Appendix III: Glossary of Terms Commonly Used in Disaster Preparedness and Response Download PDF Permissions Share Share this chapter Copy link Share via email Share via: Close table of contents chapter information Contents Table of Contents Dedication Contributors Reviewers Foreword by Frederick M. Burkle, Jr., MD, MPH, DTM, PhD(Hon.), FAAP, FACEP Foreword by Patricia M. Davidson, PhD, MED, RN, FAAN Foreword by Loretta C. Ford, RN, PNP, EdD Preface How to Use This Book Editor’s Note Section I: Disaster Preparedness 1: Essentials of Disaster Planning 2: Leadership and Coordination in Disaster Healthcare Systems: The U.S. National Preparedness System 3: Hospital and Emergency Department Preparedness 4: Emergency Health Services in Disasters and Public Health Emergencies 5: Emergency Medical Consequence Planning for Special Events, Mass Gatherings, and Mass Casualty Incidents 6: Legal and Ethical Issues in Disaster Response Section II: Disaster Mental Health and High-Vulnerability Populations 7: Identifying and Accommodating High-Risk, High-Vulnerability Populations in Disasters 8: Human Services in Disasters and Public Health Emergencies: Social Disruption, Individual Empowerment, and Community Resilience 9: Understanding The Psychosocial Impact of Disasters 10: Management of the Psychosocial Effects of Disasters 11: Unique Needs of Children During Disasters and Other Public Health Emergencies 12: Disaster Nursing in Schools and Other Community Congregate Child Care Settings 13: Care of the Pregnant Woman and Newborn Following a Disaster Section III: Global Disasters and Complex Human Emergencies 14: Disaster Nursing and the United Nations 2015 Landmark Agreements—a Vital Force for Change in The Field of Disaster Nursing 15: Complex Humanitarian Emergencies 16: Nursing in Disasters, Catastrophes, and Complex Humanitarian Emergencies Worldwide 17: Natural Disasters 18: Environmental Disasters and Emergencies 19: Restoring Public Health Under Disaster Conditions: Basic Sanitation, Water and Food Supply, and Shelter 20: The Role of the Public Health Nurse in Disaster Response 21: Climate Change and Health: The Nurse’s Role in Policy and Practice Section IV: Disaster Response 22: Disaster Triage 23: Disaster Management 24: Public Health Emergencies Involving Community Violence and Civil Unrest: Taking Planned Action 25: Management of Burn Mass Casualty Incidents 26: Traumatic Injury Due to Explosives and Blast Effects 27: Caring for Patients With HIV Following a Disaster Section V: Disaster Caused by Chemical, Biological, and Radiological Agents 28: Biological and Chemical Terrorism: A Unique Threat 29: Chemical Agents of Concern 30: Biological Agents of Concern 31: Surveillance Systems for Detection of Biological Events 32: Infectious Disease Emergencies 33: Medical Countermeasures Dispensing 34: Radiological Incidents and Emergencies 35: Decontamination and Personal Protective Equipment Section VI: Special Topics in Disasters 36: U.S. National Disaster Nurse Readiness: Practice and Education for a Prepared Workforce 37: American Red Cross Disaster Health Services and Disaster Nursing: National Capability—Local Community Impact 38: Directions for Disaster Nursing Research and Development 39: Improving Children’s Health Outcomes Through Pediatric Disaster Research and Policy 40: Information Technology in Disaster Management Epilogue: Disaster Recovery: Creating Healthy, Resilient, and Sustainable Communities After Disasters Appendix I: At-A-Glance: Capability Definitions, Functions, and Associated Performance Measures Appendix II: Sequence for Putting on Personal Protective Equipment Appendix III: Glossary of Terms Commonly Used in Disaster Preparedness and Response Appendix IV: Creating a Personal Disaster Plan Appendix V: CDC’s Public Health Emergency Preparedness Program: Every Response is Local Appendix VI: Radiation Infographics DOI: 10.1891/9780826144225.ap04 advanced life support A medical procedure performed by paramedics that includes the advanced diagnosis and protocol-driven treatment of a patient in the field. aftershocks A sequence of smaller earthquakes that follow larger magnitude earthquakes; aftershocks may be felt for many months after an earthquake and can exacerbate damage; also a type of ground failure. alarm procedure A means of alerting concerned parties to a disaster; various optical and acoustical means of alarm are possible including flags, lights, sirens, radio, and telephone. analysis-epidemiological measures Indicators such as descriptive statistics, specific disease and/or death rates, secular trends, and tests for sensitivity and validity. assessments The evaluation and interpretation of short- and long-term measurements to provide a basis for decision making and to enhance public health officials’ ability to monitor disaster situations. assets A term used for all resources required, including human, to adequately respond to a disaster. avalanche The sudden slide of a huge mass of snow and ice, usually carrying with it earth, rocks, trees, and other debris. basic life support Noninvasive measures used to treat unstable patients, such as extraction of airway obstructions, cardiopulmonary resuscitation, care of wounds and hemorrhages, and immobilization of fractures. becquerel (bq) A unit of nuclear activity (e.g., 1 Bq represents the amount of radioactive substance that disintegrates in 1 sec); this unit replaces the curie. bioterrorism The unlawful release of biological agents or toxins with the intent to intimidate or coerce a government or civilian population to further political or social objectives; humans, animals, and plants are often targets. branch An organizational level that has functional or geographical responsibility for major parts of the incident command system (ICS) or incident operations (the incident commander may establish geographical branches to resolve span-of-control issues, or functional branches to manage specific functions [e.g., law enforcement, fire, and emergency medical]; a branch is managed by the Branch Director). case One (unit) documented