Final Seminar on Disaster

7/29/2019 Final Seminar on Disaster.

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SEMINAR

ON

DISASTER NURSING

SUBMITTED TO: SUBMITTED

BY:


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GENERAL OBJECTIVE

At the end of the seminar the group will be able to understand about the Disaster

Nursing and apply it in daily practice.

SPECIFIC OBJECTIVE

At the end of seminar, the group will be able to;-

1. Meaning of disaster and hazard.

2. Explain the types of disaster.

3. Discuss the phases of disaster.

4. Explain the dimensions of disaster.

5. Describe the triage system of disaster management.

6. Explain stages of disaster and the role of nurse in disaster management.

7. Describe role of Community Health Nurse in Disaster Response.

8. Explain role of Community Health Nurse in Disaster Recovery.


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INTRODUCTION

Presently at the global level, there has been considerable concern over natural

disasters. Even as substantial scientific and material progress is made, the loss of

lives and property due to disasters has not decreased. In fact, the human toll and

economic losses have mounted. There has been an increase in the number of

natural disasters over the past years and with it, increasing losses on account of

urbanization and population growth, as a result of which the impact of natural

disasters is now felt to a larger extent. According to the United Nations, in 2001

alone, natural disasters of medium to high range caused at least 25,000 deaths

around the world, more than double the previous year and economic losses of

around US $36 billion. These figures would be much higher, if the consequences

of the many smaller and unrecorded disasters that cause significant losses at the

local community level were to be taken into account.

Natural disasters are not bound by political boundaries and have no social or

economic considerations. They are borderless as they affect both developing and

developed countries. They are also merciless and as such the vulnerable tend to

suffer more at the impact of natural disasters. For example, the developing

countries

are much more seriously affected in terms of the loss of lives, hardship borne by

population and the percentage of their GNP lost. Since 1991, two-third of the

victims of natural disasters was from developing countries, while just 2 percent

were from highly developed nations. Those living in developing countries and

especially those with limited resources tend to be more adversely affected. With

the alarming rise in the natural disasters and vulnerability per se, the world

community is strengthening its efforts to cope with it.


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MEANING

Disaster means that any occurrence that causes damage, ecological disruption, loss

of human life or deterioration of health and health services on a scale sufficient to

warrant and extraordinary response from outside the affected community or area

(WHO, 1995).

TYPES

Disaster is an occurrence, either natural or man-made that causes human suffering

and creates human needs that victims cannot alleviate without assistance.

Disasters can be natural & man-made.

Natural disasters include droughts, earthquakes, tsunamis, forest fires,

landslides and mudslides, blizzards, hurricanes, tornadoes, floods and volcanic

disruptions.

Man-made disasters includes hazardous substance accidents (e.g.,

chemicals, toxic gases), radiologic accidents, dam failures, resource shortage

(e.g., food, electricity and water), structural fire and explosions and domestic

disturbances (e.g., terrorism, bombing and riots), Bioterrorism.

DISASTER FACTORS

Agent

It is the physical item that actually causes the injury or destruction. Primary

agents include falling buildings, heat, wind, rising water and smoke. Secondary

agents include bacteria and viruses that produce contamination or infection

after the primary agent has caused injury or destruction.

Primary and secondary agents will vary according to the type of disaster.

Host:


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The host is human kind. Host factors are those characteristics of humans that

influence the severity of the disaster's effect. Host factors include age, immuni-

zation status, pre-existing health status, degree of mobility and emotional

stability.

Environment:

Environmental factors that affect the outcome of a disaster include physical,

chemical, biological and social factors.

Physical factors include the time when the disaster occurs, weather

conditions, the availability of food and water and the functioning of utilities

such as electricity and telephone service.

Chemical factors influencing disaster outcome include leakage of stored

chemicals into the air, soil, ground water or food supplies.

Biological factors are those that occur or increase as a result of

contaminated water, improper waste disposal, insect or rodent proliferation,

improper food storage, or lack of refrigeration owing to interrupted electrical

services.

Social factors are those that contribute to the individual's social supportsystems. Loss of family members, changes in roles, and the questioning of

religious beliefs are social factors to be examined after a disaster.

Psychological factors contribute to the effect of the disaster on individuals.

Psychological factors are closely related to agent, host and environmental

conditions. The nature and severity of the disaster affect the psychological

distress experienced by victims. The existence and length of a warning period

and physical proximity to the actual site of the disaster influence the amount of

psychological distress experienced by victims. The closer an individual is to the

actual site of the disaster and the longer the individual is exposed to the

immediate site of the disaster, the greater the psychological distress that

individual will experience.


