Physical effects – Emergencies/disasters often cause physical effects on people, including physical injuries, and even deaths. Lindell and Prater (2003) discuss how hurricanes have led to the most number of deaths and injuries. From 1947 to 1980, a total of about 500,000 deaths have been credited to these hurricanes. There were 450,000 deaths from earthquakes recorded in the same time period and about 190,000 deaths from floods were also seen in this same period. Deaths due to volcanic eruptions registered 9000 deaths, landslides caused about 5000 mortalities, and tsunamis also registered about 5000 deaths. Many of these mortalities were seen in developing countries of Asia, Africa, and South America. About 3,000 deaths per disaster in these developing nations have been seen on the average; this is a stark contrast to the 500 deaths seen in developed countries per disaster (Lindell and Prater, 2003). Illnesses attributed to bacterial infection and respiratory diseases have also been seen in the aftermath of these disasters/emergencies. 2. Behavioural effects– In terms of behavioural impact, these emergencies and disasters have also manifested various health issues, including stress, post-traumatic stress disorder include exhaustion, gastrointestinal issues, confusion, anxiety, depression, grief, sleep disturbance, substance abuse, and appetite disturbance (Gerrity and Flynn, 1997, as quoted by Lindell and Prater, 2003). The bulk of these behavioural impacts have been apparent among children, and among the vulnerable members of society, including the elderly, the mentally ill, the disabled, the racial and ethnic minorities, and those who have suffered significant losses. Emergency and disaster relief workers have also been known to behavioural and psychological issues because of these emergencies/disasters. These relief workers usually work long and hard hours to rescue victims who may in the end be found dead; they may also suffer long hours without adequate food and rest; and these factors usually cause them to suffer through psychological burdens and trauma (Lindell and Prater, 2003). Effects on community structure As far as the community is concerned, their bonds with each other are usually damaged and broken by disasters or emergencies. These bonds are usually rebuilt when the reconstruction efforts are carried out (Cronan, 1998). The social activism in the community is usually triggered and this often disturbs the politics in the community (Lindell and Prater, 2003). Issues are often seen when it comes to setting up temporary housing for the victims. This can sometimes lead to conflicts among neighbours. The original housing zones and property regulations are sometimes not followed and this can cause further conflicts among neighbours (Lindell and Prater, 2003). Effects on property, environment, infrastructure, economy Buildings, houses, and other structures, as well as livestock and agricultural crops have been lost and damaged by emergencies and disasters (Lindell and Prater, 2003). Economic effects of emergencies – Economic impact from disasters and emergencies have been seen in terms of economic losses, lost income, lost potential gains, and even lost businesses and supply chains. With the onset of recovery and rehabilitative measures, economic losses would include cost incurred from repair and maintenance (Committee on Assessing the Costs of Natural Disaster, 1999). Environmental effects of emergencies and disasters – Environmental impact includes the losses and damage of agricultural crops, trees, forests, rangelands. It also includes the damage to wild regions, including protected environmental regions which ultimately cause a significant amount of ecological losses, as well as loss of animal habitat and rainforests. Other environmental concerns which are seen from disasters include the soil runoffs to the rivers and other bodies of water, silting of waterbeds, and the damaging of coastlines (Lindell, and Prater, 2003). Why emergency management Emergency management is important because most communities face a persistent hazard and risk for losses from emergencies and disasters. These hazards may come in the form of natural threats like floods, cyclones, earthquakes, and tsunamis; it also includes technological hazards like chemical, biological, and radiological threats (Emergency Management Australia, 2004). Australia is situated in an earthquake prone region which it at a continuous threat from earthquakes and tsunamis, as well as volcanic eruptions. It is also in a region likely to be hit by storms which lead to floods and landslides. It s humid temperature also places it at a higher risk for suffering bushfires. The management of these emergencies and disasters are dependent on the adequate management and cooperation between the concerned government authorities, as well as private institutions. The extent to which Australia can adequately recover from these disasters is largely based on the delivery of basic services and resources (Emergency Management Australia, 2004). Emergency management is the process which links all of these systems with each other. Framework for emergency management Management functions 1. Planning – This function includes data collection, the analysis of such data, and the utilization of the data gathered. Planning is also used during the development, the implementation, as well as the maintenance of the planned activities (Allegheny County, n.d). It also includes the establishment of a team, the assessment of vulnerabilities, and the implementation of the plan (Wahle and Beatty, 1993). 