The Importance of Evidence-Based Disaster Planning[1]
Summary
A critical examination of disaster planning assumptions against empirical field disaster research. The author argues that planning is only as good as its assumptions, and that much conventional wisdom is at variance with what field studies actually find. Seven common assumptions are examined and compared with research findings: that dispatchers will hear of the disaster and send units; that trained emergency personnel will carry out field search and rescue; that trained EMS personnel will perform triage, provide stabilising care and decontaminate casualties before transport; that casualties will be transported by ambulance; that casualties will reach appropriate hospitals without any receiving a disproportionate share; that authorities on scene will promptly notify hospitals of numbers, types and severities; and that the most seriously injured will be transported first. The paper discusses the current status and limitations of disaster research and offers potential interventions, framed as hypotheses for future work.
So what
Every one of the seven assumptions this paper dismantles is embedded in the standard mass-gathering mass-casualty annex - particularly that casualties travel by ambulance, that they are distributed evenly across hospitals, and that the sickest go first. A plan written against the research rather than against convention should assume self-transport, hospital overload concentrated at the nearest facility, and reverse triage in the first wave.
Read the paper
- Publisher (DOI) ↗may be paywalled