EM Vivas · Disaster preparedness
Disaster preparedness — HICS, surge continuum and decontamination
Systems viva on preparedness planning.
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Target exams
ACEMFRCEMABEM
Prompt
As ED director you are asked how your department prepares for a chemical plant explosion with possible contamination. Discuss PICE, HICS, surge and decon.
Interpretation
Reveal interpretationShowHide
PICE classifies by functional impact. HICS structures command; IC never treats. Surge continuum: conventional → contingency → crisis standards of care. Decontamination zones hot/warm/cold with disrobing the critical first step; PPE; lockdown against contaminated self-presenters. Antidote caches and mutual aid pre-planned. Drill and after-action review.[1][2][8][9]
References4ShowHide
- [1]Koenig KL, Dinerman N, Kuehl AE. Disaster nomenclature — a functional impact approach: the PICE system. Academic Emergency Medicine, 1996.PMID 8816190
- [2]Hick JL, Hanfling D, Cantrill SV Allocating scarce resources in disasters: emergency department principles. Annals of Emergency Medicine, 2012.PMID 21855170
- [8]Jovan JD, Foggle J Implementation of the Hospital Incident Command System in response to the COVID-19 pandemic in the United States: a systematic review. Journal of Emergency Management, 2024.PMID 39545433
- [9]Alshaikh E, et al. Pediatric Decontamination Considerations in CBRN Events: A Scoping Review. Disaster Medicine and Public Health Preparedness, 2025.PMID 41321230