EMS Disaster Response


The disaster cycle involves four phases: preparation, response, recovery, and mitigation.[1] The cycle illustrates the steps that emergency managers take when planning for and responding to a disaster. Preparation is the phase where response plans are constructed. The response is the phase where there is immediate action to limit the hazards created by the disaster. Recovery is the effort to return a community to pre-disaster levels of functioning. Mitigation is the phase where new measures are undertaken to prevent or minimize the effects of future disasters.  Some sources refer to the mitigation phase as “prevention.”

To meaningfully discuss disaster response, it is essential also to discuss disaster and disaster management. Though there exists no consensus definition of disaster, the various definitions published by organizations and agencies at the forefront of disaster management have overlapping concepts.

A disaster is a state in which the usual, normal day-to-day human activities within a determined geographic area cease indefinitely. It is defined by a severe disruption in the basic structure and function of a society. This abnormal state is triggered by some extraordinary circumstance, either occurring naturally or as the result of human activity.

A disaster is the consequence of a sudden event or series of events of grand magnitude, which results in injury, disease, illness, loss of life, destruction of property, and/or damage to critical infrastructure and essential services.[2] The precipitating event may be natural, i.e., natural disasters (e.g., tornado, hurricane, drought, famine, earthquake, landslides, infectious disease outbreaks, etc.) or man-made.[3][4] Man-made events may be unintentional (fires, building collapses, nuclear reactor meltdowns) or intentional (terrorism, sabotage, cyber-attacks, conflict-based). In recent times, both man-made and natural disasters have occurred at an increasing frequency.[5]

Due to its scale and dimension, a disaster exceeds the emergency management capacity of local organizations and agencies, thus necessitating external assistance. That assistance may come from the state, national, and/or international levels. The rapid, immediate, and short-term actions circumjacent to a disaster are known as disaster response.[6]

Disaster response is one of the core activities of disaster management. It involves the execution of a disaster plan in the event of a disaster.

Issues of Concern

A vital concept core within the field of disaster management is that all disasters are local. This concept refers to the idea that the response to a disaster nearly always begins before making an official disaster declaration. Whether the event is a major transportation accident such as the Hong Kong subway fire of 2017, a natural disaster such as Hurricane Katrina, or a planned attack like 9/11, the first to be notified and arrive on the scene are always local first responders.[7][8][9][8][7] Police, firefighters, and EMS personnel within the jurisdiction are called to the scene and begin their work, which could involve any number of rescues, life-saving interventions, hazard reduction, or evacuation efforts.[10]

Throughout the disaster response phase, the local incident management command structure is responsible for directing response efforts and effectively implementing the disaster plan. One of the most important qualities of an advantageous disaster plan is to minimize its complexity.[11] The best plans effectively identify what resources are available to the incident management team and outline procedures to access those resources without applying extensive constraints to their utilization; this allows the plan to be adaptable to the specific needs of the situation. 

The primary objective of disaster response is to provide immediate short-term assistance to meet the myriad needs that arise when a disaster occurs.[12]

If the disaster reaches a significant enough magnitude and presents a drain to local resources, the governor of the affected state or tribal leader of the Native American reservation, makes a formal request for a major disaster declaration to the federal government.[13] Once a disaster is recognized and declared, federal disaster responders and other response resources are activated and moved into position for deployment.

Those individuals and professions potentially involved at this stage are too numerous to name realistically. Local responders will still be involved.  This team of responders could include professional rescuers, police officers, firefighters, paramedics, cities and county emergency managers, public works and other utility workers, local healthcare workers, teams of engineers, members of the media, local volunteers, and many more.

In the United States, federal assets deployed in response to a major disaster declaration bring many more actors to the scene.  The Federal Emergency Management Agency (FEMA) is responsible for coordinating the federal operational and logistical disaster response capability within the National Response Framework.  The available resources break down into bundles, referred to as “Emergency Support Functions (ESFs) [14][15][16]:

