Disaster Management and UNDRR

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Questions and Answers

In a highly decentralized disaster response scenario, which of the following coordination strategies would MOST effectively address the challenge of resource allocation across multiple jurisdictions with potentially conflicting priorities?

  • Establishing a multi-jurisdictional coordination entity with binding authority to reallocate resources based on dynamically assessed needs, overriding local control where necessary.
  • Implementing a 'laissez-faire' approach, allowing each jurisdiction to manage its resources independently, fostering innovation through competition and minimizing bureaucratic overhead.
  • Developing a sophisticated resource-sharing agreement with predefined escalation protocols, facilitated by a real-time resource tracking system incorporating game theory principles to optimize distribution. (correct)
  • Mandating a standardized Incident Command System (ICS) structure across all participating jurisdictions to ensure seamless interoperability.

Considering the Sendai Framework's emphasis on risk-informed development, how should a national government MOST effectively integrate climate change projections, characterized by deep uncertainty and non-stationary processes, into its long-term urban planning and infrastructure investment decisions?

  • Implementing a moratorium on new infrastructure development in vulnerable coastal areas until climate models achieve higher precision, minimizing exposure to potential future hazards.
  • Adopting a 'no-regrets' approach, prioritizing investments that yield benefits across a wide range of plausible climate futures, maximizing resilience to unforeseen impacts.
  • Utilizing a dynamic adaptive policy pathways (DAPP) framework, continuously monitoring climate change indicators and adjusting infrastructure plans based on predefined trigger points, enabling flexible responses to evolving risks. (correct)
  • Employing a traditional cost-benefit analysis using the most likely single climate scenario to guide investment decisions, ensuring efficient resource allocation under predictable conditions.

Given the complexities of cascading disasters, such as an earthquake triggering a nuclear plant failure, which risk assessment methodology would provide the MOST holistic understanding of potential systemic vulnerabilities and interdependencies?

  • Implementing a Bayesian network-based risk assessment that models the interdependencies between infrastructure systems (e.g., energy, communication, transportation) and their probabilistic failure cascades. (correct)
  • Performing a qualitative scenario analysis, identifying potential high-impact, low-probability events without quantifying probabilities or interdependencies.
  • Employing a probabilistic risk assessment (PRA) focused solely on the initiating event (earthquake) and its immediate consequences (structural damage).
  • Conducting a hazard-specific vulnerability analysis for the nuclear plant, independent of external triggers.

In the context of the Hyogo Framework for Action and its emphasis on building resilience, what strategies should be prioritized to address the 'attribution problem' – the difficulty in directly linking specific disaster risk reduction (DRR) interventions to quantified reductions in disaster losses?

<p>Employing robust counterfactual analysis, leveraging advanced statistical techniques and spatial econometrics to isolate the impact of DRR interventions from confounding factors. (D)</p> Signup and view all the answers

Considering the complexities of urban informal settlements regarding disaster risk, what integrated policy approach would MOST effectively reduce vulnerability while respecting the rights and livelihoods of residents?

<p>Adopting a participatory, in-situ upgrading approach, integrating disaster risk reduction measures, secure land tenure, basic services provision, and livelihood support, co-designed with residents. (A)</p> Signup and view all the answers

Given the limitations of traditional top-down approaches to risk communication during a rapidly evolving pandemic, what innovative strategies could be MOST effectively employed to foster public trust and encourage adherence to public health guidelines?

<p>Enlisting trusted community leaders and influencers to co-create and disseminate culturally relevant risk communication messages, leveraging social networks and addressing local concerns. (A)</p> Signup and view all the answers

Within a healthcare setting, what advanced logistical optimization strategy would MOST effectively ensure timely and equitable distribution of scarce medical resources (e.g., ventilators, critical medications) during a mass casualty event?

