3 June : Ten days workshop on “ROLE OF NURSES IN DISASTER MANAGEMENT” will be organized

from 3rd – 12th June 2010 in National Institute of Nursing Education, PGIMER, Chandigarh funded by
GOI, DGHS (Nursing Section), New Delhi for Development of Nursing Training of Nurses working in
different hospital and educational Institutes in North India. The Topic are as under:-

1. Disaster its causes and its effects

2. Policies, acts and administration set up of disaster management

3. Vulnerable population : women, children, elderly

4. Disaster preparedness: Do’s and Don’ts

5. Prevention and management of fire

6. Prevention and management of disaster due to climatic conditions: earth quake, floods, drought

7. Prevention and management of disaster due to blast or accidents and bio disaster

8. Disaster management : the first respondent

9. Preparation of hospital for disaster management

10. Coordinating all the systems during the disaster for assessing disaster impact, search, rescue,
first aid, field care, triage and termination of dead.

11. Resource generation and its management for managing disaster

12. Rumor management and providing right information through alternate means of communication

13. Managing effects of disaster through surveillance, disease control and nutrition

14. Rehabilitation of victims of disaster

15. Role of voluntary organizations and insurance companies in disaster management

16. Role of nurse in disaster management

17. Managing disaster by Police

18. Empowering general population for disaster management

Total 30 participants will be participating in the workshop

DISASTER MANAGEMENT:

Role of Community Health Nurse:

Can initiate or update disaster plans at workplace and community and ensure education, drill
participation

Knowledge of vulnerable populations, available community resources

Assessing and reporting of environmental hazards, unsafe equipment, faulty structures, disease
outbreaks, e.g., measles, flu

Before anything happens:

Prepare for Safety in a Disaster :

Four steps:

1. Find out what could happen to you:

Determine what types of disasters are most likely to happen

Learn about warning signals in community

Ask about care for pets

Review the disaster plans at workplace, and other places where families spend time together

Determine how to help the elderly or disabled

2. Create a disaster plan:

Discuss types of disasters that are likely to happen and review what to do

Pick 2 types of places to meet

Choose an out-of-state friend to contact

 Review evaluation

Plans

3. Complete this checklist:

Post emergency numbers next to phone

Teach how to call disaster emergency number-911

Determine when and how to turn of water, gas, and electricity

Check adequacy of insurance coverage

Locate and review use of fire extinguishers

Install and maintain smoke detectors

Conduct a home hazard hunt

Stock emergency supplies

CPR certification

Locate all escape route

Find safe spot

4: Practice and maintain your plan:

Review every 6 months.

Conduct drills

Replace stored water every 3 months and stored food every 6 months.

Test and recharge fire extinguisher

Test smoke detectors

Personal Preparedness:

Nurses who are disaster victims themselves and provide care to others will experience considerable
stress.

Stages: Preparedness, Response, and Recovery

Preparedness:

Know who is at risk, Personal, Professional and Community Preparedness

Personal Preparedness:

Entails plan for keeping oneself ready for disaster, both mentally and physically

Individuals not personally prepared will have less to give to family, community, job, and other
disaster victims

Nurses can be disaster victims- personal preparation needed to attend to patients

Checklist helpful to prepare

Professional Preparedness:

Requires nurses and other personnel to be aware of and understand the disaster plans at their
workplace and community- participate in mock drills

Adequately prepared nurses will function in leadership capacity and assist towards smoother
recovery phase

Fieldwork, shelter management requires creativeness and willingness

American Red Cross provides training for health professionals to adapt existing skills to disaster
setting

Community Preparedness:

Level of preparedness only as high as people/ organizations in the community make it.

Well-prepared communities have written disaster plans, conduct drills, have adequate warning
system, and backup evacuation plan

Office of Emergency Management- state/ county office coordinating regional plans

Understanding past disasters can influence planning for future, liabilities in resources
Response

The primary objective of disaster response is to minimize morbidity and mortality.

The level of disaster determines FEMA’s response.

Levels are not determined by the number of casualties but by the amount of resources needed.

FEMA Levels of Disaster Response:

Level III- a minor disaster, involves a minimal level of damage but could result in the president
declaring an emergency. A minimal request for federal help

Level II- moderate disaster- likely to result in major disaster being declared. Regional federal
resources engaged, other outside area may be called on

Level I- massive disaster, severe damage or multistate scope. Full engagement of federal regional
and national resources

Citizens and health professionals must be attached to official agencies with disaster management
responsibilities to avoid further risk

Levels of prevention r/t Disaster Management:

Primary Prevention

– Participate in developing a disaster management plan for the community

Secondary Prevention
– Assess disaster victims and triage for care

Tertiary Prevention

– Participate in home visits to uncover dangers that may cause additional injury to victim or cause
other problems (e.g. house fires from faulty wiring).