incidence of disease. case definition Standardized criteria for deciding whether a person has a particular disease or health-related condition; often used in investigations and for comparing potential cases; case definitions help decide which disaster-specific conditions should be monitored with emergency information surveillance systems. case management The collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual’s health needs. casualty Any person suffering physical and/or psychological damage that leads to death, injury, or material loss. casualty clearing station A collecting point for victims that is located in the immediate vicinity of a disaster site where triage and medical treatment can be provided. central holding area A location from which ambulances leave to pick up patients from the casualty clearing station, or deliver patients to neighboring hospitals according to a victim distribution plan. community emergency response team (cert) The CERT program supports local response capability by training volunteers to organize themselves and spontaneous volunteers at the disaster site, to provide immediate assistance to victims and to collect disaster intelligence to support responders’ efforts when they arrive. community profile The characteristics of the local environment that are prone to a chemical or nuclear accident (these characteristics can include population density; age distribution; number of roadways, railways, and waterways; type of buildings; and local relief agencies). comprehensive emergency management A broad style of emergency management, encompassing prevention, preparedness, response, and recovery. concept A view or idea persons hold about something, ranging from something highly concrete to something highly consequence management An emergency management function that includes measures to protect public health and safety, restore essential government services, and provide emergency relief to governments in the event of terrorism. (Consequence management responses are managed by the Federal Emergency Management Agency [FEMA] and use protocols established under the National Response Plan. Consequence management efforts can also include support missions as described in other federal operations plans, such as predictive modeling, protective action recommendations, and mass decontamination.) contamination An accidental release of hazardous chemicals or nuclear materials that pollute the environment and place humans at risk. contingency plan An emergency plan developed in expectation of a disaster; often based on risk assessments, the availability of human and material resources, community preparedness, and local and international response capabilities. coordination A systematic exchange of information among principal participants to carry out a unified response in the event of an emergency. covert releases (of a biological agent) An unannounced release of a biological agent that causes illness (detection of a biological agent is dependent on traditional surveillance methods; if undetected, a covert release of a contagion has the potential to spread widely before it is detected). crisis management Administrative measures that identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve a threat to public health and safety (e.g., terrorism). data collection Gathering, assembling, and delivering data to a centralized collection point. decontamination The removal of hazardous chemicals or nuclear substances from the skin and/or mucus membranes by showering or washing the affected area with water or by rinsing with a sterile solution. disaster Any event, typically occurring suddenly, that causes damage, ecological disruption, loss of human life, deterioration of health and health services, and which exceeds the capacity of the affected community on a scale sufficient to require outside assistance. These events can be caused by nature, equipment malfunction, human error, or biological hazards and disease (e.g., earthquake, flood, fire, hurricane, cyclone, typhoon, significant storms, volcanic eruptions, spills, air crashes, drought, epidemic, food shortages, and civil strife). disaster case management The formal process of org-anizing and providing a timely, coordinated approach to assess disaster-related needs including healthcare, mental health, and human services needs that were caused or exacerbated by the event and may adversely impact an individual’s recovery if not addressed. disaster continuum or emergency management cycle The life cycle of a disaster or emergency. disaster epidemiology The study of disaster-related deaths, illnesses, and injuries in humans; also includes the study of the factors and determinants that affect death, illness, and injury following a disaster. (Methodology involves identifying and comparing risk factors among disaster victims to those who were left unharmed. Epidemiological investigations provide public health professionals with information on the probable public health consequences of disasters.) disaster field office (dfo) The office established in or near the disaster area that supports federal and state response as well as recovery operations. The DFO houses the Federal Coordinating Officer (FCO), the Emergency Response Team (ERT), the State Coordinating Officer (SCO), and support staff. Often referred to as the Joint Field Office (JFO/JOC) when shared by multiple agencies. disaster informatics The theoretical and practical operation of processing information and communicating in a disaster situation. disaster severity scale A scale that classifies disasters by the following parameters: the radius of the disaster site, the number of dead, the number of wounded, the average severity of the injuries sustained, the impact time, and the rescue time. disaster vulnerability A measure of the ability of a community to absorb the effects of a severe disaster and to recover; vulnerability varies with each disaster, depending on the disaster’s impact on the affected population or group. disaster-prone The level of risk that is related to the hazard or