Emergency

An emergency is a situation which poses an "immediate risk" to health, life, property or environment. [cite web|title=UK Government Advice on Definition of an Emergency|url=http://www.ukresilience.info/upload/assets/www.ukresilience.info/15mayshortguide.pdf|accessdate=2007-05-30|format=PDF] Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative care for the aftermath.

Whilst some emergencies are self evident (such as a natural disaster which threatens many lives), many smaller incidents require the subjective opinion of an observer (or affected party) in order to decide whether it qualifies as an emergency.

The precise definition of an emergency, the agencies involved and the procedures used, vary by jurisdiction, and this is usually set by the government, whose agencies (emergency services) are responsible for emergency planning and management.

Defining an emergency

In order to be defined as an emergency, the incident should be one of the following:
* Immediately threatening to life, health, property or environment.
* Have already caused loss of life, health detriments, property damage or environmental damage
* Have a high probability of escalating to cause immediate danger to life, health, property or environmentFact|date=May 2007

Whilst most emergency services agree on protecting human health, life and property, the environmental impacts are not considered sufficiently important by some agenciesFact|date=May 2007. This also extends to areas such as animal welfare, where some emergency organisations cover this element through the 'property' definition, where animals which are owned by a person are threatened (although this does not cover wild animals). This means that some agencies will not mount an 'emergency' response where it endangers wild animals or environmentFact|date=May 2007, although others will respond to such incidents (such as oil spills at sea which pose a threat to marine life). The attitude of the agencies involved is likely to reflect the predominant opinion of the government of the area.

Types of emergency

Dangers to life

Many emergencies cause an immediate danger to the life of people involved. This can range from emergencies affecting a single person, such as the entire range of medical emergencies which include heart attacks, strokes and trauma, to incidents affecting large numbers of people such as natural disasters including hurricanes, floods or mudslides.

Most agencies consider these to be the highest priority of emergency, which follows the general school of thought that nothing is more important than human life. [cite web|url=http://www.ukresilience.info/upload/assets/www.ukresilience.info/emergresponse.pdf|title=UK Government document stating that life-saving activity is the highest priority in an emergency|accessdate=2007-05-30|format=PDF]

Dangers to health

Some emergencies are not immediately threatening to life, but might have serious implications for the continued health and well-being of a person or persons (although a health emergency can subsequently escalate to be threatening to life).

The causes of a 'health' emergency are often very similar to the causes of an emergency threatening to life, which includes medical emergencies and natural disasters, although the range of incidents which can be categorised here is far greater than those which cause a danger to life (such as broken limbs, which do not usually cause death, but immediate intervention is required if the person is to recover properly)

Dangers to property

Other emergencies do not threaten any people, but do threaten peoples' property. An example of this would be a fire in a warehouse which has been evacuated. The situation is treated as an emergency as the fire may spread to other buildings, or may cause sufficient damage to make the business unable to continue (affecting livelihood of the employees).

Many agencies categorise property emergency as the lowest priority, and may not take as many risks in dealing with it. For instance, firefighters are unlikely to enter a burning building which they know to be empty, as the risk is unjustified, whereas they are more likely to enter a building where people are reported as trapped.

Dangers to the environment

Some emergencies do not immediately endanger life, health or property, but do affect the natural environment and creatures living within it. Not all agencies consider this to be a genuine emergency, but it can have far reaching effects on animals and the long term condition of the land. Examples would include forest fires and marine oil spills.

ystems of classifying emergencies

Agencies across the world have different systems for classifying incidents, but all of them serve to help them allocate finite resource, by prioritising between different emergencies.Fact|date=May 2007

The first stage in any classification is likely to be defining whether the incident qualifies as an emergency, and consequently if it warrants an emergency response. Some agencies may still respond to non-emergency calls, depending on their remit and availability of resource. An example of this would be a fire department responding to help retrieve a cat from a tree, where no life, health or property is immediately at risk.

Following this, many agencies assign a sub-classification to the emergency, prioritising incidents which have the most potential for risk to life, health or property (in that order). For instance, many ambulance services use a system called the Advanced Medical Priority Dispatch System (AMPDS) or a similar solution. [cite web|url=http://www.tampagov.net/dept_fire/rescue_division/general_info/advanced_medical_priority_dispatch.asp|title=Tampa Fire Department EMS dispatch details|accessdate=2007-05-30] [cite web|url=http://www.londonambulance.nhs.uk/helpweoffer/help1.html|title=London Ambulance Service details of AMPDS use|accessdate=2007-05-30] The AMPDS categorises all calls to the ambulance service using it as either 'A' category (immediately life threatening), 'B' Category (immediately health threatening) or 'C' category (non-emergency call which still requires a response). Some services will now also have a fourth category, where they believe that no response is required after clinical questions are asked.

