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Concepts in Disaster Medicine

Definition and Functions of Health Unified Command and Emergency Operations Centers for Large-scale Bioevent Disasters Within the Existing ICS

Frederick M. Burkle Jr, MD, MPH, DTM, Edbert B. Hsu, MD, MPH, Michael Loehr, MRP, Michael D. Christian, MD, David Markenson, MD, Lewis Rubinson, MD, PhD and Frank L. Archer, MBBS, MEd, MPH

The incident command system provides an organizational structure at the agency, discipline, or jurisdiction level for effectively coordinating response and recovery efforts during most conventional disasters. This structure does not have the capacity or capability to manage the complexities of a large-scale health-related disaster, especially a pandemic, in which unprecedented decisions at every level (eg, surveillance, triage protocols, surge capacity, isolation, quarantine, health care staffing, deployment) are necessary to investigate, control, and prevent transmission of disease. Emerging concepts supporting a unified decision-making, coordination, and resource management system through a health-specific emergency operations center are addressed and the potential structure, function, roles, and responsibilities are described, including comparisons across countries with similar incident command systems.

Key Words: emergency operations center • incident command system • triage • surge capacity • biological • pandemics/epidemics




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