2. Organizing – This function includes the process of establishing and linking the elements of any organization in order to meet its goals (Cronan, 1998, p. 21). It is also about establishing the essential elements of any organization in order to ensure their utilization in the fulfilment of organizational goals 3. Leading – This function includes the process of leading and guiding interpersonal actions, and providing motivation to the different members in the efficient accomplishment of their duties and the eventual accomplishment of organization goals (Cronan, 1998). 4. Controlling – This function is all about evaluating the activities of the members of the organization. It also involves the evaluation of the overall efficacy of the organization. This process makes it possible to assess whether or not the organization is fulfilling its goals and planning its activities towards the fulfilment of such goals (Pierce and Dunham, 1990). EM functions 1. Prevention. This includes the process of making physical preparations in order to prevent and reduce the impact of disasters on individuals and larger communities (Cronan, 1998). This process can be established by identifying mitigation plans (Department of Health and Families, 2009). 2. Preparedness. This involves the process of ensuring that the necessary tools which can be used to prevent and minimize the impact of disasters are in place and are mobilized in the community (Cronan, 1998). It also includes the process of coordinating with the personnel who shall assist in the management of these disasters (Department of Health and Families, 2009). 3. Response. This is a function which coordinates the activities to be carried out in the immediate aftermath of the emergency, with the end goal of reducing its impact (Cronan, 1998). This function involves the following activities: deployment of medical personnel; evaluation of public health and welfare needs; implementation of places; coordination with local and regional authorities; and disaster control (Department of Health and Families, 2009). 4. Recovery. This involves the process of planning arrangements for affected communities with the end goal of achieving normal status (Community Emergency Planning Guide, 1992). It also includes arrangements for public health and welfare services and the deactivation of response teams, as well as support for emergency recovery plans (Department of Health and Families, 2009). Linkages of the eight functions in the EM framework The different functions affect each other. Cronan (1998) suggests that the functions impact on each other with the planning process impacting on the preparedness, which then also impacts on the efficacy of the response. The response then impacts on the recovery of the community from the disaster. With adequate coordination processes among the agencies and organizations, all these functions can fulfil organization goals. Emergency prevention Emergency prevention defined Emergency prevention mostly includes the process of conceptualizing long-term activities which would minimize the impact of disasters (Australian Counter Disaster College, 1981). Mitigation defined Mitigation – It is possible to reduce the impact of emergencies and disasters, even if they be man-made or natural (Carter, 1991). The process of mitigation seeks to limit the possibility of emergencies causing a significant impact on communities. These measures include simple activities like proper garbage disposal, building code provisions, and land-use management activities (Drabek, 1986). These processes also include activities which limit the size of the hazard (Klingensmith, n.d). Mitigation is also about moving people away from the proximity of the hazard. Early warning activities, including the education of people on preventive measures also help mitigate the impact of disasters. Four goals of prevention and mitigation Cronan (1998) discusses four main goals for preventing and mitigation. 1. Modifying the hazards in order to change their very nature by controlling its impact and its size (Klingensmith, n.d) 2. Providing protective measures for people and properties, thereby making them less vulnerable to the hazard or emergency (Klingensmith, n.d) 3. Reducing the utilization of facilities in order to reduce the impact of such disasters (Klingensmith, n.d) 4. Reducing the impact and even preventing the occurrence of hazards through the use of early warning devices (Klingensmith, n.d) All hazards approach Australia uses the all hazards approach in facing risks and emergencies. This approach includes the various arrangements in the management of the effects of the disasters (Attorney General’s Department, 2009). This approach is significant because various risks can cause various issues and emergency measures, including warning, evacuation, as well as community recovery. These remedies help the different government agencies before and after the disasters. Prepared Community Requirements of a prepared community A prepared community is a community where: 1. The members and the local government officials are working closely and are cooperating with each other. A prepared community is also one where the members of the community, as well as the government officials support the different disaster prevention measures (ACDC, 1986). 