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Disaster Nursing

Christina Barrick

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Objectives

• Describe examples of natural and manmade disasters. attack.

• Describe the different phases of a disaster.• Discuss the nurse’s role in managing the disaster

victim.• Compare the reactions of children and the elderly.• Discuss the role of the nurse in primary, secondary,

and tertiary care.• Apply principles of triage to select situations. • Describe the principles of disaster management.

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What is a Disaster?

• Forces overwhelm a community.• Services are compromised.• Outside assistance is required.

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Characteristics of Disaster Agents

• Predictability • Frequency• Controllability/Mitigation• Time: speed, duration• Scope• Intensity• Community Implications

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Manmade Disasters: Terrorism

• D.O.D estimates that as many as 26 nations possess chemical or biological agents.

• 10 countries are believed to possess biological agents as weapons

• Attack can take many forms• Aerosolized agents

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Nuclear Attack

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Nuclear and Radiological Attack

• “Dirty Bomb”• Appeal to terrorists• Availability

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Natural Disaster: Tsunami

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Phases of a Disaster

• Pre-disaster• Warning• Impact• Emergency

• isolation• rescue• remedy

• Recovery

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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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Reactions of Children to a Disaster

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

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Reactions of Children to a Disaster

• Interventions• Research• www.fema.gov/kids

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• Generally cope better• Prob. related to chronic illness/resources• Fear loss of independence• Interventions

• assistance with clean up• financial, legal, and tax info.• refer to a support team• refer to appropriate comm. agencies

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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Criteria for Post Traumatic Stress Disorder

• The trauma is universally recognized • Re-experience the trauma• Demonstrate either emotional numbing

or decrease in normal events

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Three Tier Triage System

• First Priority• Second Priority• Third Priority

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Three Tier Triage System

• Special Cases:• pregnancies

• injured disaster personnel• family of rescue worker• agitated of violent patients

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Role of the Nurse at the Disaster Site

• Insure safety• First Aid • Emergency care

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Role of the Nurse in a Shelter

• Objective: temporary means of caring• Assessment• Planing:

• 24/7 nursing and ancillary coverage• Supplies

• Implementation• Evaluation

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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

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Prevention Levels in Disaster Management

• Primary Prevention• Secondary Prevention• Tertiary Prevention

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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