Vincenzo Mauro Giaconella

Title: Ruck truck house plan (RTHP) and primary alternate contingency emergency (PACE) approach: Relevance and potential perspectives in nursing disaster management

Abstract

The RTHP terminology provides a standardized language for medical personnel and command elements to understand what level of care and equipment is feasible at a given location or stage of a mission. While originating in military medicine, the RTHP concept provides a valuable framework for civilian disaster preparedness and response, particularly in remote, rural, or austere settings where evacuation may be delayed (prolonged field care conditions). While the RTHP model is specific to military/remote operations for planning logistical needs, the principles of understanding resource availability and planning for different levels of care are relevant to any disaster preparedness and response plan. Overall, the RTHP system is an organizational and logistical tool that complements core nursing competencies in disaster scenarios, such as triage, assessment, and intervention, ensuring more effective planning for prolonged care in resource limited environments. Meanwhile, the planning and preparedness of the nurses involved in disaster management should also consider the Primary, Alternate, Contingency, and Emergency (PACE) plan as a methodology used to build resilient strategies (most commonly for communications) by establishing a sequence of backup options in case the primary method fails. For this reason, the Nursing Disaster Management could make use of this conceptual model to:

1.Assess and Plan Resources: Determine what medical supplies and equipment are available and how they change as patients are moved through different levels of care or evacuation.

2.Enhance Communication: Use the shared terminology to ensure clear communication with incident command, other responders, and logistics personnel regarding the limitations and capabilities of their current location.

3.Identify Gaps: Pinpoint deficiencies in capabilities at various stages (e.g., lack of specific monitoring equipment when moving from Truck to Plane stage) to improve disaster action plans and preparedness training.