2. There are laws which help secure a community prepared to meet all the implications of disasters. In this instance, forecasting, training, and organizing are important in this prepared community (ACDC 1981). These are details which assist relief workers in making the necessary preparations in order to serve the community during these emergencies and disasters. 3. The process of planning is crucial during preparedness stages because this process helps ensure that relief workers are able to predict situations where the necessary countermeasures are needed (Carter, 1991). 4. A hazards analysis is carried out and good plans are carried out in order to establish realistic aims (Tierney, 1990, as cited by Cronan, 1998). Emergency management planning and community involvement A prepared community is aware of disaster planning necessities. In most instances, the assistance of the community is needed in the planning stages of emergency management in this prepared community (Drabek, 1986). The prepared community is properly informed on the various ways of emergency management. These methods include imparting data to the schools and carrying out training in the community (Cronan, 1998). Other preparedness measures Other preparedness measures which can be implemented to manage emergencies are the team trainings (Laye, n.d.). In the improvement of team work, team trainings with simulations must be carried out. The team in these cases must acknowledge the fact that their responsibility is to ensure a well-coordinated decision-making process. The team must also acknowledge the fact that the members of the team need to carry out realistic trainings in order to adequately assess the skills application and the deficiencies of the members (Laye, n.d). These trainings are meant to improve the skills of the rest of the team and also improve their safety in the actual field. Command control and coordination Command defined Emergency Management Australia (1998) describes command as the process of directing the resources of the agency to fulfil the agency’s role. It also includes the coordination of the different involved agencies with each other from the highest to the lowest position. Command is very much impacted by laws and by the consensus of various government agencies (Emergency Management Australia, 1998). It also includes the process of guiding members of the organization, monitoring these members and making sure that they are carrying out their duties as members of the organization (Cronan, 1998). Control defined Control refers to the act of providing general direction of the emergency management process and activities during actual emergencies (Emergency Management Australia, 1998). In relation to command, control functions horizontally covering elements and processes within the agencies involved. On the other hand, control includes the actual applications of processes during emergencies. Moreover, the power which resides in the control process is based on laws and it also involves the apportioning duties to other agencies which are actually needed in the emergency management process. Coordination defined Coordination refers to the act of consolidating the manpower, agencies, and resources in order to provide efficient emergency response (Emergency Management Australia, 1998). It also includes the acquisition and utilization of resources based on the needs brought forth by the emergency. Coordination also ensures that the agencies and organizations involved in disaster management are closely linked with each other. It is an orderly activity where the different elements of emergency management all emerge (Cronan, 1998). It moves both vertically and horizontally within organizations (Community Emergency Planning Guide, 1992). The human factor Human responses to emergencies and disasters: 5 myths & realities 1. Myth: Emergency warnings must not be given until there is an absolute certainty about the emergency, otherwise people would panic. Reality: People will not necessarily panic during emergencies. Warnings must be disseminated the soonest possible time (Government of Alberta, n.d). 2. Myth: People will only look out for themselves without being concerned about others (Cronan, 1998). Reality: People are more likely to assist each other during emergencies (Government of Alberta, n.d). 3. Myth: Anti-social attitudes are often exacerbated during disasters. Reality: The reality is that anti-social attitudes are not dominant in society, and do not emerge during emergencies. Most people are actually more likely to relate and communicate with others, even strangers during emergencies (Wachtendorf, n.d). 4. Myth: People are overwhelmed with hopelessness during emergencies (Cronan, 1998). Reality: People affected by disasters would be more responsive and active. They sometimes end up helping in the rescue of other victims without having to wait for government authorities (Government of Alberta, n.d). 