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Individuals may suffer impaired intellectual functioning, have difficulty

concentrating, or making decisions and experience impaired memory. Psycho-

somatic complaints and mental illness are also responses to disaster situations

and are evidenced by loss of appetite, fatigue, intestinal upset, sleep disorders

and muscular weakness.

PHASES OF A DISASTER

Pre-Impact Phase:

The pre-impact phase is the initial phase of the disaster, prior to the actual

occurrence. A warning is given at the sign of the first possible danger to a

community. Many times there is no warning, but with the aid of weather

networks and satellites, many metrological disasters can be predicted. The

earliest possible warning is crucial in preventing loss of life and minimizing

damage. This is the period when the emergency preparedness plan is put into

effect.

Emergency centers are opened by the local Civil Defense Authority.

Communication is a very important factor during this phase; disaster personnelwill call on amateur radio operators, radio and television stations and any

available method to alert the community and keep it informed. The community

must be educated to recognize

the threat as serious. When communities experience false alarms several times,

members may not take future warnings very seriously. The role of the nurse

during this warning phase is to assist in preparing shelters and emergency aid

stations and establishing contact with other emergency service groups.

Impact Phase:

The impact phase occurs when the disaster actually happens. It is a time of

enduring hardship or injury and of trying to survive. This is a time when

individuals help neighbors and families at the scene, a time of "holding on"


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until outside help arrives. The impact phase may last for several minutes or for

days or weeks (e.g., in a flood, famine or

epidemic).

This phase must provide for preliminary assessment of the nature, extend and

geographical area of the disaster. The number of persons requiring shelter, the

type and number of needed disaster health services anticipated and the general

health status and needs of the community must be evaluated. The impact phase

continues until the threat of further destructions has passed and the emergency

plan is in effect. If there has been no warning, this is the time when the

Emergency Operation Center (EOC) is established and put in operation. The

EOC is the operating center for the local chapter of the American Red Cross. It

serves as the center for communication with other government agencies, the

center for recruitment of health care providers to staff shelters

Post impact Phase:

Recovery beings during the emergency phase and end with the return of normal

community order and functioning. For persons in the impact area this phase

may last a lifetime (e.g., victims of the atomic bombing of Hiroshima).

The victims of a disaster go through four stages of emotional response:

1. Denial: During the first stage, the victim may deny the magnitude of the

problem or, more likely, will understand the problem but may seem unaffected

emotionally. The problems created by the disaster are being denied or have not

fully "registered." The victim may appear unusually unconcerned.

2. Strong emotional response: In the second stage, the person is aware of the

problem but regards it as overwhelming and unbearable. Common reactions during

this stage are trembling, tightening of the muscles, sweating, speaking with

difficulty, weeping, heightened sensitivity, restlessness, sadness, anger, and

passivity. The victim may want to retell or relive the disaster experience over and

over.


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3. Acceptance:During the third stage, the victim begins to accept the problems

caused by the disaster and makes a concentrated effort to solve them. He or she

feels more hopeful and confident. It is especially important for victims to take

specific actions to help themselves and their families.

4. Recover: The fourth stage represents a recovery from the crisis reaction.

Victims feels that they are back to normal. Routines become important again. A

sense of well-being is restored. The ability to make decisions and carry out plans

returns. Victims develop a realistic memory of the experience.

DIMENSIONS OF A DISASTER

Disasters have a number of dimensions in which they may differ: predictability,

frequency, controllability, time and scope or intensity. These dimensions influence

the nature and possibility of preparation planning, as well as response to the actual

event.

Predictability:

Some events are more easily predicated then others. Advances in meteorology, for

example, have made it more feasible to accurately predict the probability of certain

types of natural, weather-related disasters (e.g., tornadoes, floods, and hurricanes),

while others, such as earthquakes, are not as easily predicted. Man-made disasters,

such as explosions or weeks, are also less predictable. Whenever an event is

predictable, authorities and emergency personnel have more time to prepare for

situation than when an event is not foreseeable (i.e., spontaneous).

Frequency:

Although natural disasters are relatively rare, they appear more often in certain

geographical locations. Residents of the coastal area live in what is commonly

referred to as cyclone are at greater risk for experiencing later greater risk for

earthquakes, and people who live near large river systems are at greater risk for


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flooding than people who live elsewhere

Controllability:

Some situations allow for pre warning and control measures that can reduce the

impact of the disaster; others do not. Emergency planners were able to control

some of the effects of the flooding by sandbagging levees and river or sea banks to

reduce the effects of water damage, and by deliberately blasting dikes and dams to

divert flood waters to less populated areas. The immediate impact on people was

reduced by the ability of emergency personnel to organize evacuations and reduce

the risk of injury and death.