<p>Employing a sophisticated agent-based simulation model, incorporating real-time patient data, resource availability, and ethical considerations, to dynamically optimize resource allocation based on predicted outcomes (e.g., lives saved, morbidity reduced). (D)</p> Signup and view all the answers

Following a catastrophic earthquake, what innovative financial mechanisms could be MOST effectively employed to accelerate long-term recovery and reconstruction, mitigating the risk of prolonged economic stagnation?

<p>Developing a catastrophe bond that triggers payouts based on predefined reconstruction cost indices, transferring risk to capital markets and ensuring rapid access to recovery funds. (B)</p> Signup and view all the answers

How should the framework of the United Nations International Strategy for Disaster Reduction (UNISDR, now UNDRR) MOST effectively promote the integration of indigenous knowledge and local practices into national disaster risk reduction (DRR) strategies, ensuring culturally appropriate and context-specific interventions?

<p>Developing a participatory knowledge co-creation process, integrating indigenous practices with scientific knowledge within a transdisciplinary DRR framework, empowering local communities as active agents of resilience. (D)</p> Signup and view all the answers

Considering scenario planning for a large-scale cyberattack targeting critical infrastructure, what type of simulation exercise would MOST effectively assess the cascading impacts and interdependencies across multiple sectors (e.g., energy, finance, healthcare)?

<p>A full-scale exercise involving multiple agencies and private sector partners, simulating a coordinated response to a multi-sector cyberattack with cascading physical and economic consequences. (B)</p> Signup and view all the answers

Given the increasing frequency and intensity of extreme weather events, what innovative legal and regulatory frameworks could be MOST effectively implemented to promote 'climate-smart' land use planning and development, mitigating future disaster risks?

<p>Implementing a system of transferable development rights (TDRs) to redirect development away from high-risk areas combined with ecological conservation easements to enhance natural hazard protection. (C)</p> Signup and view all the answers

In the context of disaster preparedness, what strategic advantage could a 'digital twin' – a high-fidelity virtual replica of a city or region – offer in optimizing evacuation planning and resource allocation during a major hurricane?

<p>Allowing for iterative testing of different evacuation scenarios and resource allocation strategies under varying hurricane intensity parameters, optimized through machine learning algorithms, to generate actionable insights for emergency managers. (D)</p> Signup and view all the answers

Considering the ethical complexities of disaster triage in resource-scarce environments, what novel decision-making framework could MOST effectively balance utilitarian principles (maximizing lives saved) with considerations of equity and procedural justice?

<p>Employing a multi-criteria decision analysis (MCDA) framework, incorporating clinical severity scores, age, comorbidities, and social vulnerability factors, weighted based on community input, to generate a composite triage score that guide resource allocation decisions in a transparent and consistently justified manner. (C)</p> Signup and view all the answers

What are the critical elements of a comprehensive 'PACE' (Primary, Alternate, Contingency, Emergency) communication plan, and how can it be dynamically adapted to ensure resilience in the face of evolving technological disruptions and cybersecurity threats during a prolonged disaster?

<p>A modular communication framework incorporating diverse technologies (satellite, radio, cellular, mesh networks), with automated switching capabilities based on real-time assessments of network availability, cybersecurity threat levels and stakeholder communication needs, continuously updated through machine learning algorithms. (C)</p> Signup and view all the answers

How can decision makers MOST effectively reconcile the tension between the need for rapid response in a disaster (e.g., deploying emergency personnel) and the imperative of conducting thorough risk assessments prior to intervention, especially in complex and unfamiliar environments?

<p>Employing a phased response approach, initiating a limited initial assessment with remote sensing and reconnaissance data to triage immediate needs, followed by a more comprehensive risk assessment integrated into subsequent intervention phases. (D)</p> Signup and view all the answers

In the context of post-disaster reconstruction, how can decision-making models incorporating circular economy principles (emphasizing resource reuse and waste minimization) contribute to achieving more sustainable and resilient outcomes compared to traditional linear models (extract, produce, dispose)?

