MEDICAL FIRST AID,TRIAGE AND PSYCHOSOCIAL
CARE –DISASTER MANAGEMENT
PROFESSOR ANIL OHRI
DEPARTMENT OF ANAESTHESIA IGMC SHIMLA
INTRODUCTION:
Dr ANIL OHRIProfessor IN Anaesthesia
HEAD,Academics&researchChairman Disaster Cell
NODAL OFFICER IGMC SHIMLAState secretary indian
medicalassociation
QUESTIONS…..? PLEASE NOTE ALL QUESTIONS AND I
ASSURE YOUR EVERY QUESTION ALL WILL BE CLEAR AT THE END OF SESSION
IF ANY THING LEFT CAN BE DISCUSSED IN QUESTION ANSWER SESSION
PSYCHO-SOCIAL CARE DEFINATION:
PSYCHOSOCIAL: TERM REFFERING TO:
IT IS MIND ABILITYTO CONSCIOUSLY OR UNCONSCIOUSLY ADJUST AND RELATE BODY TO RELATE THE BODY TO SOCIAL ENVIRONMENT. A PART OF HOLISTIC APPROACH.
ALLOW PERSON TO SEEK BOTH INFORMATIONAL AND EMOTINAL SUPPORT FROM CARE-GIVERS TO MANAGE MENTAL TRAUMA
PSYCHOSOCIAL CARDINAL POINTS: “TIPS UMBRELLA”TO REMEMBER: LIFE CYCLE/MOTHER CHILD/DEATH 1942? I-I-R-R COUNSELLING CONTINUOUS
LONG DRAWN PROCESS ASSURANCE AVOID TRANSFERENCE DEAL INDIVIDUAL AS IT IS SELF CARE/DEBRIEFING
COCONUT GROOVE NIGHT CLUB FIRE-1944 Cocoanut Grove was BOSTON's premier NIGHT
CLUB during the post-Prohibition 1930s and 1940s. ON NOV. 28, 1942, DEADLIEST NIGHT CLUB
FIRE,[1] KILLED 492 (which was 32 more than the building's authorized capacity) and INJURED HUNDREDS
TRAGEDY SHOCKED NATION AND REPLACED HEADLINES OF WORLD WAR-II REFORMED SAFETY STANDARD CODES IN COUNTRY
MAJOR CHANGES IN TREATMENT AND REHABLITATION OF BURN VICTIMS.
SECOND SINGLE BUILDING DEADLIEST FIRE IN AMERICAN HISTORY; 1903 IROQOUIS THEATRE FIRE in CHICAGO KILLED 605. 1901- RYTHEM CLUB FIRE KILLED -209.[2]
THE NUCLEAR REACTOR AFTER THE DISASTER. REACTOR 4 (CENTER). TURBINE BUILDING (LOWER LEFT). REACTOR 3 (CENTER RIGHT)-26 APRIL 1986.
CHIRNOBYL DISASTER:II Time01:23 (MOSCOW TIME UTC+3) Date26 April 1986Location PRIPYAT,
(former UKARANIAN SSR,USSR) Cause:Inadvertent explosion of core
during emergency shutdown of reactor whilst undergoing power failure experiment
Deaths:31 (direct)
CHIRNOBYL DISASTER-IV April 26, 1986, explosions at a reactor at Chernobyl in Ukraine produced radiation effects almost
14 times greater than the 2011 Fukushima Daiichi disaster in Japan
400 times more powerful than the 1945 atomic bomb dropped on Hiroshima
COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-II TimeAround 10:15 P.M. Date-November 28, 1942Location BAY VILLAGE,BOSTON,
Massachusetts, United States Cause Ignition of synthetic palm tree Decorations
Deaths-492 Suspect-(s)Barney Welansky Charges-Manslaughter, numerous
building code and safety violations VerdictGuiltyConvictionsManslaughter
COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-V 1944, Lindemann published
psychological aftermath of the Coconut Grove nightclub fire in Boston.
psychologists have attempted to relieve distress of victims, disasters RELATE TO several important psychological constructs.
Disasters allowed psychologists the opportunity to observe how extreme stress impacts individuals and groups
COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-V11 The Cocoanut Grove. Erected by the Bay
Village Neighborhood Association, 1993. In memory of the more than 490 people that died in the Cocoanut Grove fire on November 28, 1942.
"Phoenix out of the Ashes“AS BROUGHT MAJOR CHANGES
"This plaque crafted by Anthony P. Marra, youngest survivor of the Cocoanut Grove fire".
PSYCHOSOCIAL ASPECTS: NO DISASTER MANAGEMENT IS COMPLETE WITHOUT PSYCHOSOCIAL RECOVERY PLAN
DISASTER DEVASTATING IMPACT ON INDIVIDUAL LIFE,STRUCTURES AND HEALTH CARE SYSTEM.