Time:

There are several characteristics of time as it relates to the impact of a disaster; the

speed of onset of the disaster, the time available for warning the population, and

the actual length of time of the impact phase.

Scope and Intensity:

A disaster may be concentrated in a very small area or involve a very large

geographical region, usually affecting many more people. A disaster can be very

intense and highly destructive, causing many injuries, deaths, and property

damage, or less intense, with relatively little damage done to property or

individuals.

THE NURSING ROLE IN DISASTERS

Disaster nurses play key leadership and service provision roles in planning

and implementing disaster relief efforts, preventing technologic disasters,

and addressing problems that occur during a disaster, such as the physical

and emotional stress of disaster victims.

During a disaster many environmental health problems emerge. The scope

and magnitude of these problems determines the nursing role. Nurses


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collaborate with community agencies and officials to recognize and reduce

disaster risks and maximize the health and safety of individuals involved in

disaster crises.

Following a disaster, nurses make numerous referrals to community

agencies for a variety of needs including psychologic care, emotional

support services, and treatment for victims and their families. Recovery

encompassed dealing with many disaster effects such as loss of life, income,

and home. The communicable disease implications of disasters are also

immense:

Assess the Community

Is there a current community disaster plan in place?

What previous disaster experiences has the community been involved with

locally, statewide, nationally?

How is the local climate conducive to disaster formation (e.g., hurricanes,

tornadoes, blizzards)?

How is the local terrain conducive to disaster formation (e.g., earthquakes,

flooding, forest fires, avalanches, mudslides)?

What are the local industries?

Are there any community hazards (e.g., toxic waste and chemical spills,

industrial or agricultural pollutants, mass transportation problems)?

What personnel are available for disaster interventions (e.g., nurses, doctors,

dentists, pharmacists, clergy, volunteers, emergency medical teams)?

What are the locally available disaster resources (e.g., food, clothing, shelter,pharmaceutical)?

What are the local agencies and organizations (e.g., hospitals, schools,

churches, emergency medical, Red Cross)?

What is immediately available for infant care (e.g., formula, diapers) and care


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of the elderly and disabled?

What are the most salient chronic illnesses in the community that will need

immediate attention (e.g., diabetes, arthritis, cardiovascular)?

Diagnose Community Disaster Threats

Determine actual and potential disaster threats (e.g., toxic waste spills,

explosions, mass transit accidents, hurricanes, tornadoes, blizzards, floods,

earthquakes).

Community Disaster Planning

Develop a disaster plan to prevent or deal with identified disaster threats.

Identify a local community communication system.

Identify disaster personnel, including private and professional volunteers, local

emergency personnel, agencies, and resources.

Identify regional backup agencies, personnel.

Identify specific responsibilities for various personnel involved in disaster

coping and establish a disaster chain of command.

Set up an emergency medical system and chain for activation. Identify location

and accessibility of equipment and supplies. Check proper functioning

emergency equipment. Identify outdated supplies and replenish for appropriate

readiness.

Implement Disaster Plan

Focus on primary prevention activities to prevent occurrence of man-made

disasters.

Practice community disaster plans with all personnel carrying out their

previously identified responsibilities (e.g., emergency triage, providing supplies

such as food, water, medicine, crises and grief counselling).

Practice using equipment, obtaining and distributing supplies.

Evaluate Effectiveness of Disaster Plan


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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 response of personnel involved in disaster relief efforts.

PHASES OF DISASTER MANAGEMENT

It has been identified that there are four phases of disaster management which

include:- mitigation, preparedness, response, and recovery, which serve as a model

for community disaster preparations and nursing interventions.

Mitigation

Mitigation includes my activities that prevent a disaster, reduce the chance of a

disaster happening, or reduce the damaging effects of unavoidable disasters.

Nurses have a 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.

Effective mitigation includes recognizing and preventing potential technologic

disasters and being adequately prepared should such events occur.To plan effectively for disaster prevention the nurse needs to have community

assessment information, including knowledge of community resources (e.g.,

emergency services, hospitals, and clinics), community health personnel (e.g.,

nurses, doctors, pharmacists, emergency medical teams, dentists, and volunteers),

community government officials, and local industry. Disasters such as floods,

tornadoes, hurricanes, and

Early warning systems alert the public to the probability of immediate danger and

help to reduce the impact of predictable disaster such as hurricanes or tornadoes.

