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• Disaster nursing adapts professional nursing knowledge, skills, and attitude to meet disaster victims' physical and emotional needs.
• It also refers to when a health professional volunteers in a crisis through an aid or volunteer organization.

What is a Disaster?

• Defined by WHO: Any occurrence causing damage, ecological or economic disruption, loss of life, health deterioration, demanding extraordinary response.
• Defined by UNDRR, UN Office for Disaster Risk Response: Serious community disruption affecting human, material, economic, and environmental aspects.
• Also defined as a natural or man-made occurrence causing human suffering and needs that victims cannot meet alone (American Red Cross / ARC).
• The Philippines faces seismic, volcanic, and typhoon risks, making it disaster-prone.

National Risk Index

• Provides risk index percentiles and ratings based on expected annual loss from natural hazards, social vulnerability, and community resilience.
• Community Risk Factor scales social vulnerability and community resilience in the National Risk Index.
• Risk Index represents potential negative impacts from natural hazards.

Expected Annual Loss

• It is a measure of the average economic loss in dollars resulting from natural hazards each year.
• Computed in US dollars.

Risk Index Defined

• It measures the "possibility or potential na magkaroon ng disaster sa isang bansa" ("possibility or potential of a disaster in a country").

Social Vulnerability

• It enhances risk and represents the susceptibility of social groups to adverse hazard impacts.

Community Resilience

• It reduces risk by representing a community's ability to prepare, adapt, withstand, and recover from disruptions.
• The World Risk Index 2022 ranked the Philippines as the most disaster-prone country.
• Annually, 20 typhoons enter the Philippines, especially intense between July and October, and can lead to floods and landslides.
• The Global Risks Report 2023 indicates that natural disasters and extreme weather events are top risks for the country.

Disaster Risk Drivers

• These processes/conditions raise disaster risk by increasing exposure/vulnerability or decreasing capacity:
• Factors include: Poverty, climate change, urbanization, and poor land management.

Hazards

• These are threats that will likely have a negative impact.
• Natural hazards: Earthquakes, landslides, tsunamis, cyclones, extreme temperatures, floods, and droughts.
• Biological hazards: Disease outbreaks in humans, animals, and plants.
• Technological hazards: Chemical/radiological releases, explosions, transport failures, and infrastructure collapse.
• Societal hazards: Conflict, terrorism, migration, and humanitarian emergencies.
• Secondary agents: Bacteria and viruses that cause contamination or infection.

Mitigation vs. Preparedness

• Mitigation: Actions to lessen disaster effects.
• Preparedness: Focus on preparing people.
• Mitigation: Concerns infrastructure, materials, and resources.

Factors Contributing to Disaster Potential

• Host Factors: Age, health, mobility, etc.
• Agent Factors: Natural or technological cause.
• Environmental Factors: Contribute to or mitigate the disaster.
• Disaster damage: Occurs during/immediately after.
• It's measured physically (e.g., square meters of housing).
• Describes destruction/disruption of physical assets and livelihoods.
• Disaster impact: Total effect (negative/positive) of a hazardous event.
• Includes economic, human and environmental impacts (e.g., death, injuries, disease).
• It can be immediate and localized.
• It can be widespread and prolonged.
• The effect may exceed a community or society's coping capacity.
• May require external assistance.

Classifications of Disasters and their effects

• Direct effects are immediately apparent with quantifiable monetary term
• Ex. Property damage or business interuption
• Indirect effects are not as easily quantifiable but still apparent.

Natural Disasters

• An event that overwhelms local resources and threatens safety.
• Highly harmful events following a natural hazard.

Geophysical

• Hazards originating from solid earth
• Such as earthquakes, mass movements, volcanos

Meteorological

• Caused by changes to the Earth's atmosphere
• Such as cyclones, droughts, blizzards, bushfires

Hydrological

• Flash floods occur due to rainfall or breakage
• Limnic eruptions are caused by magma and produce too much carbon dioxide

Climatological

• Caused by long-lived, atmospheric processes
• Such as heat/cold waves, and land fires

Biological

• Involves disease, disability or death on large scale
• Caused by organisms like bacteria, virus, toxins, epidemics

Man-made disasters

• Acts of individuals that cause deviation and destruction; war, terrorist bombings
• It also has negligence, or error
• Technological disasters can be community infrastructure or accidents with nuclear materials.
• Complex emergencies are disasters from war, diseases, and political unrest.
• External disasters happen at separate locations from the hospital.
• Internal disasters occur such as bomb threats or laboratory accidents.

Disaster Nursing - Key Concepts

• D - Detection
• I - Incident Command
• S - Safety and security
• A - Assess: The situation and the casualty
• S - Support: Physical, psychological, spiritual
• T- Triage and treatment
• E - Evaluation
• R - Recovery
• The goal is to ensure the highest level of care is delivered through active disaster management.

Additional goals

• Minimize casualties
• prevent further casualties

Disaster Prevention (Levels 1-3)

• Level 1 is primary prevention, which targets vulnerable groups exposed to disasters.
• Such as drills and aid
• Level 2 is secondary prevention which mitigates health consequences.
• Such as use of carbon monoxide detectors
• Level 3 is tertiary prevention, which minimizes effects of disaster.
• Isolating individuals from spreading infectious illnesses
• Level 1: Basic nurses authorized to practice.
• Level 2: Nurses within an institution that are designated responder
• Level 3: Frequent responders that are prepared for a wide range of diaster

8 Domains of Disaster Management

• Domain 1: Actions taken apart from any specific emergency to increase the readiness and confidence
• Domain 2: Conveying essential approach to working or doing emergency assignments
• Domain 3: The structure of disaster/emergency response requirement and actions to make them effective
• Domain 4: Ensuring that nurses, colleagues and patients add to the burdens of unsafe practices
• Domain 5: Collecting data that helps basis of disaster action
• Domain 6: Taking assessment in response of patients
• Domain 7: Taking any steps that facilitate individual activity and organization function

Phases of a Disaster

• Pre-disaster: No disaster yet
• Consultation of planning
• Threat: Survival actions and strategies
• Social and Physical Impact: Period of onset
• Inventory: Recalling the impact
• Rescue: extricating individuals or local unorganized events
• Remedy: Professional services Fig 1: Recovery and rehabilitation shown by the eight socio-temporal stages of a disaster

Phases of disaster (pre-impact, impact)

• Pre-impact is the initial phase prior to actual occurance with weather networks
• Communication is a major role and nurses assist in preparing shelters with emergency service goods
• Impact is when the disaster has actually happened and hardship is occuring.
• Can last minutes or days .
• Continues til threat of distruction has passed and placed in effect.
• Emergency operation center established and put in place.
• Nurses are a member of the disaster action team.
• Recovery begins when there is return of normal community orders and functioning.
• Victims may deney magnitude of the problem.
• It's important for victims to help themselves or families.
• Victims feel that they are back to normal.
• Victims develop the realistic memory.
• Mitigation occurs before a disaster takes place.
• It reduces vulnerability to disaster impacts.
• Clearing space is an example of mitigation.

Cert Disaster Response

• It provides a standardized training and framework to community members
• Consists of volunteers to help suplement existing workers post disaster.
• It locates water, extenguishes small fires, and conducts light search and rescue.
• The return operations go back to normal.
• Takes place after disaster.

HRVA: Hazzard Risk and Vulnerability Analysis

• If someone is looking for a hazard is the source or situation
• Where the risk refers to the likehood that something will occur
• An HRVA helps assist in answering questions about what hazards can occur or if it can make communities resilient.