**8. The role of emergency medicine in disasters**

Emergency medicine plays a critical role in disaster response and planning [16]. Understanding and appreciating its role and the importance of emergency medicine leadership in hospital planning are critical to hospital resiliency.

Issues affecting and mechanisms of resiliency regarding emergency medicine include:

### **8.1 Surge**

Very few parts of healthcare ever need to undergo clinical surge, whereas in emergency medicine this is common and inevitable. The concept and practice of surge involves a paradigm of, and mechanisms for, flexibility. This impacts all areas of healthcare delivery, such as, the workforce, materials and environmental management and workflow [17].

### **8.2 Triage**

Disaster triage relates not only to the need for choosing where and in what order to care for patients but also the limiting of resources when necessary. With regard to the order and location of care, emergency medicine with its understanding of diverse pathology, familiarity and relationship to other areas of the hospital, and focus on public health, trauma and infectious disease is ideally suited to triage. What is more is that during a disaster triage will become of greater importance as volumes of patients, some with no medical needs overwhelm the system. Limiting of care or Utilitarian theory referred to as 'maximize collective welfare' or to 'do the greatest good for the greatest numbers of people,' is another major component of disaster triage. The principle and practice of Utilitarian theory is part of emergency medicine training [18].

### **8.3 Access**

Access to the health system. The emergency department is the most common way of accessing care in many health systems and it is likely to remain so during a disaster event. Utilizing this tried and established framework, with appropriate augmentation has many practical advantages.

*Resilient Health System and Hospital Disaster Planning DOI: http://dx.doi.org/10.5772/intechopen.95025*
