Disaster Nomenclature–A Functional Impact Approach: The PICE System

Authors

  • Kristi L. Koenig MD,

    Corresponding author
    1. Alameda County Medical Center; Highland General Hospital, Highland, CA. Department of Emergency Medicine
      Highland General Hospital, Direcror of Prehospital and Disaster Medicine, Department of Emergency Medicine, 1411 East 31st Street, Oakland, CA 94602. E-mail: kristik@hghed.com
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  • Norm Dinerman MD,

    1. Eastern Maine Medical Center; Emergency Services, Bangor; MN
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  • Alexander E. Kuehl MD, MPH

    1. Cornell MedicaI Center; Department of Surgery, Emergency Services, New York, NY
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Highland General Hospital, Direcror of Prehospital and Disaster Medicine, Department of Emergency Medicine, 1411 East 31st Street, Oakland, CA 94602. E-mail: kristik@hghed.com

ABSTRACT

A standard nomenclature that concisely describes any disaster is currently lacking. This article describes a model taxonomy system. Instead of the term “disaster,” a root word “PICE,”“potential injury-creating event,” is used. Descriptive modifiers to account for all possible scenarios surround this root word, as illustrated. inline image

A modifier is chosen from each column and a stage is assigned to each PICE. Column A describes the potential for additional casualties. Column B describes whether resources are overwhelmed and, if so, whether they must simply be augmented (disruptive) or they must first be reconstituted (paralytic). Column C describes the extent of geographic involvement. “Stage” refers strictly to the likelihood that outside medical assistance will be needed. Stage 0 means there is little chance, stage I means there is a small chance (place outside help on “alert”), stage II means there is a moderate chance (place on “standby”), and stage III means local medical resources are clearly overwhelmed (immediately dispatch outside resources, commit personnel, prepare remote hospitals). For example, a multiple vehicle crash in a large city would be a ”static, controlled, local PICE, stage 0.” In conclusion, a new nomenclature for describing disasters is reported. A short phrase describes the incident and communicates the need for outside assistance. The model may be useful for disaster planning, management, and research.

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