Disaster Nursing

WORLDS GREATEST

DISASTERS

Gujarat Earthquake

DISASTERSDisasters are events that inflict significant damage

to life or property and that substantially overwhelm the local community’s resources.

DISASTER NURSING

• THE GOAL OF DISASTER NURSING is ensuring that the highest achievable level of care is delivered through identifying, advocating, and caring for all impacted populations throughout all phases of a disaster event, including active participation in all levels of disaster planning and preparedness.

Concept and Meaning of Disaster Nursing

D- DetectionI- Incident commandS- Safety and securityA- AssessS- SupportT- Triage and treatmentE- EvaluationR- Recovery

Principles of disaster Nursing• Prevent the disaster– Primary prevention– Secondary prevention– Tertiary prevention

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

Classification of Disaster

• Natural disasters– Ex: Hurricanes, flood, cyclones, earthquakes, land

slides, wind storm, epidemics and draught• Man made disasters– Fire explosion, Accidents of passenger vehicles,

bomb blast, terrorism, riots and violence

Policies related to emergency/disaster management

1. “First come, first treated” principle will not be followed during emergencies.

2. Triage protocol3. ABCDE care is provided– Airway– Breathing– Circulation– Disability limitation– Exposure / environmental control

4. Trauma team and trauma code5. Management of cardiopulmonary arrest6. Emergency medicine records7. Chain of command in the team and system8. Alternative chains and flexibility standards9. Procedures involving medico-legal issues10. Disaster preparedness11. Disaster drills12. Infection control measures13. Quality management of disaster services

Disaster Management cycle/PhasesPrepared

ness

Response

Recovery

Prevention

Disaster

Disaster Preparedness

• Personal preparedness• Professional preparedness• Community preparedness

Disaster Management Team• Medical Superintendent• Additional Medical Superintendent• Nursing superintendent• Chief medical officer (Casualty)• HOD’d of all the dept.s• Blood bank incharge• Security officers• Dietician• Transport officer• Sanitary personnel

Equipments• Resuscitation equipment• IV sets and IV fluids• Disposable needles, syringes & gloves• Dressing & suturing materials and splints• Oxygen delivery devices• Suction catheter and machine• ECG monitors, defibrillators and ventilators• Cut down sets, tracheostomy sets and lumbar

puncture sets• Linens and blankets

Guidelines/Elements of disaster plans• Chain of authority• Lines of communication• Routes & modes of transport• Mobilization• Warning• Evacuation• Rescue & recovery• Triage• Treatment• Support of victims and families• Care of dead bodies• Disaster worker rehabilitation

Triage Protocol/System

Red: High priority for treatment & transfer

Yellow: Medium Priority

Green: Ambulatory patients

Black: Dead or Moribund patients

Resources for disaster management

• Administrative system• Policies, procedures and protocols• Physical facilities• Components & equipments• Emergency/Disaster medical systems• Staffing and training• Resources for disaster drills• Effective evaluation system

Coordination & involvement of various Govt. and Non-Govt. organization

• India– National disaster management authority of India– Emergency Management and research Institute

• Worldwide– International association of emergency managers– Red cross/red crescent– United Nations– World bank– European union– International recovery platform

Role of Nurse

• Assess the community• Diagnose community disaster threats• Community disaster planning• Implement disaster plans• Shelter management plans• Evaluate the effectiveness of disaster plans

Legal aspects of disaster nursing

• Licensure• Good Samaritan law• Good rapport• Standard care• Standing order• Written consent for

operation and procedures

• Correct identity• Drug maintenance• Self discharge of the

patient• Documentation• Protection of patient

property• Reporting

Impact on health and after effects

• Social reaction• Communicable

diseases• Population

displacements• Climatic exposure

• Food & Nutrition• Water supply &

sanitation• Mental health• Damage to the

health infrastructure

Post Traumatic Stress Disorder (PTSD)

• PTSD is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma.

• Symptoms: Flashbacks and nightmares

Diagnosis of PTSD• History of exposure to a traumatic event• Persistent re-experiencing• Persistence avoidance and emotional numbing• Persistent symptoms of increased arousal not

present before• Duration of symptoms for more than 1 month• Significant impairement

Management of PTSD

• Provide sense of safety• Calm the patient• Improve self efficacy of the patient• Make social connectedness• Give hope

Rehabilitation after Disaster

• Water supply• Food supply• Basic sanitation• Personal hygiene• Physical rehabilitation• Psychosocial rehabilitation• Financial rehabilitation• Relocation

Thank you.