Although federal disaster preparedness plans include provisions of surge capacity through Disaster Medical Assistance Teams (DMATS) and other resources, extraordinary and often improvised measures were needed in New Orleans and in numerous shelters and points of refuge to cope with the scale of the displaced population.
Additionally, medical care capability requires significant surge capacity during disasters, with a critical feature of hospital staffed beds [ 4].
Both Australian and international organizations and PIC respondents have acknowledged that PICs can be easily stretched beyond their HRH capacity in times of disasters, requiring external assistance for surge capacity.
The recent ACCP statement on surge capacity in a disaster recommended that ICU capacity be increased by up to 200% above baseline capacity [25].
Secondly, for disaster resources, simply stockpiling materials fails to achieve adequate hospital surge capacity, especially in the aftermath of a catastrophic disaster.
This human resource shortage compounded the limited surge capacity of the hospitals during disasters.
A major benefit of EMEDS is that capability assigned to US bases, when not deployed overseas, provides a surge capacity within the US in the event of disaster.
It was noticed that in some key areas (e.g., safety evaluation, planning and cooperation, MOUs, personal protective equipment, rescue, surge capacity and drills), there was a difference in disaster resilience arrangements between tertiary A and tertiary B hospitals.
The ability to successfully and safely expand and maintain surge capacity will depend on the following: 1. Type of disaster 2. Number of critically injured casualties 3. Duration of the casualty-generating circumstance 4. Available infrastructure (including staffing, equipment, and drugs and other consumables) 5. Quantity and duration of the enhanced critical care provision that is required.
This article provides consensus suggestions for expanding critical care surge capacity and extension of critical care service capabilities in disasters or pandemics.