5. Myth: Children are too young to be affected by these disasters (Thristan 1995). Reality: Children are more vulnerable to trauma during disasters, however, the same amount of trauma would likely impact on other individuals who also have inadequate coping skills, including children, and other victims (Wachtendorf, n.d). Human behaviour following trauma Human response after disasters and traumatic events follow the pattern of behaviour (Charles Sturt University, 2004). First and foremost, the loss or the trauma would cause the initial defence response of denial. A person is unable to fathom the fact that such a traumatic incident occurred and has caused him to lose his loved one or his home. This stage of denial is then followed by a feeling of sadness and anxiety. Such feelings often cause sleep disturbances and other changes in a person’s usual activities. Alienation and withdrawal also settled in and soon after, a person would feel remorse and guilt over the loss. Eventually, feelings of panic also manifest, along with difficulties in decision-making. Anger and resentment are also seen. Eventually, the traumatized person would try to re-think his situation and reflect on how good his situation was before the disaster. In the process, the recovery process would now be seen. Acceptance would follow and would eventually renew his outlook on his life (Charles Sturt University, 2004). Principles of recovery 1. Understanding how complicated a situation is refers to the importance of recognizing the data and recovery tools which may not be successful at first, but are set to impact significantly over time. 2. Community-initiated resources are mostly related to what the community can accomplish and how the community can assist in the recovery plans (Families and Communities, n.d). 3. In guaranteeing the linkages in all the activities, the experience of those who are skilled in leadership can be gained. 4. Efficient communication is a sure way of guaranteeing that all data passed to the concerned individuals are relevant and timely. 5. Supporting and improving capacity is also a viable means of assessing gaps in recovery programs of the community (Families and Communities, n.d). Emergency legislation Integrated approach Laws passed during emergencies are charged as responsibilities of government authorities. Through these emergency legislative acts help secure immediate funding for disaster relief. They also secure the coordinated relations between and among the Federal and the local authorities (Cronan, 1998). Roles of agencies/organizations Local government authorities are tasked with securing the local structures and roads, including the services within their jurisdiction (Cronan, 1998). On the other hand the national government has a bigger and wider jurisdiction which includes law and order, health, safety, and economic development. The Federal government has an even bigger role, and its tasks mostly focus on quarantine policies, monetary, as well as fiscal policies, and other aspects of the state government, including health and defence (Cronan, 1998). Importance of values of emergency legislation The passage of laws which are needed to assist emergency management is crucial to the overall direction of disaster relief and emergency management (ACT Emergency Services Agency, n.d). Emergency laws need to be passed in order to assist the implementing agencies in the performance of their duties. Emergency legislation is a means of linking the varying regulations of emergency management by regulating the current legal statutes, making sure that they are responsive to the needs of the people affected by the disaster (ACT Emergency Services Agency, n.d). These laws also define the duties and tasks of the myriad groups involved in emergency management (Csiro, 2000). Primary features of desirable emergency legislation The main qualities of favourable emergency laws include the release of emergency and disaster relief funds from the national and local government and having these be automatically released to the emergency response teams. These laws cuts through red tape and overlooks set budgets for the releasing agencies. A state of emergency declared by the government immediately allows for the release of disaster relief funds. This gives the relief teams room to financially manoeuvre. It allows them to purchase and avail of necessary equipment as well as hire additional manpower where necessary. As a result, the impact of disasters is minimized in the long run. Conclusion There are various principles and concepts which define and govern disasters and emergencies. Basically, disasters and emergencies are unexpected events which have a significant effect on various individuals and large communities. These disasters impact significantly on the lives of many people. They bring about physical as well as psychological effects. Emergency management helps authorities cope with these disasters and it helps people recover and prepare for these emergencies. With adequate planning and coordination, the prevention and management of these incidents are ensured. The prepared communities are communities which have managed to make the necessary plans for these emergencies. The systems in this community are coordinated and the local as well as national agencies are linked with each other. With these plans in place, it is possible for people and communities to minimise the impact of disasters and emergencies. Works Cited Accident Reporting, Investigation, and Analysis (n.d) SConsultnet Ltd. Retrieved 29 September 2011 from http://www.consultnet.ie/accident%20reporting%20and%20investigation.ppt Attorney General’s Department (2002) Strategic Plan 1999-2002. State Emergency Management Committee. 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