<p>Circular economy models promote the use of locally sourced, recycled materials that can minimize environmental impact and create local economic opportunities and result in resilient models reducing long-term reliance on traditional supply chains (B)</p> Signup and view all the answers

How can disaster management strategies be adapted to address the unique challenges posed by slow-onset disasters (e.g., drought, sea-level rise), which lack the immediate triggers of rapid-onset events, and lead to a gradual and protracted erosion of community resilience?

<p>Transitioning to strategic frameworks focused on forward-looking risk assessments, long-term resilience strategy, capacity buildilng programmes and alternative livelihoods. (A)</p> Signup and view all the answers

Given the growing prevalence of 'fake news' and misinformation during disaster events, what strategies would be MOST effective for emergency management agencies to build and earn trust with the public and combat disinformation campaigns in real time?

<p>Public service campaigns and trusted public health figures and subject matter experts should be enlisted to combat disinformation. (A)</p> Signup and view all the answers

Within the START (Simple Triage and Rapid Treatment) method, which parameter is the MOST immediate determinant for classifying a trauma patient as 'Immediate' when resources are severely constrained?

<p>Respiratory rate, as adequate ventilation is paramount for rapidly deteriorating patients. This is the best method to classify (B)</p> Signup and view all the answers

During a disaster surge management event, which of the following metrics would BEST inform real-time adjustments to patient triage and resource allocation?

<p>Patient acuity scores and real-time patient volumes using a machine learning system. This provides the highest fidelity data to work with. (B)</p> Signup and view all the answers

During the immediate aftermath of a catastrophic earthquake, which of the following actions should be prioritized by first responders to maximize the potential number of lives saved?

<p>Conduct rapid structural assessments ('triage') of damaged buildings using visual inspection and marker systems looking for salvageable victims. (C)</p> Signup and view all the answers

Considering long-term community resilience, what is the MOST critical factor in enabling a community to adapt and thrive and learn from the events following the devastation following the event.

<p>The development and cultivation of pre-disaster community social capital. (D)</p> Signup and view all the answers

In the context of 'Critical Incident Stress Debriefing (CISD)', when should this intervention be used?

<p>A few days to a couple weeks after the incident has occurred and it's been determined that this support will be necessary. (C)</p> Signup and view all the answers

What is the MOST important goal of 'Psychological First Aid'?

<p>To provide safety, foster calm and build support for survivors. (C)</p> Signup and view all the answers

Which of the following is the MOST efficient and practical strategy for Emergency Room (ER) nurses to implement the 'Daily Triage' approach in a hospital setting?

<p>Adhering to an effective triaging algorithm with well-defined parameters and utilizing an internal survey instrument. (C)</p> Signup and view all the answers

Which of the following qualities is the MOST critical for a triage officer during a disaster to possess, according to Frederick Burkle Jr.?

<p>Knowledge of available resources. (C)</p> Signup and view all the answers

Which patient should be tagged 'Expectant' according to disaster-triage protocols?

<p>Patients with injuries so severe that they are likely to die with the existing resources. (D)</p> Signup and view all the answers

Your agency, tasked with community rebuilding has received the task of setting up new transitional housing for homeless disaster victims. What should be the PRIMARY goal?

<p>Address shelter needs as a step towards transitioning to long-term goals. (B)</p> Signup and view all the answers

What is the MOST IMPORTANT action that triage personnel should take during a disaster?

<p>Not becoming victims themselves by utilizing appropriate protective equipment such as masks and gloves. (B)</p> Signup and view all the answers

Which is the MAJOR function performed by nurses as part of their role in mitigation?

<p>Educating (C)</p> Signup and view all the answers

Which task is the MOST significant task to prepare for a disaster?

<p>Building community resilience. (A)</p> Signup and view all the answers

After a disaster strikes, how can the 'recovery phase' be described?

<p>The recovery phase takes place after a disaster and involves physical, economic and social stability. (B)</p> Signup and view all the answers

Which of the following actions is MOST related to the disaster-response phase of an emergency?

<p>Coordinating rescue efforts. (B)</p> Signup and view all the answers

R.A. 10121, otherwise known as 'The Philippine Disaster Risk Reduction and Management Act of 2010', has what main goal during prevention?

