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DISASTER PREPAREDNESS AND MANAGEMENT IN

VARIOUS SETTINGS INCLUDING ORGANIZATION OF DRILLS

DISASTER PREPAREDNESS AND MANAGEMENT

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•define disaster•enumerate the aims and objectives of disaster prepardness•identify different types of disaster•describe the principles of disaster management•discuss levels of disaster.

•explain the phases of disaster management.•recognize the different roles of nurse in disaster management.•Explain disaster drill.•Etc…………………..

Disaster “Disaster can be defined as an overwhelming

ecological disruption, which exceeds the capacity of a community to adjust and consequently requires assistance from outside”. -Pan American Health Organisation(PAHO)

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CLASSIFICATION OF DISASTERS

Natural disasters Metrological disaster: Storms, cold spells, heat

waves and droughts. Typological Disaster: (landslides, avalanches,

mudflows and floods) Telluric and Teutonic (Disaster originate

underground Biological Disaster

CLASSIFICATION OF DISASTERSMan Made Disasters Warfare: conventional & non-conventional

warfare Civil disasters. Accidents: transportation, structural

collapse , explosions and fires Technological failures

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Level iii disasterLevel iii disaster – considered a minor – considered a minor disaster. These are involves minimal level disaster. These are involves minimal level of damage of damage

Level ii disasterLevel ii disaster- - considered a moderate considered a moderate disaster. The local and community disaster. The local and community resources has to be mobilized to manage resources has to be mobilized to manage this situationthis situation

Level i disasterLevel i disaster- - considered a massive considered a massive disaster- this involves a massive level of disaster- this involves a massive level of damage with severe impact.damage with severe impact.

Aims and objectives of disaster preparedness It refers to measures taken to prepare for and

reduce the effects of disasters Disaster preparedness is a continuous and

integrated process Objectives Increasing the efficiency, effectiveness and impact

of disaster emergency response mechanisms at the community, national and Federation level

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Objectives

Strengthening community-based disaster preparedness .

Developing activities that are useful for both addressing everyday risks that communities face and for responding to disaster situations

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Disaster preparedness strategy

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Hazard, risk and vulnerability assessments • Identify the characteristics, frequency and potential

severity of the hazards a community faces • Identify the particular geographical areas and communities

that are most susceptible and vulnerable to those hazards • Identify the main sectors of a community (population,

infrastructure, housing, services, etc.) that would be affected by a specific type of hazard and anticipate how they might be affected

• Assess the ability of those sectors to withstand and cope with the effects of hazardous phenomena

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Response mechanisms and strategies evacuation procedures search and rescue teams (including plans for training

them) assessment teams (including plans for training them) procedures for activating distribution systems preparations for emergency reception centres and

shelters procedures for activating emergency programs for

airports, harbours and land transport

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Preparedness planning Disaster preparedness planning involves

identifying organisational resources, determining roles and responsibilities, developing policies and procedures and planning preparedness activities aimed at ensuring timely disaster preparation and effective emergency response

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Coordination organisations, Civil Defence and government emergency

structures, fire brigades, health departments and clinics, Red Crescent/Red Cross Societies, international agencies, NGOs and others.

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Information management Disaster preparedness and response depend

on gathering, analysing and acting on timely and accurate information before (hazard and early warning information), during (disaster needs assessment) and after disasters (progress of post-disaster recovery).

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Early warning systems The purpose of early warning systems is to detect,

forecast, and when necessary, issue alerts related to impending hazard events.

Early warning information comes from a number of sources: e.g. meteorological offices; Ministries of Health (for example, disease outbreaks) and Agriculture (for example, crop forecasts); local and indigenous sources; media sources and increasingly from Internet early warning services

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Resource mobilisation National Societies should develop strategies,

agreements and procedures for mobilising and acquiring emergency funds, supplies and equipment in the event of a disaster.

A preparedness plan should spell out the policies for acquisition and disbursement of funds, use of outside equipment and services, and emergency funding strategies.

