An emergency is an urgent, unexpected, and usually dangerous situation that poses an immediate risk to health, life, property, or environment and requires immediate action. [1] Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative care for the aftermath.
While some emergencies are self-evident (such as a natural disaster that threatens many lives), many smaller incidents require that an observer (or affected party) decide whether it qualifies as an emergency. The precise definition of an emergency, the agencies involved and the procedures used, vary by jurisdiction, and this is usually set by the government, whose agencies (emergency services) are responsible for emergency planning and management.
An incident, to be an emergency, conforms to one or more of the following, if it:
In the United States, most states mandate that a notice be printed in each telephone book that requires that someone must relinquish use of a phone line, if a person requests the use of a telephone line (such as a party line) to report an emergency. State statutes typically define an emergency as, "...a condition where life, health, or property is in jeopardy, and the prompt summoning of aid is essential." [3]
Whilst most emergency services agree on protecting human health, life and property, the environmental impacts are not considered sufficiently important by some agencies[ citation needed ]. This also extends to areas such as animal welfare, where some emergency organizations cover this element through the "property" definition, where animals owned by a person are threatened (although this does not cover wild animals). This means that some agencies do not mount an "emergency" response where it endangers wild animals or environment[ citation needed ], though others respond to such incidents (such as oil spills at sea that threaten marine life). The attitude of the agencies involved is likely to reflect the predominant opinion of the government of the area.
This section needs additional citations for verification .(August 2014) |
Many emergencies cause an immediate danger to the life of people involved. This can range from emergencies affecting a single person, such as the entire range of medical emergencies including heart attacks, strokes, cardiac arrest and trauma, to incidents that affect large numbers of people such as natural disasters including tornadoes, hurricanes, floods, earthquakes, mudslides and outbreaks of diseases such as coronavirus, cholera, Ebola, and malaria.
Most agencies consider these the highest priority emergency, which follows the general school of thought that nothing is more important than human life. [4]
Some emergencies are not necessarily immediately threatening to life, but might have serious implications for the continued health and well-being of a person or persons (though a health emergency can subsequently escalate to life-threatening).
The causes of a health emergency are often very similar to the causes of an emergency threatening to life, which includes medical emergencies and natural disasters, although the range of incidents that can be categorized here is far greater than those that cause a danger to life (such as broken limbs, which do not usually cause death, but immediate intervention is required if the person is to recover properly). Many life emergencies, such as cardiac arrest, are also health emergencies.
Some emergencies do not immediately endanger life, health or property, but do affect the natural environment and creatures living within it. Not all agencies consider this a genuine emergency, but it can have far-reaching effects on animals and the long term condition of the land. Examples would include forest fires and marine oil spills.
Agencies across the world have different systems for classifying incidents, but all of them serve to help them allocate finite resource, by prioritising between different emergencies.[ citation needed ]
The first stage of any classification is likely to define whether the incident qualifies as an emergency, and consequently if it warrants an emergency response. Some agencies may still respond to non-emergency calls, depending on their remit and availability of resource. An example of this would be a fire department responding to help retrieve a cat from a tree, where no life, health or property is immediately at risk.
Following this, many agencies assign a sub-classification to the emergency, prioritising incidents that have the most potential for risk to life, health or property (in that order). For instance, many ambulance services use a system called the Advanced Medical Priority Dispatch System (AMPDS) or a similar solution. [5] [6] The AMPDS categorises all calls to the ambulance service using it as either 'A' category (immediately life-threatening), 'B' Category (immediately health threatening) or 'C' category (non-emergency call that still requires a response). Some services have a fourth category, where they believe that no response is required after clinical questions are asked.
Another system for prioritizing medical calls is known as Emergency Medical Dispatch (EMD). [7] [8] Jurisdictions that use EMD typically assign a code of "alpha" (low priority), "bravo" (medium priority), "charlie" (requiring advanced life support), delta (high priority, requiring advanced life support) or "echo" (maximum possible priority, e.g., witnessed cardiac arrests) to each inbound request for service; these codes are then used to determine the appropriate level of response. [9] [10] [11]
Other systems (especially as regards major incidents) use objective measures to direct resource. Two such systems are SAD CHALET and ETHANE, [12] which are both mnemonics to help emergency services staff classify incidents, and direct resource. [13] Each of these acronyms helps ascertain the number of casualties (usually including the number of dead and number of non-injured people involved), how the incident has occurred, and what emergency services are required.
