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JAMA Patient Page
August 7, 2013

Health Care Concerns After a Disaster

JAMA. 2013;310(5):550. doi:10.1001/jama.2013.3976

Disasters, whether natural or not, can occur at any time. Disasters often cause deaths and can injure hundreds or thousands of individuals in a short amount of time.

Injury, illness, and death can also occur in the aftermath of a disaster because normal services (like water, electricity, gas, communication systems, sewage treatment, and hospitals and other health care services, including emergency response teams) may be partially or completely disrupted.

Even in the face of the best planning, plans and systems can fail. You can take steps to protect yourself and your family in the event of a disaster. Preparing ahead of time may save your life if you have only a few minutes to evacuate your home or business. Knowing what to do after a disaster can help keep you safe and healthy even in the face of extreme hardship.

Effects of Disaster on Health Care Facilities

  • Hospitals are required to have disaster plans and to practice for events such as mass casualty situations.

  • Disaster preparedness includes preparing for possible medical problems such as treating injuries or avoiding illness, developing evacuation plans for hospitals, nursing homes, and other care facilities, and planning for the emergency care of large numbers of injured persons.

  • Because hospitals may be damaged or destroyed by a disaster and access to health care facilities may be cut off, physicians, nurses, and other personnel (including ambulance crews) may not be able to get to work or to the areas where injured persons are.

  • Emergency care may be given in alternate locations.

  • In extreme emergency situations, usual care standards may be waived, including stringency of medical record requirements. Electronic health record systems do not work in the event of a lengthy power outage, and emergency generators may not be able to function.


  • Make a disaster plan for you and your family. Many resources are available (online, in print, and via telephone) to help you put together a plan.

  • Every home should have a basic first aid kit that contains bandages, disinfectant, scissors, tape, tweezers, antibiotic ointment, and a first aid manual.

  • Keep mobile telephones and electronic devices charged.

  • Have plenty of supplies on hand, including a flashlight, batteries, candles, matches, toilet paper, trash bags, disinfectant wipes, and any medications you and your family may need.

  • Keep at least 3 days’ worth of food and water, enough for your entire family, in a safe place.

  • Prepare a pet emergency kit if you have pets.

  • Have some extra cash on hand.

  • Know where important documents are and have them ready to access quickly. These include birth certificates, proof of identity, insurance documents, deeds and titles, and health records.

  • Keep electronic copies of these documents in multiple, secure locations.

Keep Yourself Healthy

  • Following a disaster, boil water before drinking, brushing your teeth, or bathing. Water may be contaminated because water treatment may be affected by power outages or broken pipes.

  • Do not smoke or use an open flame if there is any chance of a gas leak.

  • Do not eat food from a refrigerator or freezer when the power has been off for more than 6 hours.

  • Do not wade through or swim in floodwaters. You can easily be swept away and drowned by the current. Floodwaters can contain trash and large debris, sewage, snakes, environmental pollutants (like oil and chemical products), and other harmful materials.

  • Do not stay in a home that is unsafe. During and after disasters, shelters are available through local government and aid agencies. Locations of these shelters can be found through news media and social media and by emergency notification methods.

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Article Information

Sources: American Red Cross, Federal Emergency Management Agency, Centers for Disease Control and Prevention

Topic: Public Health