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Public education, training and rehearsals public education campaigns, training of

response teams and rehearsals of emergency response scenarios

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Community-based disaster preparedness Local populations in disaster-stricken areas are

the first to respond to a disaster. They are usually involved in search and rescue

activities as well as in providing emergency treatment and relief to their families, friends and neighbours.

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Phases of disaster management

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Disaster management plans

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Disaster management plansAims of disaster plans to provide prompt and effective medical care to the

maximum possible in order to minimize morbidity and mortality

Objectives To optimally prepare the staff and institutional  resources

for effective performance in disaster situation To make the community aware of the sequential steps

that could be taken at individual and organizational levels

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Disaster management committee Medical superintendent/ director Additional medical superintendent Nursing superintendent/ chief nursing officer Chief medical officer (casualty) Head of departments- surgery, medicine, orthopedics,

radiology, anesthesiology, neurosurgery Blood bank in charge Security officers Transport officer Sanitary personnel05/03/23 25

Rapid response team

The medical superintendent will identify various specialists, nurses and pharmacological staff to respond within a short notice depending up on the time and type of disaster.

The list of members and their telephone numbers should be displayed in the disaster control room.

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Information and communication

The disaster control team would be responsible for collecting, coordinating and disseminating the information about the disaster situation to the all concerned

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Logistic support system

Resuscitation equipments Iv sets, iv fluids, Disposable needles, syringes and gloves Dressing and suturing materials and splints Oxygen masks, nasal catheters, suction machine and suction

catheters Ecg monitors, defibrillators, ventilators Cut down sets, tracheostomy sets and lumbar puncture sets Linen and blankets Keys of these cupboards should be readily available at the

time of disaster

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Elements of disaster plan Chain of authority Lines of communication Routes and modes of transport Mobilization Warning Evacuation Rescue and recovery Triage Treatment Support of victims and families Care of dead bodies Disaster worker rehabilitation05/03/23 29

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THE DISASTER MANAGEMENT CYCLE

READINESS FOR DISASTER

1. Resource for readiness. RED CROSS COMMUNITY AND LOCAL GOVERNMENT CIVIL DEFENCE SERVICES 2. Disaster pre planning. HOSPITAL DISASTER PLANING EVACUATION ORDERLY FLOW OF CASUALITY COMMUNICATION SYSTEM

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TRIAGEObjectives of triage Ensure immediate medical intervention in life

threatening situations. Expedite the care of patents through a systematic

initial assessment. Ensure that patients are prioritised for treatment

in accordance with the severity of their medical condition.

Reduce morbidity through early medical intervention.

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Objectives of triage Improve public relations by

communicating appropriate information to friends and relatives who accompany patients.

Improve patients flow within emergency departments and/or disaster management situation.

Provide supervised learning for appropriate personnel

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Principles of triagePrinciples of triage

Every patient should be received and Every patient should be received and triaged by appropriate triaged by appropriate skilled health-skilled health-care professionals. care professionals.

Triage is a clinic-managerial decision Triage is a clinic-managerial decision and must involve and must involve collaborative collaborative planning.planning.

The triage process The triage process should not cause should not cause a delay a delay in the delivery of effective in the delivery of effective clinical care.clinical care.

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Color code

• Red indicate high priority treatment or transfer

• Yellow signals medium priority• Green indicate ambulatory patients• Black indicates dead or moribund

patients

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Triage system

1. GOLDEN HOUR 2. IMMEDIATE OR HIGH PRIORITY 3. DELAYED OR MEDIUM PRIORITY 4. MINOR OR MINIMAL OR

AMBULATORY PATIENTS 5. EXPECTANT OR LEAST

PRIORITY

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HOSPITAL DISASTER PLAN

1. Internal Hospital disasters like fire, building collapse, terrorism, etc

2. External disasters like earthquakes, floods, etc

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OBJECTIVES OF HOSPITAL DISASTER PLAN