<p>Avoidance of the impact of hazards and elimination of flood risks. (A)</p> Signup and view all the answers

Consider several common challenges with disaster situations. Which of the following is the MOST relevant to disaster communication challenges?

<p>Challenges with systems among organizations and the vast scope among people are a main priority during disaster. (B)</p> Signup and view all the answers

Flashcards

Disaster Management

The process of preparing for and responding to disasters, organizing resources to lessen harm, and managing prevention, preparedness, response, and recovery.

UNISDR

A UN initiative for disaster risk reduction essential for sustainable development hinging on risk-informed development path.

UNDRR

Supports disaster risk reduction implementation, voluntary approach to disaster risk reduction, and people centered.

Sendai Framework

A 15-year, voluntary agreement that sets out priorities and actions for disaster risk reduction at the global, regional, and national levels

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HFA Strategic Goals

Integrating disaster risk, strengthening institutions/mechanisms, and incorporating risk reduction approaches

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Hyogo Framework Priorities

Make disaster risk reduction a priority, know the risks, build understanding, reduce risk, be prepared and ready

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Disaster Prevention and Mitigation

Seeks to decrease hazard impacts/disasters, promotes actions to prevent potential adverse impacts, and lessen hazard impacts.

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Nurse's Role in Mitigation

Knowing community resources, assessing risks, evaluating risks, treating risks, and monitoring risks.

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Disaster Preparedness

Set of measures undertaken in advance to better respond and cope with the aftermath of disasters.

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Disaster Challenges

Communication, Information, and Coordination are key to consider how jurisdictions respond to scenarios

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Surge Management

A plan that counts for surge during a possible/likely disaster. Triage and distribution of patients to various sites.

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Disaster Planning

A plan that must include a community mutual aid plan where healthcare facilities evacuate patients to safety.

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Emergency Kit

Kit with important items for preparing for a disaster, tailored for specific needs.

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Learning Preparedness

Knowledge, abilities, and actions to anticipate, respond, and recover from emergencies to minimize harm.

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PACE

A methodology planning/redundancy for communication involving primary, alternate, contingency, & emergency.

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Disaster Triage

Sorting and choosing patients to make sure they get the right level of care at the right time in the right place.

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Triage Officer Traits

Clinically experienced, judgement and leadership, calm/cool, decisive, knowledgeable, humor, creative, availabl and experienced.

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Daily Triage

Performed by nurses routinely utilizing clinical judgement to treat those in most need of treatment.

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Local EMS Overload

General term with high emergency overload; local emergency services overwhelm patients

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Minimal/Minor (Green)

Well compensated, extended period to care, and minimal deterioration

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Delayed (Yellow)

Compensated physiology and many may need temporary stabilizing with significant deterioration in field.

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Immediate (Red)

Injuries with a threat to life that need rapid interventions consuming a lot of resources.

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Deceased (Black)

Patients that have no detectable vital signs and aren't breathing.

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Expectant (Gray)

They are in pain/critical from medical issues that they aren't likely to recover from due to resource limitations.

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Triage Personnel

Personnel's responsibility to not become injured.

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START Triage

Used adult MCI primary tool for triage developed and devised for adults with limited limit of 100 lbs.

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START Parameters

Measure the ability to walk, respirations, perfusion, and ability to obey commands.

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JumpSTART Triage

Objective tool developed, modified in 2001, used in children setting EMS and pediatric.

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Disaster Recovery

Restoration in the event through physical, environmental, economic, and social stability.

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Community Rebuilding

Recognizing differing needs return to original sites and building information.

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Health & 1st Aid

Restore safe water with 1st aid to the center of healthcare.

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Community Infrastructure

Education with promotion of safety to organizations and community.

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Local Capacity

Service local groups to volunteer and strengthen the core of healthcare.

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Early Recovery Transition

The relief to assessment transitions into the quality support of the people hit by the disaster.