the immediate cause of a disaster, which is determined by analyzing the history of past events as well as new conditions that may increase the risk of a disaster taking place. dispatch communications system A system used to assign ambulance personnel and other first responders. division The organizational level that has responsibility for operations within a defined geographical area (the division level is the organizational level between single resources, task forces, or strike teams and the branch level). emergency Any natural or man-made situation that results in severe injury, harm, or loss of humans or property. emergency management agency (ema) Also referred to as the Office of Emergency Preparedness (OEP); the EMA, under the authority of the governor’s office, coordinates the efforts of the state’s health department, housing and social service agencies, and public safety agencies (e.g., state police) during an emergency or disaster; the EMA also coordinates federal resources made available to the states, such as the National Guard, the Centers for Disease Control and Prevention (e.g., Epidemic Intelligence Service officers), and the Public Health Service (e.g., Agency for Toxic Substances Disease Registry [ATSDR]). emergency medical services (ems) system The coordination of the prehospital system (e.g., public access, dispatch, emergency medical technicians and medics, ambulance services) and the inhospital system (e.g., emergency departments, hospitals, and other definitive care facilities and personnel) to provide emergency medical care. emergency medical technicians (emts) and paramedics (emt-ps) Trained emergency medical respondents (both paramedics and EMTs are trained to diagnose and treat most common medical emergencies in the field and to provide medical treatment while en route to the hospital; paramedics are more highly trained than EMTs). emergency operations center (eoc) The location where departmental heads, governmental officials, and volunteer agencies coordinate the response to an emergency. emergency public information Information disseminated to the public in anticipation of an emergency that continues for the duration of the emergency; emergency public information directs actions and gives instructions. emergency response team A team of federal personnel and support staff that is deployed by FEMA during a major disaster or emergency; the duty of the team is to assist the FCO in carrying out his or her responsibilities under the Stafford Act; team members consist of representatives from each federal department or agency that has been assigned primary responsibility for an emergency support function (ESF) as well as key members of the FCO’s staff. emergency support function (esf) A functional area of response activity established to coordinate the delivery of federal assistance during the response phase of an emergency. (ESF’s mission is to save lives, protect property, preserve public health, and maintain public safety; ESF represents the type of federal assistance most needed by states overwhelmed by the impact of a catastrophic event on local and state resources.) enhanced fujita scale Updated scale using a set of wind estimates (not measurements) based on damage occurring from a tornado. epidemic The occurrence of any known or suspected contagion that occurs in clear excess of normal expectancy (a threatened epidemic occurs when the circumstances are such that a disease may reasonably be anticipated to occur in excess of normal expectancy). esf-6 mass care Mass Care includes sheltering and feeding victims of disaster, emergency first aid, family reunification, and the distribution of emergency relief supplies; the American Red Cross (ARC) is designated by the National Response Plan (NRP) as the primary agency responsible for ESF Mass Care. esf-8 health and medical Led by the U.S. Public Health Service’s OEP, ESF-8 Health and Medical serves as the basis for federal response to the health needs of disaster victims. evacuation An organized removal of civilians from a dangerous or potentially dangerous area. evaluation A detailed review of a disaster relief program designed to determine whether program objectives were met, to assess the program’s impact on the community, and to generate lessons learned for the design of future projects (evaluations are most often conducted at the completion of important milestones, or at the end of a specified period). evaluation research The application of scientific methods to assess the effectiveness of programs, services, or organizations established to improve a patient’s health or prevent illness. exposure surveillance To look for exposure to risk (in a disaster setting, exposure may be based on the physical or environmental properties of the disaster event; also known as a “risk factor variable,” “predictor variable,” or “independent variable”). exposure variable A characteristic of interest; also known as “risk factor” or “predictor variable.” famine early warning system A system established by the U.S. Agency for International Development to monitor a number of factors that are predictive of famine including climate, availability of food, and nutrition-related morbidity. federal coordinating officer (fco) The person appointed by FEMA following a presidential declaration of a severe disaster or of an emergency to coordinate federal assistance. (The FCO initiates immediate action to ensure that federal assistance is provided in accordance with the disaster declaration, any applicable laws or regulations, and the FEMA–state agreement. The FCO is also the senior federal official appointed in accordance with the provisions of Public Law No. 93–288, as amended [the Stafford Act], to coordinate the overall consequence management response and recovery activities. The FCO represents the president as provided by Section 303 of the Stafford Act by coordinating the administration of federal relief activities in the designated disaster area. Additionally, the FCO is delegated responsibilities and performs those for the FEMA director as outlined in