They may also provide information on an evacuation plan or other immediate

actions that improve the chance of survival and reduce the probability of injures.

The primary goals of disaster management are to prevent or minimize death,


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disability, suffering and loss on the part of disaster victims.

Preparedness

PRINCIPLES OF DISASTER MANAGEMENT

There are eight fundamental principles that should be followed by all who have a

responsibility for helping the victims of a disaster. It is critical that rescue workers

use these principles in proper sequence, or they will be ineffective and possibly

detrimental a disaster victims. The eight basic principles are as follows (Grab and

Eng 1969):

Prevent the occurrence of the disaster whenever possible.

Minimize the number of casualties if the disaster cannot be prevented.

Prevent further casualties from occurring after the initial impact of the disaster.

Rescue the victims.

Provide first aid to the injured.

Evacuate the injured to medical facilities.

Provide definitive medical care.

Promote reconstruction of lives.

TRIAGE

There are several times during the emergency response in which triage may be

necessary to best determine the needs of injured victims. Triage is a French word

meaning "sorting" or "categorizing." The term first came into use during World

War 1 when casualties were sorted during battle. During a disaster, the goal is to

maximize the number of survivors by sorting the treatable from the untreatable

victims. In a disaster, the potential for survival and the availability of resources are

the primary criteria used to determine which patients receive immediate treatment.

In a disaster situation, saving the greatest number of lives is the most important

goal. Triage may take place during the rescue operation at the scene of the disaster,


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and again at each stage of transport for the disaster victims.

Prioritising of victims for treatment can be done in many ways; some communities

use color coding. Probably the best and most easily understood four-category

system is the first-priority, second-priority, third-priority, and dying-or-dead

system:

Red - most urgent, first priority

Yellow - urgent, second priority

Green - third priority

Black - dying/dead

STAGES OF DISASTER AND THE ROLE OF NURSES

1. Preparedness

Personal Preparedness

Great stress is placed on the nurse with client responsibilities who also becomes a

disaster victim. Conflicts arise between family and work-related responsibilities. In

addition, the community health nurse who will be assisting in disaster relief efforts

must be as healthy as possible, both physically and mentally. A disaster worker

who is not well is of little service to his or her family, clients, and other disaster

victims. Personal preparedness can help case some of the conflicts that will arise

and allows nurses to attend to client needs sooner that one may anticipate.

Professional Preparedness

Professional preparedness requires that nurses become aware of and understand

the disaster plans at their workplace and community. Nurses who take disaster

preparation seriously will take the time to read and understand workplace and

community disaster plans and will participate in disaster drills and community


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mock disasters. The more adequately prepared nurses are, the more they will be

able to function in a leadership capacity and assist others toward a smoother

recovery phase. Personal items that are recommended for any nurse preparing

to help in a disaster include the following

A copy of their professional license

Personal equipment, such as a stethoscope

A flashlight and extra batteries

Cash

Warm clothing and a heavy jacket (or weather-appropriate clothing)

Record-keeping materials

Pocket-sized reference books

Community Preparedness

The level of community preparedness for a disaster is only as good as the people

and organisations in the community make it. Some communities remain vigilant as

to the possibility of a disaster hitting their community and stay prepared by having

a solid disaster plan on paper and by participating in yearly mock disaster drills

ROLE OF THE COMMUNITY HEALTH NURSE IN DISASTER

RESPONSE

The role of the community health nurse during disaster depends greatly on the

nurse's past experience, role in the institutions and community's preparedness,specialized training, and special interest. The most important attribute for

anyone working in a disaster, however, is flexibility. One certain factor about

disaster is that change is a constant.

Although valued for their expertise in community assessment, case finding and


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referring, prevention, health education, surveillance, and working with

aggregates, at times the community health nurse is the first to arrive on the

scene and must respond accordingly.

Community health nurses working as members of an assessment team have the

responsibility of feeding back accurate information to relief managers to

facilitate rapid rescue and recovery. Many times nurses are required to make

home visits to gather needed information, a task that comes quite naturally to

the community health nurse. Types of information included in initial

assessment reports include the following:

Geographical extent of disaster's impact

Population at risk or affected

Presence of continuing hazards

Injuries and deaths

Availability of shelter

Current level of sanitation

Status of health care infrastructure.

.