1. Preparedness of staff, optimising of resources and mobilisation of the logistics and supplies within short notice

2. To make community aware about the hospital disaster plan and benefits of plan

3. Training and motivation of the staff 4. To carry out mock drills 5. Documentation of the plan and making hospital

staff aware about the various steps of the plan

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DESIGNING OF HOSPITAL DISASTER PLAN

1. Disaster management committee: a. Director of the hospital b. HOD of accidents and emergency services c. All heads of the departments d. Nursing superintendent e. Hospital administrator f. Representatives of the staff

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Functions of the disaster management committee

a. To prepare a hospital disaster plan for the hospital b. To prepare departmental plan in support of the hospital

plan c. Assign duties to the staff d. Establishment of criteria for emergency care e. To conduct, supervise and evaluate the training

programmes f. To supervise the mock drills g. Updating of plans as need arises h. Organise community awareness programmes, through

mass media

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Role and functions

a. Disaster co-ordinator: The co-ordinators role will be: Organising Communicating Assigning duties Deployment of staff Taking key decisionsb. Administrator: The responsibilities of the administrator is to execute

the authority through the departmental headsc. Departmental heads: Development of departmental plansd. Nursing superintendent : deployment of nursing staffe. Medical staff: specific role of rendering medical care both pre-hospital

and hospital caref. Nursing staff: nursing care and support critical care

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Important departments

a. Accident and emergency departmentb. Operating departmentc. Critical care unitsd. Radiology departmentse. Laboratoryf. Bloodbank

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Support areas a. Laundry b. CSSD c. Dietary department d. Housekeeping services e. Medical records f. Public relations g. Communications h. Transportation i. Mortuary j. Medic-social worker k. Engineering department l. Security and safety services m. Media relations

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DISASTER DRILL Definition A disaster drill is an exercise in which

people simulate the circumstances of a disaster so that they have an opportunity to practice their responses.

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DISASTER DRILL Benefits Used to identify weak points in a

disaster response plan To get people familiar with the steps

they need to take so that their response in a disaster will be automatic.

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ROLE OF NURSES IN DISASTER MANAGEMENT I. In disaster preparedness II. In disaster response III. In disaster recovery

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I. In disaster preparedness

1) To facilitate preparation with community

2) To provide updated record of vulnerable populations within community

3) Nurse leads a preparedness effort 4) Nurse play multi roles in community 5) Nurse should have understanding of

community resources

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II. In disaster response

community assessment, case finding and referring, prevention, health education and surveillance

immediate plans for triage should begin

work as a member of assessment team

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III. In disaster recovery

1) Successful Recovery Preparation 2) Health teaching 3) Psychological support 4) Referrals to hospital as needed 5) Remain alert for environmental

health

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Disaster management- nurse’s role in community

Assess the community Diagnose community disaster threats Community disaster planning Implement disaster plans Evaluate effectiveness of disaster plan

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REVIEW OF LITERATURE

Personal Disaster Preparedness: An Integrative Review of the Literature

Kohn S, Eaton JL, Feroz S, Bainbridge AA, Hoolachan J, Barnett DJ

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Abstract

Experts generally agree that individuals will require partial or complete self-sufficiency for at least the first 72 hours following a disaster. In the face of pervasive environmental and weather hazards, emerging biological threats, and growing population densities in urban areas, personal preparedness is critical. However, disaster planners and policymakers require further information to create meaningful improvements to this aspect of disaster preparedness.

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REVIEW OF LITERATURE

. A systematic review of the literature was conducted to determine the state of evidence concerning personal disaster preparedness. The purpose of this integrative review is to describe and analyze the professional literature as an intended basis for advancing the field of disaster management research and practice

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REVIEW OF LITERATURE Included in the review were 36 studies that met

the predetermined inclusion criteria. The current evidence indicates that factors influencing preparedness attitudes and behaviors are complex and multifaceted, including demographic characteristics, trust in government efforts, previous exposure to a disaster, and number of dependents in a household. Furthermore, certain population groups, households, and individuals have different disaster preparedness needs and vulnerabilities. This constellation of findings has significant implications for community and national emergency planning and policymaking.

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