Disaster Nursing Introduction: Philippines

Introduction to Disaster Nursing

• Catastrophic events are devastating and widespread.
• Climate shifts, global warming, acts of aggression, and sea-level rise are considered catastrophic events.
• Major effects of disasters include premature death, impaired quality of life, altered health status, and damage to properties.
• Risk profile - the Philippines - More than 7,641 islands comprise the Philippines, with a geography exposing it to hazards and disasters, but it’s not necessarily disaster-prone.

Threats in the Philippines

• Typhoons happen on average 20 times annually, half of these are destructive, killing ~500 individuals, and causing about 4 billion in property damage per year.
• Typhoon Milenyo (Xangsane) occurred on September 28, 2006, affecting 9 regions in Luzon and Visayas, resulting in 184 deaths, 536 injuries, 47 missing, and affecting ~4,032,479 persons.
• Typhoon Paeng (Cimaron) occurred on October 30, 2006, affecting 4 regions in Luzon, with statistics: 27 dead, 65 injured, 23 missing and affected the population, 63,989 families or 314,505 persons.
• Typhoon Ondoy (Ketsana) - the most devastating typhoon in the 2009 Pacific typhoon season resulted in damage: P1.09 billion, 747 fatalities, property damage - ~6 billion, 710 direct fatalities and 37 missing persons.
• Typhoon Yolanda (Haiyan) - the most devastating typhoon in the 2013 pacific typhoon season resulted in damage: P2.2 billion, 6,300 fatalities, 1.8 million homeless, and more than 6,000,000 displaced, high spread of disease mainly due to the lack of food, water, shelter and medication.
• Averaging 866 earthquakes per year, with some proving damaging.
• 1976 Mindanao earthquake killed > ~6000 people/ ~$400 million in damage and the 1990 Luzon earthquake killed-> 1,283 people, ~1.3 million people affected and ~$12.2 billion (USD 400 Million) in damage.
• Volcanic eruptions occur, with 22 out of 220 volcanoes - active.
• June 1991 Mt. Pinatubo eruption - dubbed the 2nd largest volcano eruption of this century.
• Tsunami - August 17, 1976 Earthquake & Tsunami: 7.8 Magnitude which generated a 15 ft high tsunami, that swept coastal areas of 5 provinces in Central and Southern Mindanao, killing - 3,792 and injured - 9,240.
• Landslides - Feb. 17, 2006 Brgy. Guinsaugon landslide wiped out an entire village of around 480 has.
• Floods resulted in PHP 76 billion in damage, out of the PHP 111.46 billion total damages from natural disasters, around the 1990-2005 average of 750 people killed per year with Nov. & Dec. 2004 Landslides / Flashfloods affecting mostly Luzon.
• Red tide Outbreak from 1983 to 2001 caused a total of 42 toxic outbreaks and around 2,107 paralytic shellfish poisoning cases with 117 deaths.
• Rizal Day Bombing also as the December 30 bombings were a series of bombings that occurred around Metro Manila, that killed 78 people and injured about 400.
• Phil Sports Stadium Stampede occurred at the PhilSports Stadium in Pasig City on February 4, 2006.
• Environmental hazard the sinking of MT Solar I at Luzaran Point, Guimaras resulted in the spillage of 200,000 industrial oil affecting 3 provinces and 38 municipalities, affecting 3,357 families or 16,785 persons.
• Disaster: defined as a sudden, catastrophic event that causes significant disruption, destruction, and distress, devastating the capacity to cope with resources.

Categories of Disaster

• Natural disasters result from an ecological disruption or threat that exceeds the adjustment capacity of the affected community.
• Three Broad Categories of Man-made disaster: Complex emergencies, technological disasters and disasters that occur in Human Settlements e.g. Famine, drought or epidemics.

Disaster Classification

• Rapid on-set events are short durations but with a sudden impact like earthquakes and tornadoes.

Phases of Disaster

• Pre-impact phase, a warning is given with the aid of weather networks and satellite systems; disaster personnel will call on amateur radio operators, radio, and television stations, nurses to assist shelters and emergency aid stations and establish contact with other emergency service group like LD PNP / Bureau of Fire.
• Impact Phase occurs when the disaster actually happens, is a time of enduring hardship or injury end of trying to survive and continues until the threat of further destruction has passed and emergency plan is also in effect.
• Post-impact - Recovery starting during emergency with the return normal order and lasts a lifetime for the persons involved, survivors go through Denial, Strong Emotional Response, Acceptance stages.

Four Phases of Disaster Management

• Pre-disaster Phase - cause feelings of vulnerability, fear of the future, lack of security, and loss of control.
• Impact phase - reactions can range from shock to overt panic.
• Heroic phase - survivors exhibit adrenaline-induced rescue behavior with a high activity and low productivity.
• Honeymoon phase - community bonding occurs.

Goal of Disaster Nursing

• Best possible level of health for the people and the involved disasters.
• Steps to attain the goals. Involves basic services like food, clothing and water, identify any potential secondary disasters and make an assessment of the safety level.

Principles of Disaster Nursing

• Rapid assessment of the situations and of nursing care needs. Triage initiation of life need. Selective use of measures for emergency. Adapting other emergencies based on information

Essentials of Disaster Planning and Management:

• Local emergency response personnel and organizations can deal with disasters. Regional aids in community. Statewide assist for support

Disaster Continuum

• Also known as emergency management cycle. Provides guide on the timeline. Consists of four phases: Pre-impact, impact, post-impact and recovery.

Disaster Planning

• The planning is from mitigation and prevention. Disaster preparedness - getting ready before disaster happens. Goal is satisfactory level of response when needed.

Disaster Risk Assessment

National Disaster Risk Reduction and Management Plan

• Mitigation is to put measures in place to minimize the results of a disaster.

Disaster Risk Reduction

• Positive resources that are helpful to individual for the hazard to occur. Adjustments to normal life to locations prone to calamities.

Disaster Risk

• Function of to the hazards with modification of levels, with notations. Disaster Risk Reduction (DRR). Involves with physical, vulnerability, to natural hazards

Ethical Principles Used in Disaster Nursing

• Moral is defined by the individual and is defined as acceptable behavior. Nurses code is from provision 2 of the ANA. Includes nurse patient relationship with interpretation to care for all.

The declaration covers everyone, including provision of human rights as a core component. Also covered are those with special needs.

• Code states that under conditions must always stress. With the right information, one can follow the guidelines on the next steps to disaster.

Philippine Disaster Reduction

• Shifts environments for others to reduce their levels of problems with emergency and reduce all impacts

Nurses’ Role in Disaster Nursing

• Nurses play roles to support people for injuries. Nurses are essential to the staff being on location with access to their own needs. Proper PPE etc

National Incident Management System (NIMS)

• A nationwide approach and the federal, local, and tribal government’s work effectively during recovery. NIMS components designed the flexible structure for incident to occur

Universal Declaration of Human Rights

• All humans are equal and born with dignity. Men and women have the right to family, be able to be heard and to be understood Right to thought, expression, religion and so much more with article 16 of the UN declaration