GEOGRAPHY,CULTURAL AND ECONOMICAL STRUCTURE
PSYCHOLOGICAL FIRST AID FOR STRESS AND TRAUMA-I: DEPENDS- STRENGTH AND REACTION -Prior Experience-INTENSIY OF DISRUPTION-EMOTINAL STRENGTH OF
INDIVIDUAL-FEELING OF NO ESCAPE-LENGTH OF TIME ELAPSED SINCE
DISASTER
AFFECTED PERSON FACES FOUR PHASES-II: IMPACT PHASE(NO RESPONE-FOCUS
ON SURVIVOR) INVENTORY PHASE(Immediate After
DISASTER-LOCATE SURVIVORS,ASSESS DAMAGE,SEEK MEDICAL HELP)
RESCUE PHASE(ACCEPTING HELP FROM HELP GROUP)
RECOVERY PHASE(FEEL OPERATION ARE NOT FAST ENOUGH,AGAINST THE HELP,LOOK FOR ACCOMMODATION,INSURANCE)
DURATION OF PASES AFTER DISASTER: Phases after a disaster- Duration -Characteristics Hours Apathy, Disorientation, wandering Surprise, Fear,
perplexity Anxiety,Helplessness Heroic Up to 1-2 weeks Strong, direct feeling Heroism,
Solidarity, Optimism Honeymoon 2 weeks to 3 to 6 months Great
solidarity,Eagerness to rebuild Sharing of common experience
Disillusionment 2months to 2 years Withdrawal, loneliness Anger, frustration Community disorganization Negativity, Hostility Impulsiveness, violence Alcohol and drug abuse R
Reconstruction A lifetime Acceptance of losses Realistic assessment of the situation Search for alternatives to rebuild
DISASTER INDUCED STRESS AND TRAUMA “NORMAL” TO “ABNORMAL” SITUATION:
Pschological Symptoms PhysiologicalSymptoms
Irritability Or Anger Self Blame or others Fear of Recurrence Feeling stunned or
numb Helplessness Concentraiton
Problems Sadness Denial Mood Swings
Loss of appetite Headache Chest pain Nausea,diaeehoea,st
omach pain Lack of sleep and
low energy Hyperactivity Increase in alchohol
or Drug consumption
HUMANISING RECOVERY Knowledge of Symptoms Be A Good Listener People are distressed as recovery-
people are same Recovery workers ouside have Distress
and Agonised Incorporate-Exercise,Meditation,Rest
Good Nutrition Long Term Assistance And Relief appeal Basic need are taken Care off Monitoring Of Symptoms, Medication if needed
COMMON PROTECTIVE RESPONSES TO DISASTER: PANIC FACTOR SHOCK-INTENSE EMOTIONAL
FEELING-STUNNED / OR DAZED DENIAL-NOT ACKNOWLEDGING-
NUMB/DISCONNECTED FROM LIFE POST TRAUMATIC STRESS
DISORDER(SERIOUS EVENT AND MUST BE GIVEN DUE ATTENTION)
“TIPS UMBRELLA”TO REMEMBER: COUNSELLING CONTINUOUS LONG DRAWN PROCESS
ASSURANCE AVOID TRANSFERENCE DEAL INDIVIDUAL AS IT IS
NORMAL RESPONSE: REMEMBER NO STANDARD PATTERN ANXIOUS OR NERVOUS/DEPRESSED THOUGHTS AND
BEHAVOR ,EATING/SLEEP PATTERN TRIGGERING—FEAR THAT EVENT
WILL OCCUR INTERPERSONAL RELATIONS
STRAINED-ARGUMENTS SOME PHYSICAL SYMPTOMS
DISCUSSED ALREADY
WHAT NEXT……RECOVER-AS AFTER ANY DEATH ? HELP YOUR SELF AND YOUR
FAMILY.. GIVE TIME TO YOURSELF AND
FAMILY ALLOW UR-SELF MOURN ASK FOR HELP FROM PEOPLE YOU
KNOW COMMUNICATE WITH FAMILY
MEMBERS FIND OUT HELP TRY TO BE IN GROUP ENGAGE IN HEALTHY
CONVERSATION ESTABLISH YOUR ROUTINE AVOID MAJOR DECISIONS OF YOUR
LIFE
COUNTERING THROGH COUNCELLING: KEEP FULL PRIVACY TIPS-HELP ARRANGING BASIC NEEDS INITIATE RETURN TO NORMAL,ROUTINE
AND ACTIVITIES ASSIST IN AVAILING BENEFITS FROM
GOVERNMENT HELP FILLING COMPENSATION FORMS INFORM AUTHORITIES –MENTALLY
ILL,FAMILIES,CHILDREN,PERSON WITH DISABILITIES ENSURE THERE RELIEF RE- SOURCES
BE A GOOD LISTENER
BEHAVIORAL REACTIONS EXAMPLES: Loss of interest in life A 65-year-old man, "Why
should I live anymore ? What is the vise of my life without my grandson and my granddaughter? The waves should have killed me also.''''
Reduced activity, no energy A 40-year-old man," There is nothing much to do here — just eat and then sit around. We have not started working. My days just pass by. I do not know what to do. Earlier I used to do a lot of work. Now without doing much I feel very tired and my body aches.“
Over activity and inability to rest (restlessness) A 25-year-old man, " I am unable to lie down, even for a minute. I need to do something or the other. My body is stiff. I am not able to sit or stand for a single minute.”
BEHAVIORAL REACTIONS-II Taking intoxicants or eating betel leaf 'paan' A 42-
year-old man, "I have nothing to do here in the relief camp. I sit idle all the time. If I sit idle, it reminds me of my two children whom I have lost. If I drink, I can atleast forget my sorrows for some time and get relief from the pain ".
Difficulty in concentration A 36-year-old woman, "I am not able to do any thing properly. I am forgetting to put salt while cooking. I keep looking at the sea and try to understand the sound, whether it is increasing".
Sleep disturbances and problem A 48-year-old woman, "During nights when I go to sleep, I get these images and thoughts of waves coming and destroying everything. I cannot sleep properly. I have to take sleeping tablets to get sleep, but then also, I get sleep only at around 3 o' clock at night."
“FIRST AID” FOR OWN SELF:DEALING WITH STRESS CAN
STRESS THE MANAGER LEARN STRESS RELEASE EXERCISES-
PK-DANCE RELAX DURING WORKING ALOEVERA EYE SPECS MEDITATION SUPT- ASNA CLAP WHEN ALONE LISTEN MUSIC,DANCING-A GOOD
HABIT