Another system for prioritizing medical calls is known as Emergency Medical Dispatch (EMD). [cite web|url=http://www.911dispatch.com/info/emd/index.html|title=EMD Resources|accessdate=2007-07-07] [cite web|url=http://health.utah.gov/ems/stdseval/training/emd_curriculum_trainee.pdf|title=EMD Training Guide|publisher=Utah Bureau of Emergency Medical Services|month=January | year=2005|accessdate=2007-07-07|format=PDF] Jurisdictions that use EMD typically assign a code of "alpha" (low priority), "bravo" (medium priority), "charlie" (requiring advanced life support), delta (high priority, requiring advanced life support) or "echo" (maximum possible priority, e.g., witnessed cardiac arrests) to each inbound request for service; these codes are then used to determine the appropriate level of response. [cite web|url=http://www.dhss.delaware.gov/dhss/dph/ems/files/demsocreport2005.txt|title=DEMSOC Annual Report - 2005|publisher=Delaware Emergency Medical Services Oversight Council|year=2005|accessdate=2007-07-08] [cite web|url=http://www.emergencydispatch.org/JOURNAL/articles/UsingECHO.html|title=Using the ECHO Determinant|author=Brian Dale|accessdate=2007-07-08] [cite web|url=http://www.emergencydispatch.org/articles/themostofEMS.htm|title=EMD: Making the Most of EMS|author=Jeff J. Clawson|accessdate=2007-07-08]

Other systems (especially as regards major incidents) use objective measures to direct resource. Two such systems are CHALET and ETHANE, [cite web|url=http://www.patient.co.uk/showdoc/40001331|title=Patient Plus reference to CHALET and ETHANE systems|accessdate=2007-05-30] which are both mnemonics to help emergency services staff classify incidents, and direct resource. [cite web|url=http://www.leslp.gov.uk/firstoff.htm|title=London Emergency planning committee use of CHALET|accessdate=2007-05-30] Each of these acronyms helps ascertain the number of casualties (usually including the number of dead and number of non-injured people involved), how the incident has occurred, and what emergency services are required.

Agencies involved in dealing with emergencies

Most developed countries have a number of emergency services operating within them, whose purpose is to provide assistance in dealing with any emergency which may occur. They are often government operated, paid for from tax revenue as a public service, but in some cases, they may be private companies, responding to emergencies in return for payment, or they may be voluntary organisations, providing the assistance from funds raised from donations.

Most developed countries operate three core emergency servicesFact|date=May 2007 which are:

* Police – who deal with security of person and property, which can cover all three categories of emergency. They may also deal with punishment of those who cause an emergency through their actions.
* Fire service – who deal with potentially harmful fires, but also often rescue operations such as dealing with road traffic collisions. Their actions help to prevent loss of life, damage to health and damage to or loss of property.
* Emergency medical service (Ambulance service) – These services attempt to reduce loss of life or damage to health. This service is likely to be decisive in attempts to prevent loss of life and damage to health.

In some countries or regions, two or more of these services may be provided by the same agency [cite web|url=http://www.nyc.gov/html/fdny/html/home2.shtml|title=New York City Fire Department is the largest combined Fire and EMS service in the United States|accessdate=2007-05-30] (e.g. the fire service providing emergency medical cover), and under different conditions (e.g. publicly funded fire service and police, but a private ambulance service)

There may also be a number of secondary emergency services, which may be a part of one of the core agencies, or may be separate entities who assist the main agencies. This can include services providing specialist rescue (such as mountain rescue [cite web|url=http://www.mra.org/|title=Mountain Rescue Association (US)|accessdate=2007-05-30] or mine rescue [cite web|url=http://www.usmra.com/|title=United States Mine Rescue Association|accessdate=2007-05-30] ), bomb disposal [cite web|url=http://www.army.mod.uk/royalengineers/careers/specialist/bombdisposal.htm|title=British Army Bomb Disposal Engineer Career Page|accessdate=2007-05-30] or search and rescue [cite web|url=http://www.mcga.gov.uk/c4mca/mcga-hmcg_rescue/coastguard_operations/maritme_search_and_rescue_assets.htm|title=Maritime Search and Rescue Agencies in the UK (at the MCA)|accessdate=2007-05-30] [cite web|url=http://www.canis-uk.net/|title=CANIS specialist search dog charity in the UK|accessdate=2007-05-30] [cite web|url=http://essexsearchandrescue.org.uk/modules/news/|title=Search and Rescue service in Essex, UK|accessdate=2007-05-30] .

The Military and the Amateur Radio Emergency Service (ARES) help in large emergencies such as a disaster or major civil unrest.

Summoning emergency services

Most countries have an emergency telephone number, also known as the universal emergency number, which can be used to summon the emergency services to any incident. This number varies from country to country (and in some cases by region within a country), but in most cases, they are in a short number format, such as 911 (United States) [cite web|url=http://www.nena.org/|title=US National Emergency Number Association|accessdate=2007-05-30] , 999 (United Kingdom) [cite web|url=http://www.fire.org.uk/advice/999history.htm|title=History of the 999 System|accessdate=2007-05-30] [cite web|url=http://www.met.police.uk/999/index.htm|title=Metropolitan Police advice on using 999|accessdate=2007-05-30] , 112 (Europe) [cite web|url=http://www.ofcom.org.uk/static/archive/Oftel/publications/ind_guidelines/emer1002.htm|title=UK government advice on the use of 112 alongside 999|accessdate=2007-05-30] cite web|url=http://ec.europa.eu/environment/civil/pdfdocs/112surv-2001.pdf|title=European Commission document on the Implementation of the Single 112 emergency number|accessdate=2007-05-30|format=PDF] and 000 (Australia). [cite web|url=http://emergencycalls.aca.gov.au/|title=Australian Government Advice on Emergency Calls|accessdate=2007-05-30]

The majority of mobile phones will also dial the emergency services, even if the phone keyboard is locked, or if the phone has an expired or missing SIM card, although the provision of this service varies by country and network.

