Disaster Management & The Sendai Framework

Disaster Management

• Disaster management is effectively preparing for and responding to disasters to lessen the harm they cause.
• This involves strategically organizing resources and managing disaster prevention, preparedness, response, and recovery responsibilities.

UNISDR & UNDRR

• According to the UNISDR, reducing disaster risk is essential for sustainable development.
• A risk-informed development path is key to successfully managing disaster risks.
• UNISDR recognizes society needs to change behavior to reduce disaster losses substantially.
• On May 1, 2019, UNISDR updated their name to UNDRR.
• UNDRR supports implementing and reviewing the Sendai Framework for Disaster
• The Sendai Framework was adopted at the third UN World Conference on Disaster Risk Reduction on March 18, 2015, in Sendai, Japan.
• The Sendai Framework is anchored on four priorities for action.
• The Sendai Framework is a 15-year, voluntary, people-centered approach to reducing disaster risk.

The HFA's Three Strategic Goals

• Integrate disaster risk considerations into sustainable development policies, planning, and programming at all levels.
• Emphasize the importance of disaster prevention, mitigation, preparedness, and lower vulnerability.
• Develop and strengthen institutions, mechanisms, and capacities that can systematically improve resilience.
• Incorporate systematic risk reduction approaches into emergency preparedness, response and recovery programs.
• Include programs for rebuilding communities.

The Sendai Framework Successor

• The Sendai Framework is a successor to the Hyogo Framework for Action (HFA) 2005-2015.
• The HFA aimed to build the resilience of nations and communities to disasters.
• Stakeholder consultations initiated in March 2012, and inter-governmental negotiations from July 2014 to March 2015 supported the UNDRR at the UN General Assembly's request.
• Implementation within sectors across States at local, national, regional and global levels is needed based on Hyogo Framework for Action experience.

Priority 1: Understanding Disaster Risk

• Disaster risk management should be based on understanding disaster risk in all dimensions.
• This includes vulnerability, capacity, exposure of people/assets, hazard characteristics, and the environment.
• Risk assessment, prevention, mitigation, preparedness, and response benefit from such knowledge.

Priority 2: Strengthening Disaster Risk Governance

• Disaster risk governance is important at national, regional, and global levels for prevention, mitigation, preparedness, response, recovery, and rehabilitation.
• Disaster risk governance promotes partnerships and cooperation.

Priority 3: Investing in Disaster Risk Reduction

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

Priority 4: Enhancing Disaster Preparedness

• There is a need to strengthen disaster preparedness for response, take action in anticipation of events, and ensure all levels have the resources for effective response and recovery.
• Strengthening disaster preparedness supports the "Build Back Better" model.
• Integrating disaster risk reduction into development measures is a critical opportunity in the recovery, rehabilitation, and reconstruction phase.

Pre-Impact: Prevention and Mitigation

• Before a disaster, efforts should reduce human, material, or environmental losses from hazards to ensure minimized losses.
• Disaster mitigation refers to actions/measures that prevent a disaster's occurrence or reduces the severity of its effects.
• Mitigation includes awareness, education, and disaster prevention.
• Immunization programs and Public Education & Awareness are examples of prevention.

Disaster Prevention v. Disaster Mitigation

• Disaster prevention is outright avoidance of adverse impacts of hazards and related disasters.
• Actions in advance, eliminate flood risks, land-use regulations, and prohibition of setllement in high-risk zones are prevention examples.
• Mitigation lessens the adverse effects of hazards and related disasters.
• Mitigation measures encompass engineering techniques, hazard-resilient construction, better environmental policies, and public awareness.
• R.A. 10121 is the Philippine Disaster Reduction and Management Act of 2010.

Philippines Priority Areas

• Strategic actions in the Philippines give importance to activities revolving around hazard evaluation, mitigation, vulnerability analyses, hazard-prone area identification and mainstreaming DRRM into development plans.

Nurse's Role in Mitigation

• Measures designed should prevent hazards from causing emergencies or to lessen the likely effects of emergencies.
• Knowledge of community resources (e.g., emergency services, hospitals/clinics), community health personnel, community government officials, and local industry is essential to Community Assessment to Risk Management.
• The goal is to identify, analyze/evaluate, treat, and monitor risk.

Disaster Preparedness

• Measures are undertaken in advance by governments, organizations, communities, or individuals to better respond and cope with the immediate aftermath of a disaster.
• Training for search and rescue, establishing early warning systems, developing contingency plans, and stockpiling equipment and supplies are simple initiatives that can go a long way.
• Disaster preparedness plays an important role in building community resilience.

Communication Challenges

• Multidirectional communication among organizations a major priority in any disaster planning initiative.
• Communication and coordination are crucial in today's changing environment for emergency management.
• Failure of communication systems stems from damage, familiarity, excessive demands, integration and lack of supplies.

Information Management Challenge

• Disaster plans should facilitate data sharing, portability of health records across healthcare settings.
• Ensure support for pre- and post-disaster recovery planning and optimal recovery of infrastructure and services.

Coordination

• Jurisdictions need to consider how they will respond when the entire region is impacted.
• Planning activities should identify opportunities for effective medical and public health response, strengthen regional coordination, and ensure scale.
• Detailed processes for the efficient distribution of resources, including supplemental personnel and equipment, in plans should include multiple organizations.
• Leadership responsibilities and coordination of rescue efforts should be worked out in advance.

