This chapter focuses on the essential elements of an immediate post-disaster assessment and treatment plan for emergency physicians (EPs). The increasing frequency and impact of natural disasters combined with the ever-present threat of terrorism make the management of disaster victims an essential skill for the EP. Dissociation in disaster victims can be difficult to distinguish from delirium due to medical causes. After ruling out any serious medical issues which require stabilization, the focus should shift to assessing the degree of traumatic exposure and individual risk factors for adverse psychiatric outcomes. The concept of acute psychiatric care for victims of trauma is derived from the experience of military psychiatrists in handling traumatized soldiers. Various clinical trials have examined the role of propranolol in traumatic memory consolidation and as a potential agent for post-traumatic stress disorder (PTSD) prevention in traumatized emergency department (ED) patients.