Civil emergency services

In addition to those services provided specifically for emergencies, there may be a number of agencies who provide an emergency service as an incidental part of their normal 'day job' provision. This can include public utility workers, such as in provision of electricity or gas, who may be required to respond quickly, as both utilities have a large potential to cause danger to life, health and property if there is an infrastructure failure. [cite web|url=http://www.nationalgrid.com/uk/Gas/Safety/Emergency|title=UK National Gas Emergency Number|accessdate=2007-05-30] [cite web|url=http://www.dti.gov.uk/files/file33246.pdf|title=UK Government Gas and Electricity National Emergency Plan|accessdate=2007-05-30|format=PDF]

Emergency action principles (EAP)

Emergency action principles are the key 'rules' which guide the actions of rescuers and potential rescuers. Because of the inherent nature of emergencies, no two are likely to be the same, so emergency action principles help to guide rescuers at incidents, by sticking to some basic tenets.

The adherence to (and contents of) the principles by would be rescuers varies widely based on the training the people involved in emergency have received, the support available from emergency services (and the time it will take to arrive) and the emergency itself.

Key emergency principle

The key principle taught in almost all systems is that the rescuer, be they a lay person or a professional, should assess the situation for danger. [cite web|url=http://www.hse.gov.uk/pubns/indg347.pdf|title=UK Health and Safety Executive publication on dealing with emergencies - Danger assessment is the first point|accessdate=2007-05-30|format=PDF] [cite web|url=http://www.sja.org.uk/sja/first-aid-advice/life-saving-procedures/primary-survey.aspx|title=St John Ambulance UK Primary Assessment guide|accessdate=2007-05-30]

The reason that an assessment for danger is given such high priority is that it is core to emergency management that rescuers do not become secondary victims of any incident, as this creates a further emergency that must be dealt with.

A typical assessment for danger would involve observation of the surroundings, starting with the cause of the accident (e.g. a falling object) and expanding outwards to include any situational hazards (e.g. fast moving traffic) and history or secondary information given by witnesses, bystanders or the emergency services (e.g. an attacker still waiting nearby).

Once a primary danger assessment has been complete, this should not end the system of checking for danger, but should inform all other parts of the process.

If at any time the risk from any hazard poses a significant danger (as a factor of likelihood and seriousness) to the rescuer, they should consider whether they should approach the scene (or leave the scene if appropriate).

Managing an emergency

There are many protocols which the emergency services use in dealing with an emergency, which usually start with planning before an emergency occurs. One commonly used system for demonstrating the phases is shown here on the right.

The planning phase starts at preparedness, where the agencies decide on how they will respond to a given incident or set of circumstances. This should ideally include lines of command and control, and division of activities between agencies. This avoids potentially negative situations such as three separate agencies all starting an official rest centre for victims of a disaster.

Following an emergency occurring, the agencies then move to a response phase, where they execute their plans, and may end up improvising some areas of their response (due to gaps in the planning phase, which are inevitable due to the individual nature of most incidents).

Agencies may then be involved in recovery following the incident, where they assist in the clear up from the incident, or help the people involved overcome their mental trauma.

The final phase in the circle is mitigation which involves taking steps to ensure that no re-occurrence is possible, or putting additional plans in place to ensure less damage is done. This should feed back in to the preparedness stage, with updated plans in place to deal with future emergencies, thus completing the circle.

tate of emergency

In the event of a major incident, such as civil unrest or a major disaster, many governments maintain the right to declare a state of emergency, [cite web|url=http://www.publications.parliament.uk/pa/ld200304/ldbills/077/04077.12-18.html|title=UK Government Civil Contingencies Act, giving powers to declare a state of emergency|accessdate=2007-05-30] which gives them extensive powers over the daily lives of their citizens, and may include temporary curtailment on certain civil rights, including the right to trial (for instance to discourage looting of an evacuated area, a shoot on sight policy may be in force)

Personal emergencies

Some people undergo incidents which cause them to believe they are in an emergency situation. However, it does not pose a risk to their life, physical health or property. In some instances, people may feel that they are entitled to or deserve an emergency response from agencies they come in to contact with, which is a view that may or may not be shared by the agency.

Some of these cases may be genuine emergencies if they threaten the mental health and well-being of the person involved, but many agencies do not recognise this as valid. This is more likely to be dealt with by social services or a physician than by the traditional emergency service agencies.

See also

* Certified first responder
* Emergency medical technician
* First aid
* Emergency Response Information Network
* Emergency response unit (SWAT)
* Maritime emergency
* Medical emergency
* ARES

References