Most developed countries have a number of emergency services operating within them, whose purpose is to provide assistance in dealing with any emergency. They are often government operated, paid for from tax revenue as a public service, but in some cases, they may be private companies, responding to emergencies in return for payment, or they may be voluntary organisations, providing the assistance from funds raised from donations.
Most developed countries operate three core emergency services[ citation needed ]:
There may also be a number of specialized emergency services, which may be a part of one of the core agencies, or may be separate entities who assist the main agencies. This can include services, such as bomb disposal, search and rescue, and hazardous material operations.
The Military and the Amateur Radio Emergency Service (ARES) or Radio Amateur Civil Emergency Service (RACES) help in large emergencies such as a disaster or major civil unrest.
Most countries have an emergency telephone number, also known as the universal emergency number, which can be used to summon the emergency services to any incident. This number varies from country to country (and in some cases by region within a country), but in most cases, they are in a short number format, such as 911 (United States and many parts of Canada), [14] 999 (United Kingdom), [15] [16] 112 (Europe) [17] [18] and 000 (Australia). [19]
To simplify the summoning of emergency services, EmerGa, [20] [21] a French first aid association recognized as being of public interest, is developing e-mergency in 2024. This mobile application offers quick access to emergency services worldwide through an intuitive visual interface, eliminating the need to memorize different emergency numbers. [22] [23] [24] [25] [26]
The majority of mobile phones also dial the emergency services, even if the phone keyboard is locked, or if the phone has an expired or missing SIM card, although the provision of this service varies by country and network. [18]
In addition to those services provided specifically for emergencies, there may be a number of agencies who provide an emergency service as an incidental part of their normal 'day job' provision. This can include public utility workers, such as in provision of electricity or gas, who may be required to respond quickly, as both utilities have a large potential to cause danger to life, health and property if there is an infrastructure failure. [27] [28]
Generally perceived as pay per use emergency services, domestic emergency services are small, medium or large businesses who tend to emergencies within the boundaries of licensing or capabilities. These tend to consist of emergencies where health or property is perceived to be at risk but may not qualify for official emergency response. Domestic emergency services are in principle similar to civil emergency services where public or private utility workers will perform corrective repairs to essential services and avail their service at all times; however, these are at a cost for the service. An example would be an emergency plumber. [29]
This section needs additional citations for verification .(August 2014) |
Emergency action principles are key 'rules' that guide the actions of rescuers and potential rescuers. Because of the inherent nature of emergencies, no two are likely to be the same, so emergency action principles help to guide rescuers at incidents, by sticking to some basic tenets.
The adherence to (and contents of) the principles by would-be rescuers varies widely based on the training the people involved in emergency have received, the support available from emergency services (and the time it takes to arrive) and the emergency itself.
The key principle taught in almost all systems is that the rescuer, whether a lay person or a professional, should assess the situation for danger. [30] [31]
The reason that an assessment for danger is given such high priority is that it is core to emergency management that rescuers do not become secondary victims of any incident, as this creates a further emergency that must be dealt with.
A typical assessment for danger would involve observation of the surroundings, starting with the cause of the accident (e.g. a falling object) and expanding outwards to include any situational hazards (e.g. fast moving traffic) and history or secondary information given by witnesses, bystanders or the emergency services (e.g. an attacker still waiting nearby).
Once a primary danger assessment has been completed, this should not end the system of checking for danger, but should inform all other parts of the process.
If at any time the risk from any hazard poses a significant danger (as a factor of likelihood and seriousness) to the rescuer, they should consider whether they should approach the scene (or leave the scene if appropriate).
There are many emergency services protocols that apply in an emergency, which usually start with planning before an emergency occurs. One commonly used system for demonstrating the phases is shown here on the right.
The planning phase starts at preparedness, where the agencies decide how to respond to a given incident or set of circumstances. This should ideally include lines of command and control, and division of activities between agencies. This avoids potentially negative situations such as three separate agencies all starting an official emergency shelter for victims of a disaster.
Following an emergency occurring, the agencies then move to a response phase, where they execute their plans, and may end up improvising some areas of their response (due to gaps in the planning phase, which are inevitable due to the individual nature of most incidents).
Agencies may then be involved in recovery following the incident, where they assist in the clear up from the incident, or help the people involved overcome their mental trauma.
The final phase in the circle is mitigation, which involves taking steps to ensure no re-occurrence is possible, or putting additional plans in place to ensure less damage is done. This should feed back into the preparedness stage, with updated plans in place to deal with future emergencies, thus completing the circle.
