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Disaster Management

Ns. Farida Yuanita, SKep

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What is a Disaster?

• A disaster is an event that causes human suffering and creates unmet needs and demands exceeding the abilities of the community to cope without outside assistance

• Disasters are defined by what they do to people and are therefore relative to the context in which they occur

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Types of Disasters• Natural Disasters

– meteorological

– topological

– disasters that originate underground

– bacteriological

• Human-generated Disasters

– warfare

– civil disasters

– accidents

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Types of DisastersTypes of DisastersNaturalNatural Man-made Man-made

TechnologicalTechnologicalBiologicalBiological

UnintentionalUnintentional Tsunamis, Tsunamis, Floods, Floods, Hurricanes, Hurricanes, Earthquakes, Earthquakes, Wildfires, etc.Wildfires, etc.

e.g., Bhopal, Haz-e.g., Bhopal, Haz-Mat, Nuclear Power Mat, Nuclear Power plant accidentplant accident

Epidemic e.g., Epidemic e.g., 1918 Influenza 1918 Influenza PandemicPandemic

IntentionalIntentional ““Act of God”Act of God” Chemical, Nuclear, Chemical, Nuclear, Radiological, Radiological, Explosion, Acts of Explosion, Acts of TerrorismTerrorism

BioterrorismBioterrorism

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Phases of a Disaster• Pre-disaster• Warning• Impact• Emergency

• isolation• rescue• remedy

• Recovery: Reconstruction, or rehabilitation

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Health Effects of Disasters

• Physical

– Sleep disturbance

– Poor concentration

– Back pain

– Tachycardia

– Poor diet

• Psychological– Loss of self and

relationships– Emotional pain– Brooding– Aggressive

thoughts– Depression

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Health Effects of Disasters• Sociocultural

– Loss of intimacy

– Loss of sense of belonging to once-claimed culture

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Populations at Risk in Disasters• the chronically ill• the elderly• pregnant women• disabled persons• homebound persons• children• the poor

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Reactions of Children to a Disaster

• Developments level• Family’s reactions• Separation anxiety• School refusals• Enuresis• Guilt

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• Generally cope better

• Prob. related to chronic illness/resources

• Fear loss of independence

Elderly Reactions

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Caregivers Reactions

• Same as Victim• Role Strain• Concerns over Personal Safety &

Family• Possessiveness towards victims• Nurse - parent identification with

pediatric victims• Interventions

• clear disaster plans & disaster exercises

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The Disaster Plan• Purpose of disaster planning is to reduce a

community’s vulnerability to the tremendous consequences of disasters and to prevent or minimize the problems resulting from system damages associated with the disaster

• Disaster plans must change as threats to the public’s health evolve

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Phases

Pre-eventPre-event

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Characteristics of Disaster Plans

• Plan based on realistic assessment of potential problems

• Estimates of types of injuries resulting from disasters most likely to occur in area included

• Plan is brief, concise, and inclusive of all who can provide disaster aid

• Plan is organized by a timeline

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Characteristics of Disaster Plans

• Plan is approved by all agencies that provide authority endorsement

• Plan is sanctioned by those with power to see that the plan is updated and implemented

• Plan is regularly tested and revised

• Plan is considered a work in progress

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Common Elements of Disaster Plans

• Authority• Communication• Equipment and

supplies• Human resources• Team coordination• Transportation

• Documentation

• Evacuation

• Rescue

• Acute care

• Supportive care

• Recovery

• Evaluation

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Hospital Em ergency Incident Com m and SystemHEICS

P u b lic In fo rm ation O ffice r L ia ison O ffice r

S a fe ty an d S ecu rity O ffice r

D am ag e A ssessm en t an dC on tro l O ffice r

S an ita tion S ys tem sO ffice r

F ac ilit iesU n it L ead er

C om m u n ica tion s U n itL ead er

Tran sp orta tion U n itL ead er

M ateria ls S u p p ly U n itL ead er

N u trit ion a l S u p p lyU n it L ead er

L og is t ic s C h ie f

S itu a tion -S ta tu sU n it L ead er

L ab or P oo lU n it L ead er

M ed ica l S ta ffU n it L ead er

P atien t Track in gO ffice r

P a tien t In fo rm ationO ffice r

N u rs in gU n it L ead er

P lan n in g C h ie f

T im eU n it L ead er

P rocu rem en tU n it L ead er

C la im sU n it L ead er

C os tU n it L ead er

F in an ce C h ie f

M ed ica l S ta ffD irec to r

S u rg ica l S ervicesU n it L ead er

M atern a l C h ildU n it L ead er

C rit ica l C areU n it L ead er

G en era l N u rs in gC are U n it L ead er

O u t P a tien t S ervicesU n it L ead er

In -P a tien t A reasS u p erviso r

Triag eU n it L ead er

Im m ed ia te Trea tm en tU n it L ead er

D e layed Trea tm en tU n it L ead er

M in or Trea tm en tU n it L ead er

D isch arg eU n it L ead er

M org u eU n it L ead er

Trea tm en t A reasS u p erviso r

M ed ica l C areD irec to r

L ab ora to ryU n it L ead er

R ad io log yU n it L ead er

P h arm acyU n it L ead er

C ard iop u lom on aryU n it L ead er

A n c illa ry S ervicesD irec to r

S ta ff S u p p ortU n it L ead er

P sych o log ica l S u p p ortU n it L ead er

D ep en d en t C areU n it L ead er

H u m an S ervicesD irec to r

O p era tion s C h ie f

In c id en t C om m an d er

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Disaster Management• Goal is to prevent or

minimize death, injury, suffering, and destruction

• Interdisciplinary, collaborative team effort coordinated by community officials

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Response and Recovery

• The team’s response is initiated during and after the impact stage of the disaster. Local, state, regional, national, federal, and volunteer agencies assist communities in need.

• Recovery is a long-term process that occurs during the rehabilitation stage of the disaster.

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Role of the Nurse ??

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Emergency Nursing – (usually) involves the provision of nursing care for patient or patients with acute injuries or life threatening illnesses. (Usually) care is provided at ED, Urgent care, Trauma unit and/or ICU/CCU

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Disaster Nursing – involves response to (and preparedness for) natural or man-made events that affect an entire community or communities. (Usually) involve massive numbers of casualties and extensive property damage.

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Role of the Nurse at the Disaster Site

• Insure safety

• First Aid

• Emergency care

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Field Triage

Category Respiration Radial Pulse LOC

Critical/ Immediate

> 30/min Absent Unconsciousor AMS

Delayed < 30/min Present Normal

Dead / Non-salvageable

Absent Absent Unconscious

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Role of the Nurse in a Shelter

• Objective: temporary means of caring

• Assessment• Planing• Implementation• Evaluation

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Immediate Physical Management of the Disaster Victim

• Validate what you hear• Perform a thorough assessment• Assess for other

injuries/illnesses even when symptoms are absent

• Is the condition life-threatening• What is past medical history?• Do not ignore patient fears or

complaints

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Management of the Psychosocial Aspects of a Disaster Victim

• Pre-disaster Preparations and Warning Phase• reactions: apathy to panic• interventions: mock drills, leadership• important goal• interventions: mental health services

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Management of the Psychosocial Aspects of a Disaster Victim

• Impact and Emergency Phase• reaction: “disaster syndrome”• Interventions: prevent isolation, rumor

control

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Management of the Psychosocial Aspects of a Disaster Victim

• Recovery Phase• reaction• interventions

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Principles of Disaster Management

• Prevent the disaster• Minimize casualties• Prevent further casualties• Rescue the victims• First aid• Evacuate• Medical care• Reconstruction