This complimentary chapter from Fundamental Disaster Management aims to: describe the most likely settings from which affected adults or children will seek care in shelters during disasters, identify chronic and acute conditions for which advanced coordination is required to ensure that necessary infrastructure and medical equipment will be in place in case of a disaster, discuss specific care that shelters must be prepared to provide to patients with severe chronic conditions and those with implanted devices, cite examples of community plans for developing unique shelters for people with special healthcare needs, and explain how the plans incorporate incoming federal and state resources.
Given advances in technology and healthcare infrastructure, Americans, including those with disabilities, are living to an average age of 73 to 76 years, independently and away from family members to assist them. Recent disasters have shown that citizens who have functional or medical deficits or are frail or elderly, reliant on medical devices, or socially or economically disadvantaged require a high degree of assistance and are more likely to require hospitalization during and following a disaster. Meeting their medical needs during a disaster requires planning, preparation, and support. Every healthcare worker volunteering to assist in a shelter during a disaster will be faced with unexpected and unanticipated medical situations.
Critical care providers must be cognizant of the need to incorporate the unique critical/acute care requirements of special populations into their hospital’s and their community’s overall intensive care unit
(ICU) and emergency preparedness plans. By preparing in advance to meet the potential acute and maintenance needs of specific vulnerable populations, critical care providers will gain greater flexibility in managing the increased demands of a mass casualty incident. If victims’ existing medical conditions are not addressed in local shelters, many will come to the hospital for their acute care needs, further straining available resources.