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Reconstruction Process

Feeling and adjusting responsibly with rebuilt roads for normal, grief free, original shape.

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Rehabilitation

Enabling healthcare to normal with services like temporary utilities for proper healing.

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Stress Debriefing

A process that gives support through effective coping with trauma education in a stressful way.

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Psychological First Aid

An intervention the safety that gives support to build resilience to survivors of trauma.

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Group Assessment

Building resilience in groups by exploring group needs and group involvement.

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Study Notes

Disaster Management

  • Disaster management is a systematic process.
  • It efficiently prepares for and responds to disasters.
  • It strategically organizes resources.
  • Aims to reduce the harm caused by disasters.
  • It includes responsibilities of disaster prevention, preparedness, response, and recovery.

United Nations International Strategy for Disaster Reduction (UNISDR)

  • It is based on the theory that reducing disaster risk is key to sustainable development.
  • Essential is a risk-informed development path for successful disaster risk management.
  • UNISDR recognizes the need for behavioral change in society.
  • Behavioral change reduces disaster losses.
  • On May 1, 2019, its name changed to UNDRR.

UNDRR (United Nations Office for Disaster Risk Reduction)

  • Supports implementation and review of the Sendai Framework for Disaster.
  • Adopted at the third UN World Conference on Disaster Risk Reduction on March 18, 2015, in Sendai, Japan.
  • Four priorities for action are the foundation of the vision.
  • The Sendai Framework is a 15-year voluntary and people-centered approach.
  • It aims to reduce disaster risk.

Three Strategic Goals of the Hyogo Framework for Action (HFA)

  • Integrate disaster risk considerations into sustainable development at all levels.
  • Emphasize disaster prevention, mitigation, preparedness, and vulnerability reduction.
  • Develop and strengthen institutions, mechanisms, and capacities.
  • Focus particularly in communities to improve resilience to hazards.
  • Incorporate risk reduction approaches in designing and implementing emergency programs.
  • Include preparedness, response, and recovery.
  • Also include programs for rebuilding affected communities.

Sendai Framework

  • It succeeds the Hyogo Framework for Action (HFA) 2005-2015.
  • It aims to build resilience of nations and communities to disasters.
  • Outcome of stakeholder consultations in March 2012.
  • Inter-governmental negotiations occurred from July 2014 to March 2015.
  • Supported by the UNDRR, requested by the UN General Assembly.
  • It requires focused action by States across sectors at local, national, regional, and global levels.

Priority Areas of Focus

  • The four priority areas of focus are as follows:

Priority 1: Understanding Disaster Risk

  • Disaster risk management should base on understanding all dimensions of disaster risk.
  • This includes vulnerability and capacity, exposure of persons and assets, hazard characteristics and the environment.
  • This knowledge is for risk assessment, prevention, mitigation, preparedness, and response.

Priority 2: Strengthening Disaster Risk Governance

  • It is important to manage disaster risk at the national, regional, and global levels.
  • Disaster risk governance is important for prevention, mitigation, preparedness, response, recovery, and rehabilitation.
  • Disaster risk governance also fosters collaboration and partnership.

Priority 3: Investing in Disaster Risk Reduction

  • Public and private investment in disaster risk prevention and reduction through structural and non-structural measures is essential.
  • This will enhance the economic, social, health and cultural resilience of persons, communities, countries and their assets, as well as the environment.

Priority 4: Enhancing Disaster Preparedness

  • Enhance disaster preparedness for effective response and to “Build Back Better” in recovery, rehabilitation, and reconstruction.
  • Growth of disaster risk means a need to strengthen disaster preparedness.
  • Take action in anticipation of events.
  • Ensure capacities are in place for effective response and recovery at all levels.
  • The recovery, rehabilitation, and reconstruction phase is critical.
  • Integrates disaster risk reduction into development measures.

Pre-Impact Phase

  • This phase occurs before a disaster.
  • It aims to reduce the potential for human, material, or environmental losses caused by hazards.
  • It ensures that these losses are minimized when the disaster strikes.