In the event of a major incident, such as civil unrest or a major disaster, many governments maintain the right to declare a state of emergency, [32] which gives them extensive powers over the daily lives of their citizens, and may include temporary curtailment on certain civil rights, including the right to trial. For instance to discourage looting of an evacuated area, a shoot on sight policy, however unlikely to occur, may be publicized.
In the United States, Community Emergency Response Team (CERT) can refer to
In medicine, triage is a process by which care providers such as medical professionals and those with first aid knowledge determine the order of priority for providing treatment to injured individuals and/or inform the rationing of limited supplies so that they go to those who can most benefit from it. Triage is usually relied upon when there are more injured individuals than available care providers, or when there are more injured individuals than supplies to treat them.
The Federal Emergency Management Agency (FEMA) is an agency of the United States Department of Homeland Security (DHS), initially created under President Jimmy Carter by Presidential Reorganization Plan No. 3 of 1978 and implemented by two Executive Orders on April 1, 1979. The agency's primary purpose is to coordinate the response to a disaster that has occurred in the United States and that overwhelms the resources of local and state authorities. The governor of the state in which the disaster occurs must declare a state of emergency and formally request from the President that FEMA and the federal government respond to the disaster. The only exception to the state's gubernatorial declaration requirement occurs when an emergency or disaster takes place on federal property or to a federal asset—for example, the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, Oklahoma, or the Space Shuttle Columbia in the 2003 return-flight disaster.
A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and gastrointestinal cannot be dealt with by the victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from first aiders through emergency medical technicians, paramedics, emergency physicians and anesthesiologists.
Emergency services and rescue services are organizations that ensure public safety, security, and health by addressing and resolving different emergencies. Some of these agencies exist solely for addressing certain types of emergencies, while others deal with ad hoc emergencies as part of their normal responsibilities. Many of these agencies engage in community awareness and prevention programs to help the public avoid, detect, and report emergencies effectively. Emergency services are often considered first responders, and typically have dedicated emergency vehicles.
A first responder is a person with specialized training who is among the first to arrive and provide assistance or incident resolution at the scene of an emergency. First responders typically include law enforcement officers, emergency medical services members, fire service members and Public Works employees such as Heavy Equipment Operators as well as Public Works Tree Department personnel. In some jurisdictions, emergency department personnel, such as doctors and nurses, are also required to respond to disasters and critical situations, designating them first responders; in other jurisdictions, military and security forces may also be authorized to act as first responders.
Emergency management is a science and a system charged with creating the framework within which communities reduce vulnerability to hazards and cope with disasters. Emergency management, despite its name, does not actually focus on the management of emergencies; emergency management or disaster management can be understood as minor events with limited impacts and are managed through the day-to-day functions of a community. Instead, emergency management focuses on the management of disasters, which are events that produce more impacts than a community can handle on its own. The management of disasters tends to require some combination of activity from individuals and households, organizations, local, and/or higher levels of government. Although many different terminologies exist globally, the activities of emergency management can be generally categorized into preparedness, response, mitigation, and recovery, although other terms such as disaster risk reduction and prevention are also common. The outcome of emergency management is to prevent disasters and where this is not possible, to reduce their harmful impacts.
Disaster response refers to the actions taken directly before, during, or immediately after a disaster. The objective is to save lives, ensure health and safety, and meet the subsistence needs of the people affected. It includes warning and evacuation, search and rescue, providing immediate assistance, assessing damage, continuing assistance, and the immediate restoration or construction of infrastructure. An example of this would be building provisional storm drains or diversion dams. Emergency response aims to provide immediate help to keep people alive, improve their health and support their morale. It can involve specific but limited aid, such as helping refugees with transport, temporary shelter, and food. Or it can involve establishing semi-permanent settlements in camps and other locations. It may also involve initial repairs to damage to infrastructure, or diverting it.
NSW Ambulance, previously the Ambulance Service of NSW, is an agency of NSW Health and the statutory provider of pre-hospital emergency care and ambulance services in the state of New South Wales, Australia.
Emergency service response codes are predefined systems used by emergency services to describe the priority and response assigned to calls for service. Response codes vary from country to country, jurisdiction to jurisdiction, and even agency to agency, with different methods used to categorize responses to reported events.