Executive Order 12148 and those responsibilities delegated to the FEMA regional director in the Code of Federal Regulations, Title 44, Part 205.) federal on-scene commander (osc) The official designated upon the activation of the Joint Operations Center who ensures appropriate coordination of the U.S. government’s overall response with federal, state, and local authorities; the OSC maintains this role until the U.S. Attorney General transfers the Lead Federal Agency (LFA) role to FEMA. first responder Local police, fire, and emergency medical personnel who arrive first on the scene of an incident and take action to save lives, protect property, and meet basic human needs. fujita scale A scale used to measure the strength of tornadoes. functional model of public health response in disasters A model for identifying what disaster-related activities are the responsibility of public health officials; this model also identifies the interface between the core components of professional public health training and emergency management functions, as well as the relationship between the framework of activities typically conducted by the emergency management community and public health practice. golden hour A principle that states that unstable victims must be stabilized within 1 hour following injury to reduce the risk of death. group The organizational level that has responsibility for a specified functional assignment in an emergency or disaster (e.g., perimeter control, evacuation, fire suppression; a group is managed by a group supervisor). hazard The probability that a disaster will occur (hazards can be caused by a natural phenomenon [e.g., earthquake, tropical cyclone], by failure of man-made energy sources [e.g., nuclear reactor, industrial explosion], or by an uncontrolled human activity [e.g., conflict, overgrazing]). hazard identification/analysis The process of determining what events are likely to occur in a specified region or environment (e.g., earthquakes, floods, industrial accidents). hazard surveillance An assessment of the occurrence, distribution, and secular trends relating to different levels of hazards (e.g., toxic chemical agents, physical agents, biomechanical stressors, and biological agents) that are responsible for disease and injury. impact phase A phase during a disaster when emergency management activities focus on warning and preparedness. incident action plan (iap) A written document, developed by the incident commander or the planning section of the ICS, that details which actions will be conducted by the ICS in response to an incident. (IAPs are developed for a specific time period, often referred to as “operational periods,” and are based on the specific needs of an incident. The incident commander is responsible for the oversight and implementation of the IAP.) incident command system (ics) The model for the command, control, and coordination of a response to an emergency; provides the means to coordinate the efforts of individual agencies. integrated communications A system that uses a common communications plan, standard operating procedures, clear text, common frequencies, and common terminology. integrated recovery programs (irps) Versatile recovery programs that respond to a variety of community needs. (IRPs often coordinate recovery activities and stimulate economic rehabilitation by working with various sectors of the community. For example, IRPs may include work schemes to repair community facilities that enable disaster victims to access cash and replace their lost possessions.) intensity A roman numerical index from I to XII that describes the physical effects of an earthquake to a specific area. (These values are subjective. Intensity is a measurement of the nature and spatial extent of the distribution of damage. The most commonly used scale is the 12-point Modified Mercalli Intensity [MMI]. An earthquake has many intensities [perceived effects], but only one magnitude [force]. The MMI does not indicate an earthquake’s magnitude.) international assistance Assistance provided by one or more governments or voluntary organizations to a country in need, usually for development or for an emergency. joint information center (jic) A center located at the scene of an emergency established to coordinate federal public information; it is also the central point of contact for all news media; public information officials from participating state and local agencies often collocate here. joint operations center (joc) The JOC acts as the focal point for the management and direction of on-site activities, coordination and establishment of state requirements and priorities, as well as the coordination of the federal response; JOCs are established by the LFA and are under the operational control of the federal on-scene coordinator. landslide A massive or rapid descent of damage-causing soil and rock (landslides are the most common and widespread type of ground failure and may include falls, topples, slides, spreads, and flows of soil and/or rock on unstable slopes). latrines A pit designed to capture and contain excreta; most often trenches with multiple platforms across them, or solitary pits surrounded by a structure. ld50 The amount of a substance (the lethal dose) that results in the death of 50% of the subjects who are exposed to it. lead agency The federal department or agency that is assigned the lead responsibility under U.S. law for the management and coordination of the federal response in a specific functional area (lead agencies support the LFA during all phases of the response). lead federal agency (lfa) The agency designed by the president to lead and coordinate the federal response. (The type of emergency determines which agency becomes the LFA. In general, the LFA establishes operational procedures to assemble and work with the cooperating agencies to provide the LFA with support. These agencies support the LFA in carrying out the president’s policy by furnishing the LFA with an initial assessment of the situation, developing action plans, monitoring and updating