Prevention and Mitigation

  • Disaster mitigation actions can prevent a disaster or reduce the severity of its effects.
  • Mitigation activities include awareness through education and disaster prevention measures.
  • Immunization programs and public education are examples.

Disaster Prevention

  • The aim is outright avoidance of adverse impacts of hazards and related disasters.
  • Achieved through action taken, such as construction or dams.
  • Action examples also include embankments that eliminate flood risks, and land-use regulations.
  • Also, action involves no settlement in high-risk zones and seismic engineering designs for critical buildings.

Disaster Mitigation

  • Aims to lessen or limit the adverse impacts of hazards and related disasters.
  • Mitigation measures encompass hazard-resilient construction.
  • Mitigation measures consist of improved environmental policies and public awareness.
  • R.A. 10121 – Philippine Disaster Reduction and Management Act of 2010

Philippines Disaster Prevention and Mitigation

  • It emphasizes key strategic actions.
  • This emphasis gives importance to hazards evaluation and mitigation.
  • Also emphasizes vulnerability analyses, identification of hazard-prone areas, and mainstreaming DRRM into development plans.

Role of Nurse in Mitigation

  • Measures are designed to prevent hazards from causing emergencies.
  • Or to lessen the likely effects of emergencies.
  • Community assessment involves knowledge of community resources.
  • Resource examples are emergency services, hospitals, and clinics.
  • Also involves knowledge of community health personnel, community government officials, and local industry.
  • Important is risk management, identify, analyze, evaluate, treat, and monitor risk.

Preparedness

  • Disaster preparedness is a set of measures taken in advance.
  • Advanced measures include governments, organizations, communities, or individuals.
  • Advanced measures intend to better respond and cope with the immediate aftermath of a disaster.
  • This includes disasters that are human-induced or caused by natural hazards.
  • Simple initiatives can go a long way.
  • Examples are training for search and rescue.
  • Other examples are establishing early warning systems, developing contingency plans, or stockpiling equipment and supplies.
  • Disaster preparedness plays an important role in building the resilience of communities.

Challenges in Disaster Situations

  • Common communication challenges must be addressed.
  • Communication among organizations and across many people is a priority.
  • It is difficult given today’s changing environment.
  • Communication and coordination are crucial aspects of emergency management.
  • Communication system failure can occur due to infrastructure damage.
  • This is due to lack of operator familiarity, demands, inadequate supplies and integration of providers and technologies.

Information Management

  • Disaster plans facilitate data sharing and portability of health records.
  • This supports pre- and post-disaster recovery healthcare planning.
  • Allows optimal recovery of infrastructure for medical and behavioral healthcare, public health and social services.

Coordination

  • It's important for jurisdictions to consider their response when entire regions are impacted.
  • Planning includes identifying opportunities to strengthen the regional coordination.
  • Aims to ensure effective medical and public health response to large-scale disasters.
  • Detailed processes for distributing resources are an essential component.
  • Critical are the processes including personnel, equipment and supplies across multiple organizations.
  • Leadership roles and rescue coordination must be worked out in advance.

Advanced Warning Systems

  • Used for evacuation from danger areas.
  • Included in community disaster response plans.
  • Lead time and reliability improvements have made the systems more useful.
  • Disseminating warnings is a way to reduce disaster losses.

Surge Management

  • Disaster plans will account for a sudden surge of patients.
  • This means the effective triage of patients.
  • Distributes patients to hospitals in a coordinated manner.
  • This may mean even distribution of patients to several hospitals.
  • This is opposed to delivering most to the closest hospital.

Disaster Planning

  • Community mutual aid plan is needed.
  • This supports hospitals, nursing homes, or other residential healthcare facilities in the event of evacuation.
  • Healthcare plans must be realistic and achievable.
  • Required is specific detail about where the relocated patients will go.
  • Also required is who will care for the relocated patients.
  • Response requires addressing alternative modes of transportation and adequate security measures.

