NP1 - 5 items question concepts

DISASTER NURSING

Introduction

Disaster is an occurrence arising with little or no warning, which causes serious disruption of life and
perhaps death or injury to large number of people.

It is may be a man made or natural event that causes destruction and devastation which cannot be
relieved without assistance.

Types of disaster

1. Natural. Eg : earthquake, floods, hurricane, tsunami.

2. Manmade.Eg: nuclear accidents, industrial accidents

3. Hybrid Eg: spread of disease in community, global warming.

Levels of disaster

A. Level iii disaster – considered a minor disaster. These are involves minimal level of damage

B. Level ii disaster- considered a moderate disaster. The local and community resources has to be
mobilized to manage this situation

C. Level i disaster- considered a massive disaster- this involves a massive level of damage with severe
impact.
I. Disaster mitigation

Disaster mitigation refers to actions or measures that can either prevent the occurrence of a disaster or
reduce the severity of its effects. (American Red Cross).

Mitigation activities include awareness and education and disaster prevention measures.

Phases of disaster management

1. Prevention phase （ lumabas to tanong is ano daw 1st phase)

2. Preparedness phase

3. Response phase

4. Recovery phase

I. Prevention phase

Identify community risk factors and to develop and implement programs to prevent disasters from
occurring.

II. Preparedness phase

Personal preparedness

Professional preparedness

Key organizations and professionals in disaster management

Health care community

HospitalsHealth professionalsPharmaciesPublic health departmentsRescue personnel

Non-health care community

Fire fightersMunicipal or government officialsMediaMedical examinersMedical supply

manufacturesPolice

Community preparedness

The level of community preparedness for a disaster is only as high as the people and organization in the
community make it.

Community must have adequate warning system and a back up evaluation plan to remove people from
the area of danger

III. Response phase

The level of disaster varies and the management plans mainly based on the severity or extent of the
disaster.

IV. Recovery phase

During this phase actions are taken to repair, rebuilt, or reallocate damaged homes and businesses and
restore health and economic vitality to the community.

Psychological recovery must be addressed.Both victims and relief workers should be offered mental
health activities and services.
Disaster management cycle

Prevention ------> preparedness

I v

Recovery <--------- response

Disaster management plans

Aims of disaster plans

☆ to provide prompt and effective medical care to the maximum possible in order to minimize
morbidity and mortality

Objectives

☆ To optimally prepare the staff and institutional resources for effective performance in disaster
situation

☆ To make the community aware of the sequential steps that could be taken at individual and
organizational levels

Disaster management committee

The following members would comprise the disaster management committee under the chairmanship
of medical superintendent/ director

Medical superintendent/ director

Additional medical superintendent

Nursing superintendent/ chief nursing officer

Chief medical officer (casualty)

Head of departments- surgery, medicine, orthopedics, radiology, anesthesiology, neurosurgery

Blood bank in charge

Security officers

Transport officer

Sanitary personnel

Disaster control room

the existing casualty may be referred as the disaster control room.

Rapid response team

The medical superintendent will identify various specialists, nurses and pharmacological staff to respond
within a short notice depending up on the time and type of disaster.

The list of members and their telephone numbers should be displayed in the disaster control room.

Information and communication

the disaster control team would be responsible for collecting, coordinating and disseminating the
information about the disaster situation to the all concerned.

Disaster beds

Requirement of beds depends up on the magnitude of the disaster.

Utilization of vacant beds, day care beds, and pre-operative beds

Convalescing patients, elective surgical cases and patients who can have domiciliary care or opd
management should be discharged

Utility areas to be converted in to temporary wards such as wards with side rooms, corridors, seminar
rooms etc.

Creating additional bed capacity by using trolleys, folding beds and floor beds

Logistic support system

Resuscitation equipments

Iv sets, iv fluids,

Disposable needles, syringes and gloves

Dressing and suturing materials and splints

Oxygen masks, nasal catheters, suction machine and suction catheters

Ecg monitors, defibrillators, ventilators

Cut down sets, tracheostomy sets and lumbar puncture sets

Linen and blankets

Keys of these cupboards should be readily available at the time of disaster

Training and drills

Mock exercise and drills at regular intervals are conducted to ensure that all the staff in the general and
those associated with management of causalities are fully prepared and aware of their responsibilities.

Elements of disaster plan

A disaster plan should have the following elements

Chain of authority

Lines of communication

Routes and modes of transport

Mobilization

Warning

Evacuation

Rescue and recovery

Triage

Treatment

Support of victims and families

Care of dead bodies

Disaster worker rehabilitation

Activation of disaster management plans

Standard operating procedures (SOPs)

Reception area

Triage

Priority one- needing immediate resuscitation, after emergency treatment shifted to intensive care unit

Priority two- immediate surgery, transferred immediately to operation theatre.

Priority three- needing first aid and possible surgery- give first aid and admit if bed is available or shift to
hospital

Priority four- needing only first aid-discharge after first aid.

Documentation
Public relations.

Essential services.

Crowd management/ security arrangement.

Disaster management- nurse’s role in community

Assess the community

Assessment - the local climate conducive for disaster occurrence, past history of disasters in the
community, available community disaster plans and resources, personnel available in the community for
the disaster plans and management, local agencies and organizations involved in the disaster
management activities, availability of health care facilities in the community etc.

Diagnose community disaster threats

Determine the actual and potential disaster threats (eg; explosions, mass accidents, tornados, floods,
earthquakes etc).

Community disaster planning

Develop a disaster plan to prevent or deal with identified disaster threats

Identify local community communication system

Identify disaster personnel, including private and professional volunteers, local emergency personnel,
agencies and resources
Identify regional back up agencies and personnel

Identify specific responsibilities for various personnel involved in the disaster plans

Set up an emergency medical system and chain for activation

Identify location and accessibility of equipment and supplies

Check proper functioning of emergency equipments

Identify outdated supplies and replenish for appropriate use.

Implement disaster plans

Focus on primary prevention activities to prevent occurrence of manmade disasters

Practice community disaster plans with all personnel carrying out their previously identified
responsibilities (eg: emergency triage , providing supplies such as food, water, medicine, crises and grief
counseling)

Practice using equipment; obtaining and distributing supplies

Evaluate effectiveness of disaster plan

Critically evaluate all aspects of disaster plans and practice drills for speed, effectiveness, gaps and
revisions.

Evaluate the disaster impact on community and surrounding regions

Evaluate the response of personnel involved in disaster relief efforts.

Conclusion

Disaster is an emergency situation, therefore coordination of actions and various departments is an

essential requisite for efficient management of mass casualties.