operational priorities, and ensuring that each agency exercises its authority within the boundaries of the law. Specific responsibilities of an LFA vary according to each agency’s statutory authority.) liaison An agency official who works with individual agencies or agency officials to coordinate interagency communications. liquefaction Occurs primarily in young, shallow, loosely compacted, water-saturated sand and gravel deposits that are subjected to ground shaking; it results in a temporary loss of load-bearing strength. local government Any county, city, village, town, district, political subdivision of any state, Indian tribe or authorized tribal organization, or Alaskan native village or organization, including rural communities, unincorporated towns and villages, or any other public entity. loss A range of adverse consequences that can impact communities and individuals (e.g., damage, loss of economic value, loss of function, loss of natural resources, loss of ecological systems, environmental impact, health deterioration, mortality, morbidity). magnitude A numerical quantity invented by Charles F. Richter that determines the size and scope of an earthquake by using a measure called a Richter. (The magnitude of an earthquake is the total amount of energy released after adjusting for differences in epicentral distance and focal depth. Magnitude is determined on the basis of instrumental records, whereas intensity is determined by subjective observations of an earthquake’s damage. Moderate earthquakes have magnitudes of 5.5 to 6.9; larger earthquakes have magnitudes of 7.0 to 7.9; and strong earthquakes have magnitudes of 8.0 and greater. The energy of an earthquake increases exponentially with magnitude. For example, a magnitude 6.0 earthquake releases 31.5 times more energy than a magnitude 5.0 earthquake or approximately 1,000 times more energy than a magnitude 4.0 earthquake.) man-made or human-generated disasters; complex emergencies Technological events that are caused by humans and occur in human settlements (e.g., fire, chemical spills and explosions, and armed conflict). maslow’s theory of human motivation and hierarchy of basic needs Proposes a hierarchical structure for human needs, from physiological drives to needs for safety, belonging, love, esteem, and self-actualization at the top of the pyramid. maximum contaminant level (mcl) The maximum permissible level of a contaminant in water in a public water system. The MCL is established by the Environmental Protection Agency (EPA). MCLs are defined in the Safe Drinking Water Act as the level that may be achieved with the use of the best available technology, treatment techniques (TTs), and other means that the EPA finds are available after taking cost into consideration. measures of biological effects A gauge of health in humans that indicates the impact of a disaster (examples include laboratory typing of organisms where infectious disease outbreaks occur, biochemical testing of exposures to toxic chemicals to assess exposure levels, and anthropometric measurements [e.g., height-to-weight ratio] that indicate the type and degree of malnutrition in famine situations). measures of physical effects to indicate magnitude An assessment of environmental conditions whose levels are negatively impacted because of a disaster (e.g., the height of river above flood stage, the level of pollutants in air after a forest fire, and the level of toxic chemicals in drinking water or sediment). measuring environmental hazards Assessing the occurrence, distribution, and the secular trends that affect the level of hazards (e.g., toxic culture agents, physical agents, biomechanical stressors, biological agents) responsible for disease and injury. medical coordination The coordination between healthcare providers during the transition from the prehospital to the hospital phase of patient care; simplification and standardization of materials and methods are a prerequisite. mitigation Measures taken to reduce the harmful effects of a disaster by attempting to limit the disaster’s impact on human health and economic infrastructure. modified mercalli scale A scale that indicates the intensity of an earthquake by assessing the degree of damage on a particular location. monitoring A process of evaluating the performance of response and recovery programs by measuring a program’s outcomes against stated objectives (monitoring is used to identify bottlenecks and obstacles that cause delays or programmatic shortfalls that require assessment). mortality data Information about the number of deaths used to assess the magnitude of a disaster, evaluate the effectiveness of disaster preparedness, evaluate the adequacy of warning systems, and aid contingency planning by identifying high-risk groups. national health security strategy (nhss) 2018 The purpose of the NHSS was to refocus the patchwork of disparate public health and medical preparedness, response, and recovery strategies to ensure that the nation is prepared for, protected from, and resilient in the face of health threats or incidents with potentially negative health consequences. It is the first comprehensive strategy focusing specifically on protecting people’s health in the case of a large-scale incident that puts health and well-being at risk. It contains two goals: build community resilience; and strengthen and sustain health and emergency response systems. These overarching goals are supported by 10 detailed strategic objectives, such as developing and maintaining the workforce needed for national health security; and ensuring timely and effective communication. national incident management system Provides a template for incident management regardless of size, scope, or cause. The template includes a core set of concepts, doctrines, principles, organizational processes, and terminology. It standardizes emergency management, personnel and resource management procedures, promoting coordination during planning and response. There are five interrelated components: preparedness, communications and information