Disaster nursing and role of nurse in disaster management

disaster, definition,causes and types of disaster,principles of disaster, phases and management and team members, supplies during disaster, emergency care and role of nurse.

1. DISASTER MANAGEMENT BY CH. ANTHONAMMA

2. DISASTER NURSING

3. Definition Disaster means any occurance that causes damage, ecological destruction, loss of human life or detereoration of health and health services on a scale sufficient to warrant an extra ordinary response from outside the affected community area. (WHO , 1995)

4. Disaster is a catastrophe causing injury or illness simultaneously to at least 30 people who will require hospital emergency treatment. A disaster is any human made or natural event that causes destruction and devastation that can’t be relieved without assistance.

5. Causes and types of disaster

6. Causes and Types of disaster Natural disaster – It is a consequence when a natural hazard affects humun ; Due to violence of nature. Eg -earthquake. Man-made – Disaster caused by human action, negligence,error or involving the failure of a system are called man-made disaster.

7. Natural disasters Natural phenomena beneath earth’s surface; Earthquake Tsunamis Volcanic eruptions Natural phenomena at earth’s surface; Landslide Avalanches

8. Natural disasters (cont….) Meterological / hydrological phenomena Wind storms, cyclones, typhoon, hurricane. Tornadoes Hailstorms and snow storms Sea surges Floods droughts Biological phenomena Locust Epidemics of disease

9. Man made disasters Caused by warfare (intentional) Conventional warfare Nuclear, biological and chemical warfare Caused by accidents (unintentional) Vehicular Plane crash, ship wreck Train and car accidents Collapse of building Explosion Fires Biological Chemical poisoning

10. Principles of disaster management Prevent the disaster ; Prevent the occurrence of disaster whenever possible. Minimize casualties ; Minimize the number of casualties if the disaster cannot be prevented. Prevent further casualties ; Prevent further casualties after the initial impact of disaster. The impact of many disasters are followed by unstable situations which are dangerous to life and can be more dangerous than the original disaster. Rescue the victims ; Removal of victims to safety.

11. Principles of disaster management First aid ; Provide first aid to the injured; prompt first aid must be initiated to prevent further damage /trauma and to prevent complications. Evacuate ; Evacuate the injured to the hospital or health care center; the victims are to be transported carefully and as quickly as possible to the nearby hospital or health care center to initiate medical management as soon as possible.

12. Principles of disaster management Medical care ; Provide definite medical care; efficient handling of a large number casualties depends upon training of doctors and nurses and to disaster preparedness of the concerned institution. However health professionals should be trained to improvise, where necessary with whatever available resources, so as to provide as effective and efficient care to the disaster victims as possible.

13. Team, Guidelines, protocols, Equipments and Resources

14. Co-ordinated response of emergency services The individuals are responsible for maintaining their wellbeing. Inter service co-ordination is the core of any disaster operation. Activities associated with disaster preparedness, mitigation and disaster response in a community has to be multidisciplinary in nature. Following are some of the emergency services which should be co-ordinated at the onset of any disaster;

15. Police Police department provides 24 hours service. Police is the first to get information about the onset of disaster and to reach to the site. They disseminate the information for the organization of an orderly rescue and relief operation. The task responsibilities of the police in disaster are; Control of traffic and crowd Protection of life and property Search and rescue operations Warning and evacuation

16. Firemen Primary role of the firemen is the extinguishing and prevention of fire. The task responsibilities of firemen are; Extinguishing and preventing fire Rescue First aid

17. Civil defence personnel The role of civil defence personnel is to co-ordinate the activities of the police and fireman. The tasks usually performed are; Co-ordinating the services of police and firemen Organising and directing Set up communication system

18. Armed forces Assist police and firemen in their function as needed Organize and establish the pattern of communication, rescue, evacuation, first aid, transportation of victims, direct relief operation.

19. Doctors The primary role of doctors is to save lives and to prevent further trauma and injury; First aid Surgical support Evacuation decisions Triage Providing basic life support measures to the victim in critical condition. I.e. Basic airway maintenance and control of serious bleeding.

20. Nurses Assessment of victims Triage Giving basic life support measures to the victims in critical condition. I.e , Basic airway maintenance and control of serious bleeding. Documentation of triage findings Regulating flow of victims for first aid First aid Evacuation

21. Red cross personnel Ambulance services Setting up first aid team Providing food, drink and temporary shelters for victims and rescuers Supplying drugs and equipment Helping in rehabilitation Supply of clothes, blankets, etc.

22. Volunteers The genuine contribution of ‘public spirited’ citizen should provide the bulk of disaster operation in co-ordination with the professionally trained persons. Rescue First aid Evacuation

23. Public work personnel They may perform any action which would lessen the chance of a secondary disaster. Removing road blocks to clear traffic for relief vehicle, dozers, ambulances. Prevention of any untoward effects. I.e , breakdown of power lines, water lines and gas lines. Assistance to firemen in obtaining adequate water for fire fighting. Removing victims from under debris.

24. The Phases of Disaster management Mitigation: Lessen the impact of a disaster before it strikes Preparedness: Activities undertaken to handle a disaster when it strikes Response: Search and rescue, clearing debris, and feeding and sheltering victims (and responders if necessary). Recovery: Getting a community back to its pre-disaster status

25. Mitigation “Includes any activities that prevent a disaster, reduce the chances of a disaster happening, or reduce the damaging effects of unavoidable disasters” (FEMA,1986)

26. Mitigation Activities that reduce or eliminate a hazard Prevention Risk reduction Examples Immunization programs Public education Improved building codes

27. Role Of Nurse In Mitigation

28. Role of Nurse in Mitigation Nurses have key role in disaster mitigation by working with local, state and federal agencies in identifying disaster risks and developing disaster prevention strategies through extensive public education in disaster prevention and readiness. The nurse needs to have knowledge about community assessment information, community resources (e.g., hospitals, clinics), community health personnel (e.g., nurses, doctors, emergency medical teams), community govt. officials and local industry.