Personal and Home Disaster Survival

  • Important is assembling an emergency kit.
  • An emergency kit is essential to prepare for an emergency.
  • Ensure the kit addresses specific needs.
  • Consider items used every day when deciding what to add to the survival kit.

What to Include in an Emergency Kit

  • Pack batteries and portable chargers for adaptive equipment, such as hearing aids

  • Pack any communication aids

  • Include at least 1 week's supply of all prescription medications and a cooler for refrigerated medications

  • Medical supplies and important health documents

  • Extra mobility devices, such as a cane or a walker, if you can obtain these additional supplies

  • A contact list (e.g., numbers and addresses of people who support one's physical or mental health) in a watertight container

  • Necessary are supplies for pets and service animals (food, water, medicine, toys and bags to treat waste)

  • Once you build your emergency kit, keep it up to date, complete, and easy to find

  • Check emergency kits every 6 months to make sure all contents are current and functional.

Learning Preparedness Skills

  • Those are the knowledge, abilities, and actions individuals, communities, and organizations take.
  • It intends to anticipate, respond to, and recover from disasters.
  • Aims to minimize harm and maximize resilience.

PACE (Primary, Alternate, Contingency, Emergency)

  • PACE is a methodology to building resilient communication plans.
  • Communication plans use the acronym Primary, Alternate, Contingency, Emergency.
  • Used for reliable communications capabilities.
  • Used if first responders, public safety agencies, enterprises, and local governments need assistance.
  • It delivers structured framework.
  • Optimizes communication efforts in emergencies.
  • It delivers backup and alternative connectivity options.
  • Primary means are compromised or unavailable.
  • Each method will be completely independent of the other systems.
  • Preferred method is communication in normal circumstances.

Impact Response: Disaster Triage Categories

  • Triage comes from the French word trier.
  • Trier means “to sort out.
  • Sort and chose a process to place the right patient to receive care.
  • Patients must receive the right level of care.
  • Baron Dominique Jean Larrey – Napoleons chief surgeon, is credited for the first triage system.
  • He died at 76 on July 25, 1842.

Abilities of A Triage Officer

  • These are the personal abilities to triage effectively:
  • Clinically Experienced
  • Good Judgement and Leadership
  • Calm and Cool under stress
  • Decisive
  • Knowledgeable of available resources
  • Sense of humor
  • Creative Problem Solver
  • Available
  • Experienced and knowledgeable regarding anticipated casualties

Daily Triage

  • Performed by nurses often in the Emergency Departmant.
  • Utilizes standardized approach augmented by clinical judgement.
  • Goal is assess and treat to identify the sickest patients.
  • Treat those before the patients who are less ill.

Incident Triage

  • Occurs when ED is stressed by a large number of patients.
  • It can be due to an acute incident or an ongoing medical crisis such as pandemic influenza.
  • Utilizes existing agency resources.
  • Care is still provided to the most critically ill patients.
  • ED delays may be longer than usual.
  • Everyone who presents for care is attended to eventually.

Disaster Triage

  • The term is for local EMS and hospital emergency services when overwhelmed.
  • This occurs to the point that immediate care cannot be provided because of available resources.
  • During disaster, patients are:
  • Minimal or Minor (Designated with the color green) –Patients are physiologically well compensated.
  • Probably to remain so for an extended period.
  • Can wait for a considerable period with minimal risk of deterioration.

Other Disaster Categories

  • Delayed (designated with the color yellow) – patients are with compensated physiology.

  • They have significant potential for deterioration.

  • Immediate (designated with the color red) – patients with uncompensated physiology and injuries and are life-threatening.

  • Deceased (designated with the color black) – patients are with no detectable vital signs.

  • Expectant (designated as color gray) patients are alive but are unlikely to survive

  • Triage personnel must not become victims during disasters.

Simple triage and rapid treatment

  • The START triage tool is commonly used adult primary tool.
  • Used for MCI patients developed by the Newport Beach Fire and Marine Department and Hoang Hospital, California.
  • First published in 1983 and revised in 1994.
  • Devised only for adults, with an arbitrary lower application limit of a patient weight of 100 pounds.