management, resource management; command and control; and ongoing management and maintenance. national preparedness goal Describes the core capabilities required for each of the five mission areas: prevention, protection, mitigation, response, and recovery. national response framework (nrf) Enacted in January 2008, supersedes the National Response Plan and serves as a guide to how the nation conducts comprehensive incident response using an all-hazards approach to respond to natural and man-made disasters. Built on its predecessor, it includes guiding principles that detail how federal, state, local, tribal, and private sector partners, including the healthcare sector, prepare for and provide a unified domestic response through improved coordination and integration. (The NRF is designed to address the consequences of any disaster or emergency situation in which there is need for federal assistance under the authorities of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121 et seq. The NRF includes 15 ESFs, each of which has a designated coordinator and primary agency and supporting agencies. The NRF works hand in hand with the National Incident Management System and incorporates the tenets of the ICS. natural disasters Natural phenomena with acute onset and profound effects (e.g., earthquakes, floods, cyclones, tornadoes). natural-technological (na-tech) disasters Natural disasters that create technological emergencies, such as urban fires that result from seismic motion, or chemical spills that result from floods. on-scene coordinator (osc) The federal official predesignated by the EPA and U.S. Coast Guard to coordinate and direct the response and removals of oil or hazardous materials under the National Oil and Hazardous Substances Pollution Contingency Plan. outcome surveillance To look for a health outcome or health event of interest, usually illness, injury, or death; also known as the “response variable,” “dependent variable,” or “effect variable” (e.g., the ARC/Centers for Disease Control and Prevention’s Health Impact Surveillance System records mortality in disaster events in which the ARC has served). outcome variable A health event, usually encompassing illness, injury, or death; also known as a “response variable.” overt release An announced release of a biological agent, by terrorists or others; this type of release allows for treatment before the onset of disease. pandemic and all-hazards preparedness act Originally passed in 2006, this law amended the Public Health Service Act to require the secretary of Health and Human Services (HHS) to lead all federal public health and medical responses to public health emergencies. Included in this legislation were many requirements to improve the ability of the nation to respond to a public health or medical disaster or emergency, such as the creation of the office of the assistant secretary for Preparedness and Response (ASPR) and the requirement to establish a near–real-time electronic nationwide public health situational awareness capability to enhance early detection of, rapid response to, and management of potentially catastrophic infectious disease outbreaks and other public health emergencies. phases of the emergency planning model The model is composed of five phases, each corresponding to a type of activity involved in preparing for and responding to a disaster; the phases include planning (preparedness), mitigation, response, recovery, and evaluation. planning To work cooperatively with others in advance of a disaster to initiate prevention and preparedness activities. postdisaster surveillance Observations conducted by health authorities after a disaster to monitor health events, detect sudden changes in disease occurrence, follow long-term trends of specific diseases, identify changes in agents and host factors for the diseases of interest, and detect changes in health practices for treating disease. postimpact phase The period of time after a disaster event; often associated with the activities of response and recovery. preimpact phase The period of time before a disaster strikes; often associated with mitigation and prevention activities. preparedness All measures and policies taken before an event occurs that allow for prevention, mitigation, and readiness. (Preparedness includes designing warning systems, planning for evacuation and relocation, storing food and water, building temporary shelter, devising management strategies, and holding disaster drills and exercises. Contingency planning is also included in preparedness as well as planning for postimpact response and recovery.) presidential policy directive 8 (ppd-8) Issued in March 2011, this directed the development of a national preparedness goal that identifies core capabilities as well as a national preparedness system to guide preparedness for the threats that pose the greatest risk to the security of the nation (Department of Homeland Security). These threats include both natural and man-made incidents such as terrorism, cyberattacks, pandemics, and catastrophic natural disasters. prevention Primary, secondary, and tertiary efforts that help avert an emergency; these activities are commonly referred to as “mitigation” in the emergency management model (e.g., prevention activities include cloud seeding to stimulate rain in a fire; in public health terms, prevention refers to actions that prevent the onset or deterioration of disease, disability, and injury). primary prevention Preventing the occurrence of death, injury, or illness in a disaster (e.g., evacuation of a community in a flood-prone area, sensitizing warning systems for tornadoes and severe storms). public access system An emergency telephone system by which the public notifies authorities of a medical emergency; accessed by dialing 911. public health surveillance The systematic collection, analysis, and interpretation of the health data that are used to plan, implement, and evaluate public health programs; also used to determine the need for public health action. public information officer The official at