Population at Greatest Risk for Disruption After a Disaster:

Persons with disabilities

Persons living on a low income, including the homeless

Refugees

Persons living alone

Single-parent families

Persons new to the area

Institutionalized persons or those with chronic mental illness

Previous disaster victims or victims of traumatic events

People who are not citizens or legally documented immigrants

Substance abusers

The five components to a comprehensive public health response to outbreaks of illness are the
following:

-Detecting the outbreak

-Determining the cause

-Identifying factors that place people at risk

-Implementing measures to control the outbreak

-Informing the medical and public communities about treatments, health consequences, and
preventative measures

Triage: the process of separating casualties and allocating treatment on the basis of the victims’
potentials for survival.

Highest priority:

It is always given to victims who have life threatening injuries but who have a high probability of
survival once stabilized.

Clients with trauma, chest pain, severe respiratory distress or cardiac arrest, limb amputation, acute
neurological deficits, and those who sustained chemical splashes to the eyes are classified as
emergent and are the number 1 priority.

Second priority:

It is given to victims with injuries that have systemic complications that are not yet life threatening
and could wait 45 – 60 minutes for treatment.

Clients with conditions such as a simple fracture, asthma without respiratory distress, fever,
hypertension, abdominal pain, or the client with a renal stone have urgent needs and are classified
as number 2 priorities.

Last priority

It is given to those victims with local injuries without immediate complications and who can wait
several hours for medical attention.
Clients with conditions such as a minor laceration, sprain, or cold symptoms are classified as non
urgent and are the number 3 priority.

Older adult health risks

Nutrition, safety, social isolation, and depression

Disaster Nursing

Disaster nursing refers to nursing services offered to the victims of disaster who experiences trauma
caused by disaster Disaster produce several kinds of trauma.

a. Physical - Fractures, burns, injuries and infections.

b. Physiological - Shock and electrolyte imbalance

c. Psychological- Anxiety, depression, substance abuse, stress

reaction.

d. Socio-economic- Unemployment, Homelessness, Environmental

destruction, disorganization.

The Symptoms related to Trauma Produced by disaster usualfy occurs in Five Phases.

a. Impact Phase: It includes event iself and is characterized by shock, extreme

b. Heroic Phase: Characterized by co-operative spirit exist between friends, neighbour and
emergency teams. Constructive activity at this time can help to overcome feelings of anxiety and
depression.

c. The honeymoon phase: It begins to appear one week to several months after the disaster, the
need to help others is sustained, and the money, resources and support received from varying
agencies allow life to begin again in the community.

d. Disillusionment phase: It last from two months to one year._ A time of disappointment,
resentment, frustration and anger. Victims often begin to compare their neighbors with their own
and may start to resent or show hostility towards others.

e. Reconstruction and reorganization phase: In this individual recognize that they must adjust with
their own problems. They begin to rebuild their homes, business and lives in constructive fashion.
This ... period may last for year after the disaster.
Ø Nurse along with the health team needs to utilize primary health care intervention in acute
emergencies as follows:-

· Nursing Management

· Immunization and preventive health

· Management of diarrheas and dehydration.

· Management of acute respiratory infections.

· Setting up a health information system.

· Safe drinking water supply.

· Sanitation.

· Training and support for health workers.

· Other basic services.

In addition to above the following psychosocial intervention are provided by the nurses:

· Crises intervention / counseling

· Group work

· Telephone contact services.

· Disaster response managements

· Health education

· Community services like facilitation of self help groups etc.

Community measures in Disaster

Pre disaster phase, appropriate management of disaster requires advance planning. A nurse should
be the part of the team for disaster planning.

a. Community Participation: It is the process by which individuals, families and communities assume
the responsibility of promoting their own health and welfare. The community heath nurse maintains
the link between professional group pf experts in disaster management and community.

b. Mock trails/training: The training of various inter-disciplinary forces like school children, voluntary
organizations can be imparted by community health nurse and her team,

c. Mass awareness: The community should have the knowledge of all the Channel communication
system, stand by equipment supplies and other resources; otherwise disaster preparedness will be
failure.
d. Education: Mass awareness through media, booklets, panel discussion, films and televisions
information is very essential.

Basic community Education should incorporate the following essentials:

a. Setting up the first aid post

b. Causality evaluation

c. Basic hygiene and sanitation

d. Safety measures

e. Maintenance of food and water supply

f. Maintenance of law and order.

g. Provision of shelters

h. Rescue streaming

i. Significance of traffic control and communication

j. Use of fire services

k. Hazards of radiation and preventive measures

l. Prevention of future disasters.

m. Grant in aid

n. Rehabilitation

CONCLUSION

Disasters are of different types which can happen any time ,any where, in the world causing
tremendous after effects such as loss of human life ,economical imbalances, food scarecity
epidemics , forced relocation of population etc. Disasters usually affect the developing countries
comparing with the developed countries. While deserting the matter we could come to the
conclusion that the adverse effects of natural disasters can be minimized by proper preventive
measures alert technologies at high risk areas, proper mobilization of resources, decreased
corruption in the field and also the mock training programmes in the community.
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