  • Emergency Support Function (ESF) #1 Transportation
    • Assists with the management of transportation systems and infrastructure
  • Emergency Support Function (ESF) #2 Communications
    • Assists in the coordination of stakeholders in response efforts and supports and restores existing communication infrastructure
  • Emergency Support Function (ESF) #3 Public Works and Engineering
    • Assists with technical aspects of maintaining necessary public services and engineering expertise
  • Emergency Support Function (ESF) #4 Firefighting
    • Assists with suppression of wildland, rural and urban fires
  • Emergency Support Function (ESF) #5 Information and Planning
    • Assists with the collection, analysis, processing, and dissemination of information
  • Emergency Support Function (ESF) #6 Mass Care, Emergency Assistance, Temporary Housing, and Human Services
    • Assists with providing secure access to finances and housing for those displaced by a disaster
  • Emergency Support Function (ESF) #7 Logistics
    • Assists with comprehensive planning of technical assistance, training, educational programs, exercises, and incident response
  • Emergency Support Function (ESF) #8 Public Health and Medical Services
    • Assists with public health initiatives, mental health, and medical care response
  • Emergency Support Function (ESF) #9 Search and Rescue
    • Assists with life-saving intervention for those trapped by disasters
  • Emergency Support Function (ESF) #10 Oil and Hazardous Materials
    • Assists with a response to actual or potential hazmat disasters
  • Emergency Support Function (ESF) #11 Agriculture and Natural Resources
    • Assists by providing nutrition assistance, and threats to agricultural infrastructure and the supply chain
  • Emergency Support Function (ESF) #12 Energy
    • Assists with technical expertise during threats to the energy sector and stabilizes/restores normal operations at energy facilities.
  • Emergency Support Function (ESF) #13 Public Safety and Security
    • Assists with local law enforcement, maintaining order, and protecting citizens.
  • Emergency Support Function (ESF) #14 Cross-Sector Business and Infrastructure Annex
    • Assists with the stabilization of key supply chains in disaster areas
  • Emergency Support Function (ESF) #15 External Affairs
    • Assists with the communication of accurate, timely and accessible information to affected audiences during a disaster

Which bundle of resources is deployed is dependent on the circumstances of the specific disaster situation and what resources are requested by the governor or tribal leader. Each package brings more actors and professions into the response united in the goal of providing immediate assistance to communities affected by disasters.

The escalation of a disaster situation often brings another player to the scene, the non-governmental organizations (NGOs).  Examples of NGOs include those widely known, such as the Red Cross and the Salvation Army, but also those not as well-known but local, regional, and even international. Though they are not government entities, they can play a crucial role in disaster response and provide relief and services to many victims. These organizations can help even absent a major disaster declaration. Each organization has a particular specific mission and funding sources. They can intervene in circumstances that fulfill their mission.  Some provide medical care. Some, like Team Rubicon, help with housing repairs and clearing debris. Some even are able to provide financial assistance to victims.[17]

In addition to those responders summoned to help with disasters, the recent increase in the occurrence of natural disasters has caused another phenomenon to develop, disaster tourism. This term refers to individuals, or groups of individuals, who “self-dispatch” themselves to a disaster. In some cases, these are people nobly motivated to help. In other cases, some of these people may want to bear first-hand witness to the situation.  Whatever their intentions, disaster responders, regardless of their origin, put stress on the local resources already struggling due to the disaster situation. When those responders are requested and providing necessary help to the community, the benefit outweighs the tax. But for those who are unplanned “responders,” their presence could cause more harm than good. The limited resources for these people could also pose a risk to their health and safety.  For those who respond to disasters, they must be attached to an official organization for both the best interests of the community affected by the disaster and the responders’ personal health and safety.[18]

Regardless of what organization originally dispatched each disaster responder, they are united in their common goal to provide immediate relief to those affected by disasters.

Clinical Significance

Despite advancing preparedness and mitigation strategies, disaster is inevitable and invariably affects human populations.[19] Though the scale of disasters varies, disaster management principles are widely applicable. Disaster management has a goal of reducing the impact of disasters. Disaster response is a crucial phase and involves the immediate actions taken in the aftermath of a disaster to protect against further loss of life and property.[20]

Responders are interdisciplinary and from a wide variety of backgrounds.  For each stakeholder to work together properly, disaster plans need to have minimal complexity and be widely applicable; the correct resources need to be activated; the incident command structure must be respected; and, responders need to be well trained. Once the immediate response phase has passed, efforts can shift towards recovery and return to the normal functioning of the affected community.