headquarters or in the field responsible for preparing, coordinating, and disseminating public information; he/she relies on the cooperation of federal, state, and local agencies. radiation Energy emitted by atoms that are unstable radiation with enough energy to create ion pairs in matter. radio bands A collection of neighboring radio frequencies; frequencies are allocated on different bands; each two-way radio is designed for a specific band (a radio designed to work on one band will not work on another band). radioactive contamination The presence of radiation-emitting substances (radioactive materials) in a place where it is not desired. rapid needs assessment A collection of techniques (i.e., epidemiological, statistical, anthropological) designed to provide information about an affected community’s needs following a disaster. readiness Links preparedness to relief; an assessment of readiness reflects the current capacity and capabilities of the organizations involved in relief activities. recovery Actions of responders, government, and the victims that help return an affected community to normal by stimulating community cohesiveness and governmental involvement. (One type of recovery involves repairing infrastructure, damaged buildings, and critical facilities. The recovery period falls between the onset of the emergency and the reconstruction period.) recovery plan A plan to restore areas affected by disaster; developed on a state-by-state basis with assistance from responding federal agencies. red cross (also known as the “American Red Cross” or the “International Red Cross”) A comprehensive designation used for all or one of the components of the International Red Cross and Red Crescent Movement, a worldwide organization active in humanitarian work. (This organization has three components: The International Committee of the Red Cross [ICRC], which acts primarily as a neutral intermediary during armed conflict and includes the Guardian of the Geneva Conventions, an advocate for the protection of war victims; the League of the Red Cross and Red Crescent Societies [LRCS]; an international federation of the National Societies, active in nonconflict disasters and natural calamities; and the National Red Cross or Red Crescent Society, a worldwide relief organization specific to individual countries.) regional operations center (roc) Temporary operations facility used in the coordination of federal response and recovery activities; located at the FEMA Regional Office (or at the Federal Regional Center) and led by the FEMA regional director or deputy regional director until the Disaster Field Office becomes operational. rehabilitation or reconstruction A long-term developmental project that follows a disaster or emergency that reconstructs a community’s infrastructure to preexisting levels; is often associated with an opportunity to improve a community rather than to simply “reconstruct” a preexisting system. relief Action focused on saving lives. (Relief activities often include search and rescue missions, first aid, and restoration of emergency communications and transportation systems. Relief also includes attention to the immediate care of survivors by providing food, clothing, medical treatment, and emotional care.) report format The instrument on which surveillance data are reported. reporting unit for surveillance The data source that provides information for the surveillance system. (Reporting units often include hospitals, clinics, health posts, and mobile health units. Epidemiologists select reporting units after they define “what a case is” because the source of data is dependent on that definition.) representativeness The accuracy of the data when measuring the occurrence of a health event over time and its distribution by person and place. resource management A management style that maximizes the use of and control over assets; this management style reduces the need for unnecessary communications, provides for strict accountability, and ensures the safety of personnel. response The phase in a disaster when relief, recovery, and rehabilitation occur; also includes the delivery of services, the management of activities and programs designed to address the immediate and short-term effects of an emergency or disaster. richter scale A scale that indicates the magnitude of an earthquake by providing a measure of the total energy released from the source of the quake; the source of an earthquake is the segment of the fault that has slipped. risk as a function of hazard and vulnerability A relationship that is frequently illustrated with the following formula, although the association is not strictly arithmetic: Risk equals Hazard times Vulnerability. risk assessment A systematic process that determines the likelihood of adverse health effects to a population after exposure to a hazard; health consequences may depend on the type of hazard and damage to infrastructure, loss of economic value, loss of function, loss of natural resources, loss of ecological systems, environmental impacts, deterioration of health, mortality, and morbidity. (The major components of a risk assessment include a hazard identification analysis and a vulnerability analysis that answer the following questions: What are the hazards that could affect a community? What can happen as a result of those hazards? How likely is each of the possible outcomes? When the possible outcomes occur, what are the likely consequences and losses? Risk assessment is a fundamental planning tool for disaster management, especially during prevention and mitigation activities.) risk indicator Descriptor that denotes risks that may cause a disaster. risk management The process of deciding which action to take when a risk assessment indicates that a danger of loss exists. (Risk management includes a range of actions [e.g., prevention, mitigation, preparedness, recovery] that are designed to mitigate an increasing risk of natural and technological hazards, decrease a risk to existing levels, and plan ways to respond to natural and technological hazards