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FAR EASTERN UNIVERITY

INSTITUTE OF NURSING
SY 11-12 1 SEMESTER EMERGENCY DISASTER NURSING OUTLINE DAYS 3 and 4 I. INTRODUCTION TO DISASTER NURSING Definition of Terms (a) Disaster any destructive events that disrupts the normal functioning of the community. ecologic disruptions or emergencies, of severity and magnitude that results in deaths, injuries, illness and property damage that cannot be effectively manage using routine procedures or resources and that require outside assistance (Landesman et al.,2001). Noji (1997) describes disaster quite simply as events that require extraordinary efforts beyond those needed to respond to everyday emergencies. (b) Disaster Nursing The adaptation of Professional Nursing KNOWLEDGE, Skills and ATTITUDE in recognizing and MEETING the nursing and MEDICAL NEEDS of DISASTER VICTIMS (c) 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. (d) Disaster Management
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Component of Disaster Debris Building Debris Household Debris Vegetative Debris Problem Waste Streams Declaration of a Disaster 10 or more people reported killed 100 people reported affected A call for international assistance Declaration of state emergency Patterns of Mortality and Morbidity Mortality Disaster events that involve water are the most significant in terms of mortality Floods, storm surges, and tsunamis all have a higher proportion of deaths relative to injuries Earthquakes and events associated with high winds tend to exhibit more injuries than deaths, as in Haiti The risk of injury and death is much higher in developing countries at least 10 times higher because of little preparedness, poorer infrastructure. Principles of Disaster

A collaborative term used to encompass all activities undertaken in anticipation of the occurrence of a potentially disastrous event, including prepareness and long term risk reduction measures

BASIC PRINCIPLES IN PLANNING FOR DISASTER NURSING D- isseminate information on the prevention and control of environmental Hazards I-nterpret health laws and regulations S- erve yourself of self-survival A-ccepts directions and take orders from an organized authority S- erve the best of the MOST T- each the meaning of warning signals E- xercise leadership R- efer to appropriate agencies BASIC PRINCIPLES OF NURSING CARE for DISASTER VICTIMS A-daptation of Skills to Situation are for Disaster Victims C-ontinuous Awareness of the patients condition T- each AUXILLARY personnel S-election of Essential Care
Nursing Importance of Disaster Nursing Roles of Nurses in Disaster Determine magnitude of the event Define health needs of the affected groups Establish priorities and objectives Identify actual and potential public health problems

General Considerations in Disaster Problems Issues and Challenges during a Disaster Need for relevant and stronger legal and policy framework for disaster management Paradigm shift from disaster management to disaster risk management? Minimum basic needs vis--vis DM and Risk Reduction Coordination issue Disaster risk reduction viewed as as an expensive investment Program and Financial Sustainability

Determine resources needed to respond to the needs identified Collaborate with other professional disciplines, governmental and non-governmental agencies Maintain a unified chain of command Communication

II. TYPES OF DISASTER 1. Natural (those cause by natural or environmental forces); result of an ecological disruption or threats that exceeds the adjustment capacity of the affected community by W.H.O. Includes earthquakes, floods, tornadoes, hurricanes, volcanic eruptions, ice storms, tsunamis and other geologic and meteorological phenomena. 2. Man-made (human generated); are those in which the principal direct causes are identifiable human actions, and deliberate or otherwise by Noji, 1996. Includes biological and biochemical terrorism, chemical spills, radiological (nuclear) events, fire, explosions, transportation accidents, armed conflicts and acts of war. a. Complex emergencies involve situation where population suffers significant casualties. b. Technologic disaster large number of people, property, community infrastructure and economic welfare are directly and adversely affected by major industrial accidents; unplanned released of nuclear energy; and fires or explosions from hazardous substance such as fuel, chemical or nuclear materials (Noji, 1996). c. Disaster that are not caused by natural hazards but occurs in human settlements 3. Hybrid spread of disease in community, global warming. III. PHASES OF DISASTER Pre-Event Phase Lessen the impact of a disaster before it strikes Activities that reduce or eliminate a hazard Prevention Risk reduction Examples Immunization programs Public education