RECOVERY

The role of the community health nurse in the recovery phase is as varied as

in the preparedness and response phases of a disaster. Flexibility remains an

important component of a successful recovery operation. Community cleanup

efforts can incur a host of physical and psychological problems. For example,

the physical stress of moving heavy objects can cause back injury, severe

fatigue, and even death from heart attacks. In addition, the continuing threat of

communicable disease will continue as long as the water supply remains

threatened and the living conditions remain crowded. Community health nurses


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must remain vigilant in teaching proper hygiene and making sure immunization

records are up to date.

Acute and chronic illnesses can be exacerbated by the prolonged effects of

disaster. The psychological stress of cleanup and moving can bring about

feelings of severe hopelessness, depression, and grief. Recovery can be

impeded by short-term psychological effects eventually merging with the long-

term results of living in adverse circumstances. In some cases, stress can lead to

suicide and domestic abuse. In addition, although most people eventually

recover from disasters, mental distress may persist in these valuable

populations who continue to live in chronic adversity. Referrals to mental

health professional should continue as long as the need exists.

The community health nurse must also remain alert for environmental health

hazards during the recovery phase of a disaster. Home visits may lead the nurse

to uncover situations such as a faulty housing structure. Lack of water supply,

or lack of electricity.


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BIBLIOGRAPHY:-

1. Basvantappa B.T. textbook of Community Health Nursing, 7th

edition,

Jaypee Brothers, New Delhi pp 953-961.

2. Gulani K Community Health Nursing, 1 st edition, kumar publishing

services New Delhi

3. Kamalan, Essentials of Community Health Nursing, 1 st edition, Jaypee

brothers New Delhi.

4. Park K Preventive And Social Medicine, 19 th edition, Banarasidas

Publishers Jabalpur Pp 600.

5. Tener Goodwin, Venera, Disaster Nursing, Spring Publication

Company New York,


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HANDOUT

SUBMITTED TO SUBMITTED

BY

Mrs. Priya D Ms. Namita

Jadhao

TOPIC: - DISASTER NURSING

INTRODUCTION

MEANING

Disaster means that any occurrence that causes damage, ecological disruption, loss

of human life or deterioration of health and health services on a scale sufficient to

warrant and extraordinary response from outside the affected community or area

(WHO, 1995).

TYPES

1) Man-made disasters

2) Natural disasters

DISASTER AGENT

Agent

Host:

Primary and secondary agents will vary according to the type of disaster

Environment:


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Physical factors Chemical factors Biological factors Social factors Psychological factors

PHASES OF A DISASTER

Pre-Impact Phase

Impact Phase

Post impact Phase

. Denial

. Strong emotional response

. Acceptance

Recover

DIMENSIONS OF A DISASTER

Predictability:

Frequency:

Controllability:

Scope and Intensity

Time:


Disaster nurses play key leadership and service provision roles in planning

and implementing disaster relief efforts, preventing technologic disasters,

and addressing problems that occur during a disaster, such as the physical

and emotional stress of disaster victims.

During a disaster many environmental health problems emerge. The scope

and magnitude of these problems determines the nursing role. Nurses

collaborate with community agencies and officials to recognize and reduce

disaster risks and maximize the health and safety of individuals involved in

disaster crises.

Following a disaster, nurses make numerous referrals to community

agencies for a variety of needs including psychologic care, emotional

support services, and treatment for victims and their families. Recovery


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encompassed dealing with many disaster effects such as loss of life, income,

and home. The communicable disease implications of disasters are also

immense:


ASSESS THE COMMUNITY

Community Disaster Planning



Mitigation



TRIAGE

Red - most urgent, first priority

Yellow - urgent, second priority

Green - third priority

Black - dying/dead

STAGES OF DISASTER AND THE ROLE OF NURSES

1. Preparedness

Personal Preparedness

Professional Preparedness

Community Preparedness


RECOVERY


RESPONSE

BIBLIOGRAPHY:-

1. Basvantappa B.T. textbook of Community Health Nursing, 7 th edition,


22/22

Jaypee Brothers, New Delhi pp 953-961.

2. Gulani K Community Health Nursing, 1 st edition, kumar publishing

services New Delhi

3. Kamalan, Essentials of Community Health Nursing, 1 st edition, Jaypee

brothers New Delhi.

4. Park K Preventive And Social Medicine, 19 th edition, Banarasidas

Publishers Jabalpur Pp 600.

5. Tener Goodwin, Venera, Disaster Nursing, Spring Publication

Company New York

Documents

Final Seminar on Disaster