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Editorial
. 2008 May 1:8:7.
doi: 10.1186/1471-227X-8-7.

The current crisis in emergency care and the impact on disaster preparedness

Robert A Cherry  1 , Marcia Trainer
Affiliations
Editorial

The current crisis in emergency care and the impact on disaster preparedness

Robert A Cherry et al. BMC Emerg Med. .

Abstract

Background: The Homeland Security Act (HSA) of 2002 provided for the designation of a critical infrastructure protection program. This ultimately led to the designation of emergency services as a targeted critical infrastructure. In the context of an evolving crisis in hospital-based emergency care, the extent to which federal funding has addressed disaster preparedness will be examined.

Discussion: After 9/11, federal plans, procedures and benchmarks were mandated to assure a unified, comprehensive disaster response, ranging from local to federal activation of resources. Nevertheless, insufficient federal funding has contributed to a long-standing counter-trend which has eroded emergency medical care. The causes are complex and multifactorial, but they have converged to present a severely overburdened system that regularly exceeds emergency capacity and capabilities. This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk. Federal funding has not sufficiently prioritized the improvements necessary for an emergency care infrastructure that is critical for an all hazards response to disaster and terrorist emergencies.

Summary: Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care. Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

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Figures

Figure 1
Figure 1
History of federal funding for trauma EMS [24, 25].
Figure 2
Figure 2
Trends relating to ED/trauma treatment during period of federal elimination 1995–2000.
See this image and copyright information in PMC

References

    1. Homeland Security Act of Public Law 107-296, 107th Congress, November 25, 2002 http://www.ise.gov/docs/hsa.pdf Accessed December 1, 2007.
    1. Homeland Security Presidential Directive-7 (HSPD-7), The White House, December 13, 2007 http://www.whitehouse.gov/news/releases/2003/12/20031217-5.html Accessed December 1, 2007.
    1. Jenkins WO. Testimony before the Little Hoover Commission, State of California – emergency preparedness and response: some issues and challenges associated with major emergency incidents GAO-06-467T. 2006.
    1. US Department of Homeland Security (DHS) Emergencies & Disasters, National Response Plan http://www.dhs.gov/dhspublic/display?theme=14&content+4264 Accessed November 3, 2007.
    1. Department of Homeland Security. National Response Framework http://www.dhs.gov/xprepresp/committees/editorial_0566.shtm Accessed April 17, 2008.

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