Emergency medical services in France are provided by a mix of organizations under public health control. The central organizations that provide these services are known as a SAMU, which stands for Service d’aide médicale urgente. Local SAMU organisations operate the control rooms that answer emergency calls and dispatch medical responders. They also operate the SMUR, which refers to the ambulances and response vehicles that provide advanced medical care. Other ambulances and response vehicles are provided by the fire services and private ambulance services.
Emergency Medical Service in Germany is a service of public pre-hospital emergency healthcare, including ambulance service, provided by individual German cities and counties. It is primarily financed by the German public health insurance system.
Disaster medicine is the area of medical specialization serving the dual areas of providing health care to disaster survivors and providing medically related disaster preparation, disaster planning, disaster response and disaster recovery leadership throughout the disaster life cycle. Disaster medicine specialists provide insight, guidance and expertise on the principles and practice of medicine both in the disaster impact area and healthcare evacuation receiving facilities to emergency management professionals, hospitals, healthcare facilities, communities and governments. The disaster medicine specialist is the liaison between and partner to the medical contingency planner, the emergency management professional, the incident command system, government and policy makers.
The Medical Priority Dispatch System (MPDS), sometimes referred to as the Advanced Medical Priority Dispatch System (AMPDS) is a unified system used to dispatch appropriate aid to medical emergencies including systematized caller interrogation and pre-arrival instructions. Priority Dispatch Corporation is licensed to design and publish MPDS and its various products, with research supported by the International Academy of Emergency Medical Dispatch (IAEMD). Priority Dispatch Corporation, in conjunction with the International Academies of Emergency Dispatch, have also produced similar systems for Police and Fire
Collaborative Fusion, Inc. (CFI) was a Pittsburgh, Pennsylvania-based provider of ESAR-VHP and incident management software for coordination of emergency personnel. Its president and vice president were founders Atila Omer and Bryan Kaplan, respectively. CFI was acquired in 2011 by the Intermedix Corporation, a firm owned by private equity firm Thomas H. Lee Partners. Following the spin-off of Intermedix Corporation and Juvare, LLC in May, 2018, Collaborative Fusion, Inc. became a wholly owned subsidiary of Juvare, LLC, a firm owned by private equity firm Thomas H. Lee Partners.
Emergency medical services in Australia are provided by state ambulance services, which are a division of each state or territorial government, and by St John Ambulance in both Western Australia and the Northern Territory.
An emergency medical dispatcher is a professional telecommunicator, tasked with the gathering of information related to medical emergencies, the provision of assistance and instructions by voice, prior to the arrival of emergency medical services (EMS), and the dispatching and support of EMS resources responding to an emergency call. The term "emergency medical dispatcher" is also a certification level and a professional designation, certified through the Association of Public-Safety Communications Officials-International (APCO) and the International Academies of Emergency Dispatch. Many dispatchers, whether certified or not, will dispatch using a standard emergency medical dispatch protocol.
In Ukraine, emergency medical services are provided by the Ukrainian Emergency Medical Services (UEMS), a special type of government rescue service, the main task of which is to provide free of charge medical assistance to victims, rescuers and any other persons who take part in the response to and/or recovery process after incidents of any kind.
A mass casualty incident describes an incident in which emergency medical services resources, such as personnel and equipment, are overwhelmed by the number and severity of casualties. For example, an incident where a two-person crew is responding to a motor vehicle collision with three severely injured people could be considered a mass casualty incident. The general public more commonly recognizes events such as building collapses, train and bus collisions, plane crashes, earthquakes and other large-scale emergencies as mass casualty incidents. Events such as the Oklahoma City bombing in 1995, the September 11 attacks in 2001, and the Boston Marathon bombing in 2013 are well-publicized examples of mass casualty incidents. The most common types of MCIs are generally caused by terrorism, mass-transportation accidents, fires or natural disasters. A multiple casualty incident is one in which there are multiple casualties. The key difference from a mass casualty incident is that in a multiple casualty incident the resources available are sufficient to manage the needs of the victims. The issue of resource availability is therefore critical to the understanding of these concepts. One crosses over from a multiple to a mass casualty incident when resources are exceeded and the systems are overwhelmed.
Emergency Medical Dispatch (EMD) refers to a system that enhances services provided by Public Safety Answering Point (emergency) call takers, such as municipal emergency services dispatchers. It does so by allowing the call taker to quickly narrow down the caller's type of medical or trauma situation, so as to better dispatch emergency services, and provide quality instruction to the caller before help arrives.
Media related to Emergencies at Wikimedia Commons