Advanced Warning Challenges

• Evacuation from dangerous areas must be included in community disaster response plans.
• Warnings are increasingly useful for responding as lead time and reliability improve.
• Disseminating warnings can reduce disaster losses.

Surge Management Challenge

• Have provisions and coordinated processes for a sudden surge of patients
• Plans must account for the effective triage, and consider distributions to hospitals (several vs. the nearest)

Disaster Planning

• Disaster planning must include a community mutual aid plan.
• The plan should address for evacuating healthcare facilities.
• Evacuation plans must be realistic and achievable.
• Evacuation plans contain detail about where the patients will be relocated and who will care for them.
• Evacuation plans address the modes of transportation and inclusion of adequate security measures.

Emergency Kit

• Emergency kits use your everyday items and meet your specific needs.

Emergency Kit Contents

• Batteries and portable chargers for hearing aids and other adaptive equipment.
• Any communication aids needed.
• At least one week's supply of prescription medications like refrigerated medications.
• Medical supplies and important health documents.
• Mobility devices, if needed
• Contact lists of support personnel.
• Supplies/documents for pets/ emotional support animals.

Kit Maintenance

• Keep up to date, complete, and easy to find by checking every 6 months that all contents are useable

Learning Preparedness Skills

• It incorporates the knowledge, capabilities, and actions individuals, communities, and organizations take to minimize harm and maximize resilience

PACE (Primary, Alternate, Contingency, Emergency)

• It has a methodology for communications during emergencies.
• Uses resilient communication plans.
• PACE provides backup & alternative connectivity given primary communication means failing.
• Preferred and most reliable normal communication circumstances.

Disaster Triage Categories

• It derives from the French word trier, to sort/choose
• It is a process that places the right patient in the right place at the right time.

Baron Dominique Jean Larrey

• Napoleons chief surgeon
• Credited for organizing the first triage system.

Personal Triage Abilities

• Effective triage officers are clinically experienced, have good judgment, are calm under pressure, and are decisive, knowledgeable, humorous, available, creative and experienced.

Different types of Triage

• Daily Triage is performed by nurses on routine basis, clinically augmented
• The goal is to identify the most sick patients for earlier assessment/ treatment than those less ill/ injured
• Incident Triage occures when ED is stressed.
• Occurs due to acute incident or pandemic. It still tends to all patients.
• ED Delays may be longer.

Disaster Triage

• It's a general term for when EMS and hospital emergency services are overwhelmed such that immediate care is not possible.

Triage Categories During Disaster

• Minimal/Minor (Green) are well-compensated, will be able to wait for basic care, have a low risk of deterioration.
• Delayed (Yellow) are compensated, but may deteriorate.
• Immediate (Red) are uncompensated patients but can be saved with rapid intervention, have low resource consumption.
• Deceased (Black) possess no vital signs.
• Expectant (Gray) are unlikely to survive due to limited resources.

Triage Guidance

• Triage Personnel must not become victims themselves.

Simple Triage and Rapid Treatment

• It was created by Newport Beach Fire and Marine, CA in 1983, revised 1994, and is for adults of at least 100 lbs.

START Parameters Assessed

• Assesses the ability to walk, presence/lack of spontaneous respiration, rates, assessment of profusion.
• Also assesses the ability to obey commands.

JumpSTART

• It's a pediatric MCI objective tool developed by Dr. Lou Romig in 1995, revised 2001.

Recovery Phase

• It's an organization's restoration following disaster, achieving physical, environmental, economic, and social stability.
• Time frames may take from 6 months to a year based on the disaster.
• It includes creating strategy/action plans for the worst impacts.

Flood Protocol should include:

• Organization's water mitigation effects and preferred water service contact and backups.

Community Rebuilding with Shelter

• It supports recognizing those who cannot return to their original sites.
• Providing shelter kits. building assistance.

Health and Waysan

• It should start with an outside approach
• Give aid to the community

Infrastructure Support

• It supports the long term support

Local Capacity Development

• Support re-establish organizations and systems through finance, resource management, volunteering and disaster planning

Early Recovery

• refers to assessment and implementation following an event
• designed to give first few months of support and strengthing

Reconstruction

• Feeling of Recovery
• Roads and infrastructure are rebuilt

Rehabilitation

• Restoration
• Returning to normality after disaster

Critical Incident Stress Debriefing (CISD)

• A facilitator helps a group work through a response
• Reduces trauma, increase effective coping, and trauma education.
• Create processing space for stressful/ traumatic events, offer support, and mitigate trauma symptoms.

CISD Signs & Symptoms

• It produces physical, emotional, cognitive, or behavioral symptoms.
• Helps managers' identify these stressors.

7 Stages of Critical Incident Debriefing

• Assess the critical incident
• Identify safety and security issues
• Allow venting of thoughts, feelings, and emotions
• Share emotional reactions
• Review symptoms and the incident's impact
• Teach and bring closure to the incident
• Assist in re-entering the workplace/ community

First Four Phases of Debriefing:

• Review the process, facts, thoughts and emotions, and reactions to what happened.

Phases 5-7 of Debriefing

• Identify the symptoms, understand trauma, cope with re-entry

Psychological First Aid (PFA)

• The intervention connects to support/ reduces reactions to trauma
• It lessens stress, promotes recovery, fulfills needs, empowers the individual connects networks, and makes referrals.

PFA Goals:

• It creates and supports a safe and empowered space that is calm, safe, and connected.