29. Preparedness “Includes plan and preparation made to save lives and help rescue operations” (FEMA 1986)

30. Preparedness 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

31. Are nurses prepared??

32. Role of nurse Community health nurse have skills in crises intervention and are involved in acute care, first aid, rescue and evacuation procedures, recognizing and preventing communicable illnesses. To establish an effective public communication system.

33. Response Activities a hospital, healthcare system, or public health agency take immediately before, during, and after a disaster or emergency occurs.

34. Response How these goals are achieved will vary with the type of disaster and the type of rescue worker. Police officers and firefighters will have an entirely different focus than health care workers. Preplanning mandates the designation of a command center and coordinated interactions among various response personnel. In the event of a disaster situation, the emergency operation center (EOC) becomes operational. The EOC includes health personnel from the local emergency medical system (EMS). These personnel will be included in treating people at the scene of the disaster as well as at other designated location, including local hospitals.

35. Response The management of mass casualties can be further divided into; Search and rescue. Field care/ first aid Triage and stabilization of victims. Hospital treatment and redistribution of patients to other hospitals, if necessary.

36. Response Tagging All patients should be identified with tags stating their name, age, place of origin, triage category, diagnosis and initial treatment. Identification of dead Removal of dead from the disaster scene. Shifting to mortuary Reception of bereaved relatives.

37. Recovery Activities undertaken by a community and its components after an emergency or disaster to restore minimum services and move towards long-term restoration. Debris Removal Care and Shelter Damage Assessments Funding Assistance

38. Recovery The reconstruction of the victim’s life begins with initial care and continues until the victim has recovered. This may take few days , months, or years. Victim and disaster workers must receive adequate psychological counseling and emotional support to be able to effectively return to normal living.

39. Disaster triage To determine the priorities of care, victims are classified into several groups. Classification according to treatment need; Minimal treatment; Persons who may assist others after treatment is given. Immediate treatment; persons who will benefit most by treatment. Delayed treatment; Persons who will not die if treatment is delayed. Expectant treatment; critically injured persons who will receive treatment if time permits.

40. Classification according to priority of care Priority one; Emergency; Persons who need immediate attention to save their lives. Priority two; Urgent; Persons who need attention within a few hours; If they do not receive attention, may suffer serious consequences. Priority three; Non-urgent; Persons who can tolerate a delay in receiving attention. Victims in this group can be attended in order of arrival and will need assurance that they have not been forgotten about. Priority four; Non-acute; Persons who do not require the services from rescuing/emergency department but can be examined by the medical staff as a regular or routine case.

41. Disaster prevention The measures designed to prevent natural phenomenon from causing or resulting in disaster or other emergency situations. It include; Formulation and implementation of long range policies and programs to prevent or eliminate the occurrence of disaster. Enactment of legislation and regulatory measures pertaining to physical and urban planning, public works and building.

42. Role of nurse in disaster management

43. Role of the Nurse at the Disaster Site Ensure safety First Aid Emergency care

44. Role of the Nurse in a Shelter Objective: temporary means of caring Assessment Planning: 24/7 nursing and ancillary coverage Supplies Implementation Evaluation

45. Role of the CHN in a Community Setting After a Disaster Goal: Achieve the best possible level of health for persons in a community after a disaster Primary Prevention Secondary Prevention Tertiary Prevention

46. Prevention Levels in Disaster Management Primary Prevention Secondary Prevention Tertiary Prevention

47. Nurses’ roles in disasters It depend on the ability of the nurse and the specific situation. A nurse may be the only healthcare provider in a given area and be responsible for giving initial first aid treatment or supervising the activity of others.

48. Nurses’ roles in disasters Identifies the type of disaster that may occur in local community. Organizes a disaster plan to be followed for different situations. Arrange for stimulated skills to test the effectiveness of plan. Determines need for education or updating of necessary skills of participants. Actively participates in planning, implementing and evaluating phase of community disaster preparedness. Develops their own nursing response plan to determine role of community health, institutional and volunteer nurse in the event of a disaster in their community.

49. Nurses’ roles in disasters During a disaster, she becomes actively involved and provides proper nursing care to the community. Determine magnitude of the event Define health needs of the affected groups Establish priorities and objectives Identify actual and potential public health problems

50. Nurses’ roles in disasters 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 Informs the relatives about the accident or illness and the name of the place where the patient is admitted.

51. Handles the patient properly if she is alone, because too much investigation and moving of the body parts for inspection can have adverse effect. Assess health needs. Provide physical and psychological support to victims in the shelters. Shift the patient at safer places. Eg . If the patient is feeling suffocation in room, shift the patient in veranda.

52. Nurses’ roles in disasters During the impact phase injured persons are triaged. Give comfortable position to the patient. Gives psychological support to the patient, his family and other people. Avoid handling the patient unnecessarily. Avoid the people to crowding around the patient because it may increase the anxiety if the patient. Only allow the people to come close who can provide the first aid. Give artificial respiration immediately, if breathing stops. Morgue facilities are established and coordinated. Search and reunion activities are organized.

53. Nursing role in disasters Assess the community Diagnose community disaster threats Community disaster planning Implement disaster plan Evaluate effectiveness of disaster plan

54. Communication is a success key Nursing organizations must have a comprehensive and accurate registry for all members Have a structured plan: Collaborate and coordinate with local authorities Have a hotline 24x7 Inform nurses where to report and how (keep records) Make sure have a coordinator to prevent chaos Ensure ways to maintain communication between nurses and their families

55. THANK YOU