(Click Image to Enlarge)
The disaster cycle illustrates the steps that emergency managers take when planning for an responding to a disaster. Preparation is the phase where response plans are constructed.  Response is the phase where immediate action is taken to limit the hazards created by the disaster.  Recovery is the effort to return a community to pre-disaster levels of functioning.  Mitigation is the phase where new measures are undertaken to prevent or minimize the effects of future disasters.
The disaster cycle illustrates the steps that emergency managers take when planning for an responding to a disaster. Preparation is the phase where response plans are constructed. Response is the phase where immediate action is taken to limit the hazards created by the disaster. Recovery is the effort to return a community to pre-disaster levels of functioning. Mitigation is the phase where new measures are undertaken to prevent or minimize the effects of future disasters.
Figure created by Taylor Klein, MS-IV, MS, NRAEMT
Article Details

Article Author

Taylor Klein

Article Editor:

Lisandro Irizarry


7/22/2020 12:24:33 PM

PubMed Link:

EMS Disaster Response



Couig MP, Willingness, ability, and intentions of health care workers to respond. Annual review of nursing research. 2012;     [PubMed PMID: 24894058]


Wong DF,Spencer C,Boyd L,Burkle FM,Archer F, Disaster Metrics: A Comprehensive Framework for Disaster Evaluation Typologies. Prehospital and disaster medicine. 2017 Oct;     [PubMed PMID: 28478770]


Hidalgo J,Baez AA, Natural Disasters. Critical care clinics. 2019 Oct;     [PubMed PMID: 31445607]


Furuya S,Chimed-Ochir O,Takahashi K,David A,Takala J, Global Asbestos Disaster. International journal of environmental research and public health. 2018 May 16;     [PubMed PMID: 29772681]


Nepal: man-made disaster looms. Lancet (London, England). 2015 Dec 5;     [PubMed PMID: 26681276]


Parra Cotanda C,Luaces Cubells C, [Disaster situations. What must we know and do?]. Anales de pediatria (Barcelona, Spain : 2003). 2011 Apr;     [PubMed PMID: 21237731]


Chan EYY,Huang Z,Hung KKC,Chan GKW,Lam HCY,Lo ESK,Yeung MPS, Health Emergency Disaster Risk Management of Public Transport Systems: A Population-Based Study after the 2017 Subway Fire in Hong Kong, China. International journal of environmental research and public health. 2019 Jan 15;     [PubMed PMID: 30650569]


McSwain NE Jr, Disaster response. Natural disaster: Katrina. Surgery today. 2010 Jul;     [PubMed PMID: 20582507]


Crane MA,Levy-Carrick NC,Crowley L,Barnhart S,Dudas M,Onuoha U,Globina Y,Haile W,Shukla G,Ozbay F, The response to September 11: a disaster case study. Annals of global health. 2014 Jul-Aug;     [PubMed PMID: 25459334]


Horrocks P,Hobbs L,Tippett V,Aitken P, Paramedic Disaster Health Management Competencies: A Scoping Review. Prehospital and disaster medicine. 2019 Jun;     [PubMed PMID: 31134873]


Wurmb T,Rechenbach P,Scholtes K, [Hospital emergency plan: the consequence-based model]. Medizinische Klinik, Intensivmedizin und Notfallmedizin. 2017 Oct;     [PubMed PMID: 27376541]


Leider JP,DeBruin D,Reynolds N,Koch A,Seaberg J, Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review. American journal of public health. 2017 Sep;     [PubMed PMID: 28727521]


de Anda HH,Braithwaite S, EMS, Criteria For Disaster Declaration 2020 Jan;     [PubMed PMID: 30969625]


Marlow R,Singleton S,Campeau D,Russell T,Hunt R,Hick JL,Harvey M,Ryan J, The evolution of healthcare disaster preparedness and response training at the FEMA Center for Domestic Preparedness. American journal of disaster medicine. 2019 Winter     [PubMed PMID: 31441023]


Bachmann DJ,Jamison NK,Martin A,Delgado J,Kman NE, Emergency Preparedness and Disaster Response: There's An App for That. Prehospital and disaster medicine. 2015 Oct     [PubMed PMID: 26369629]


Stewart A,Marlow R,Campeau D,Russell T,Ryan J, The evolution of response and management training at the FEMA Center for Domestic Preparedness. Journal of emergency management (Weston, Mass.). 2019 Jan/Feb     [PubMed PMID: 30933305]


Towe VL,Acosta JD,Chandra A, Towards More Nuanced Classification of NGOs and Their Services to Improve Integrated Planning across Disaster Phases. International journal of environmental research and public health. 2017 Nov 21     [PubMed PMID: 29160810]


Reproducibility in visual inspection of parenterals., Faesen AC,, Journal of the Parenteral Drug Association, 1978 Mar-Apr     [PubMed PMID: 20586008]


Cheong KH,Jones MC, Introducing the 21st Century's New Four Horsemen of the Coronapocalypse. BioEssays : news and reviews in molecular, cellular and developmental biology. 2020 Mar 30;     [PubMed PMID: 32227642]


Adelman DS,Fant C,Wood L,Zak C, Disasters: Who responds when? The Nurse practitioner. 2019 Oct;     [PubMed PMID: 31568031]