as well as catastrophic events.) saffir – simpson wind scale A scale used to measure strength of hurricanes; now revised and updated to establish a more accurate measurement and basis for comparison of hurricane wind. secondary prevention Mitigates the health consequences of disasters. (Examples include the use of carbon monoxide detectors when operating gasoline-powered generators after the loss of electric power, employing appropriate occupant behavior in multistory structures during earthquakes, and building “safe rooms” in dwellings located in tornado-prone areas. Secondary prevention may be instituted when disasters are imminent.) size-up/assessment To identify a problem and assess the potential consequences. (Initially, a size-up is the responsibility of the first officer to arrive at the scene of an emergency. Size-ups continue throughout the response phase and continuously update the status of the incident, evaluate the hazards present, and determine the size of the affected area as well as whether the area can be isolated. A size-up also determines if a staging area will be needed and where it should be located to allow for the best flow of personnel and equipment.) span of control The number of individuals managed by a single supervisor (the manageable span of control for one supervisor ranges from three to seven individuals, with five as optimum). staging area An area where resources are kept while awaiting assignment. state coordinating officer An official designated by the governor of an affected state upon the declaration of a major disaster or emergency to coordinate state and local disaster assistance efforts with those of the federal government and to act in cooperation with the FCO to administer disaster recovery efforts. stockpile An area or storehouse where medicine and other supplies are kept in the event of an emergency. stress Physical, mental, or emotional strain or tension. strike team A group of resources of the same size and type (e.g., five patrol units, three drug K-9 teams). supply management program (suma) A computer system that sorts and classifies supplies to prepare inventories of relief supplies that are sent to disaster-stricken countries (developed by the Pan American Health Organization). surveillance The ongoing and systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice; systems are designed to disseminate data in a timely manner and often include both data collection and disease monitoring. table-top exercise Method of evaluation of a disaster preparedness plan. task force A combination of single resources that is assembled for a particular operational need with common communications and one leader. technological hazard A potential threat to human welfare caused by technological factors (e.g., chemical release, nuclear accident, dam failure; earthquakes and other natural hazards can trigger technological hazards as well). tertiary prevention The minimization of the effects of disease and disability among those with preexisting health conditions. (Tertiary prevention shields persons with health conditions from negative health effects relating to a disaster. Examples of tertiary prevention include protecting persons with respiratory illnesses and those prone to respiratory conditions from the haze and smoke that originates from forest fires, and sheltering elderly who are prone to heat illnesses during episodes of extreme ambient temperatures.) theory A set of interrelated constructs (concepts), definitions, and propositions that present a systematic view of phenomena by specifying relations among variables, with the purpose of explaining and predicting the phenomena. timeliness How quickly information or surveillance data can be made available. top–down A command function that is established by the first officer to arrive on the scene, who then becomes the incident commander. toxicological disaster A serious environmental pollutant that causes illness by a massive, accidental escape of toxic substances into the air, soil, or water; these disasters affect humans, animals, and plants. toxin A substance capable of causing a harmful effect. treatment technique (tt) An enforceable procedure or level of technological performance that public water systems must follow to ensure control of a water contaminant. (When there is no reliable method that is economically and technically feasible to measure contaminants at particularly low concentrations, a TT is set rather than a MCL. An example of a TT rule is the surface water treatment rule, which includes disinfection and filtration.) unity of command A hierarchical methodology that states that each person within an organization should report to only one superior. victim distribution A victim distribution plan defines the transport distribution of victims among neighboring hospitals according to their hospital treatment capacity; these plans often avoid taking victims to the nearest hospital because walking victims will overcrowd hospitals closest to the disaster site. voluntary agency (volag) A nonprofit, nongovernmental, private association maintained and supported by voluntary contributions that provides assistance in emergencies and disasters. vulnerability The susceptibility of a population to a specific type of event; it is also associated with the degree of possible or potential loss from a risk that results from a hazard at a given intensity. (The factors that influence vulnerability include demographics, the age and resilience of the environment, technology, social differentiation, and diversity as well as regional and global economics politics.) vulnerability analysis The assessment of an exposed population’s susceptibility to the adverse health effects of a particular hazard. warning and forecasting Monitoring events to determine the time, location, and severity of a disaster. weapons of mass destruction (wmd) Any device, material, or substance used in a manner, in a quantity or type, or under circumstances evidencing an intent to cause death or serious injury to persons or significant damage to property.