Prevention

•     Public Health initiatives, infrastructure design, early weather warning systems, bushfire planning and proactive evacuations etc.

•     In the ED preparation consists of staff selection for involvement in the disaster response, training of staff including procedural skills, disaster specific tutorials, tabletop mock-disaster exercises (eg in Australia we have EmergoTrain, and others), and most importantly the ongoing maintenance of co-operative communications and relationships with other responder groups involved in a disaster response (eg  Displan Coordinators, ambulance, SES, Firefighters, police, volunteers, media section of your hospital)

• As the disaster unfolds, the diversion of usual ED and hospital functions will be determined by the expected number and severity of incoming casualties, and this requires a designated central coordinator who maintains communication with all relevant players within and outside the hospital
• Sending a doctor(s) to the site to enable early triage will enable hospital responses to be planned with more lead-time. Political inter-service issues often arise here, eg ambulance  vs firefighters for scene control authority.  Be Taoist: if there is an obstacle, work a way around it rather than wasting energy being upset.   

• Staff debriefing is best done by colleagues in an informal manner, eg beers at the pub.  Studies have shown that formal debriefing of casulaties and responders after disasters is associated with a worse outcome !
• Analysis of the disaster response itself is very valuable, as structural issues, decision errors, equipment problems, and overall appropriateness of resaource to requirement 'matching' can and should be done with a critical eye.