Planning and Prevention Event Phase Activities undertaken to handle a disaster when it strikes. Activities that are taken to build capacity and identify resources that may be used Know evacuation shelters Emergency communication plan Preventive measures to prevent spread of disease Public Education The Medical Response Post Event Phase Search and rescue, clearing debris, and feeding and sheltering victims (and responders if necessary). Activities a hospital, healthcare system, or public health agency take immediately before, during, and after a disaster or emergency occurs Restoration Phase Getting a community back to its predisaster status Activities undertaken by a community and its components after an emergency or disaster to restore minimum services and move towards longterm restoration. Debris Removal Care and Shelter Damage Assessments Funding Assistance IV. LEVELS OF DISASTER Level I Disaster considered a massive disaster- this involves a massive level of damage with severe impact. Level II Disaster considered a moderate disaster. The local and community resources has to be mobilized to manage this situation Level III Disaster considered a minor disaster. These are involves minimal level of damage

V. DISASTER HAZARDS, RISKS AND VULNERABILITY Hazards rare or extreme event in the natural or manmade environment that adversely affect human life, property or activity to the extent of causing disaster Risks Vulnerability Extent to which the community, structure, service or geographic area is likely to be damaged or disrupted by the impact of a particular hazard

Assessment Disaster Prevention Measures

VI. DISASTER AND HEALTH VII. DISASTER PLANNING Aims of Disaster Planning

to provide prompt and effective medical care to the maximum possible in order to minimize morbidity and mortality Objectives of Disaster Planning 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 Types of Disaster Planning a. Agent specific approach focus their preparedness activities on the most likely threats to occur based on their geographic location. b. All-hazards approach is a conceptual model for disaster preparedness that incorporates disaster management components that are consistent across all major types of disaster events to maximize resources, expenditures and planning efforts. Challenges to Disaster Planning 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 Components of Disaster Planning 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 Disaster Plan Activities Activation of Disaster Plan Standard operating procedures (SOPs) Reception area Triage

Priority one- needing immediate resuscitation, after emergency treatment shifted to intensive care unit o Priority two- immediate surgery, transferred immediately to operation theatre. o Priority three- needing first aid and possible surgery- give first aid and admit if bed is available or shift to hospital o Priority four- needing only first aid-discharge after first aid. Documentation Public relations. Essential services. Crowd management/ security arrangement.

VIII. DISASTER NURSING MANAGEMENT Goals of Disaster Management Features of a Disaster Management Phases of Disaster Management 1. Prevention phase 2. Preparedness phase 3. Response phase 4. Recovery phase Prevention phase Identify community risk factors and to develop and implement programs to prevent disasters from occurring.

Preparedness phase Personal preparedness Professional preparedness

Key organizations and professionals in disaster management Health care community Hospitals Health professionals Pharmacies Public health departments Rescue personnel

Non-health care community Fire fighters Municipal or government officials Media Medical examiners Medical supply manufactures Police

Community preparedness

Nurses Role in Community Disaster


Assess the community

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

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

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

Disaster Management Cycle Prevention Recovery preparedness response

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.

Disaster Management Framework Displacement of Disaster Victims

Implement disaster plans

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Mass Shelters Shelter management: Organized team (chain) Sleeping area and necessities Water and food handling Sanitation (toilets, showers,..) Special care to children and elderly Health services (physical, mental)

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.

IX. HOSPITAL DISASTER Define Hospital Disaster Hospital Emergency Incident Command System Disaster Preparedness Guidelines HEICS Attributes Hospital Disaster Planning Define Hospital Disaster Planning Goals and Key Concepts Key Components of Hospital Disaster Planning Phases of Hospital Disaster Planning Nurses Role in Hospital Disaster

X. DISASTER TRIAGE vs. HOSPITAL TRIAGE

XI. DISASTER RECOVERY PLAN Define Disaster Recovery Importance of Disaster Recovery Plan Disaster Recovery Plan Activities

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