Parameters of START

  1. Ability to walk
  2. The presence or absence of spontaneous respirations
  3. Respiratory rates
  4. Assessment of perfusion
  5. The ability to obey commands

JumpSTART

  • A pediatric MCI triage tool that first creates standards for triage of children.
  • Created for Multicausality or Disaster Settings.
  • Developed in 1995 and modified in 2001 by Dr. Lou Romig is a pediatric emergency physician.
  • Has a background EMS, disaster preparedness and response.

Post-Impact:

 Recovery, reconstruction, and rehabilitation

Reconstruction:

  • This phase occurs after a disaster. The restoration of an organization.
  • Organizations follow up by any impacts from a disaster.
  • The recovery by its time, the organization has achieved social stability.

The recovery phase:

  • It can last anywhere from six months to a year.
  • It depends on the depending on the severity of the incident.

An example of recovery is creating:

  • Strategic protocols and action plans to address the most serious impacts of a disaster.
  • Protocols give a clear outline of action to take
  • Create action plans for various disaster events and cover multiple scenarios.

Example for flood protocol including:

  • Mitigation plans can be water (with fan deployment, etc.)
  • Preferred water remediation
  • Secondary and tertiary services to contact

Community Rebuilding

  • Includes integrated Approaches
  • Rebuilding provides a safe shelter option through long term recovery programs.
  • The plans focus on self settlement, managed camps, and safety management
  • The rebuilds includes shelter kits,safe building information and assistance for permanent residences

Health and watsan

  • Focuses on low tech and sustainable strategies for the community This action can complement a focused approached to safe practices and medical care.
  • Community members become responsible for first- aid and sanitation services with minimal technology

Community infrastructure and services

  • Important is to Re-establish community health and education resources and services.
  • Community becomes the main resource for assistance
  • Volunteers are equipped to educate new programs regarding safety.
  • Empowerment for community is achieved through agency and organization

Local capacity development

  • Local groups are supported to create long term assistance programs These programs include sustainability with management.
  • Core volunteer services become first responders trained to assist in medical needs

Early recovery

It implements assessment by assisting with first disaster assessment .and planning

  • Creates long term quality care through early intervention following transition.

Reconstruction

  • The overall aim of reconstruction and its responsibility relies on families. As community member start, people adjust and build back former lives.
  • It is the community action to rebuild roads for daily use and infrastructure. Community members and volunteers will maintain safe environment after disaster

Rehabilitation

After a disater, the focus will be restoring the community by providing:

  • Transport
  • Utilities
  • Healthcare
  • Temporary homes

Critical Incident Stress Debriefing

  • Is the process to help people work ,often groups to promote a safe transition for traumatic events
  • Facilitators provide intervention for crisis by creating a relationship.
  • Connecting responders so similar experiences can offer education
  • This process will create healthy transitions after tragic events.

List of Symptoms from Trauma or Stress

The list of symptoms often stems from all types of stress.

  • Stress includes all signs across emotional ,behavioral and cognitive.
  • Its important for team leaders to be familiar with the varying sign

1. Introduction and Assessment:

  • To identify the group of people and its unique process, facilitators allow new members to ask questions

2. Act phase:

  • Supporters allows each community member to share unique perspectives.
  • This helps focus the conversation on actual and factual data to guide trauma transitions

3. Thought and Emotion Phase:

  • After facts been collected, people will express emotions regarding the experience.

4. Reaction Phase:

  • Facilitators act as an outlet to navigate trauma and concerns about moving forward, includes their fear of certain actions

5. Symptom phase:

  • During this phase, assistance is given for actions by facilitators. Support and coping mechanism will help community members

6. Teaching phase:

  • There is a focus on education and information to normalize any stressors and behaviors

7. Re-entry phase:

  • The aim is to connect members and support groups with professional members to encourage a safe and happy recovery.

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