Philippine Disaster Risk

• Disasters are seen as threats to development, but disaster risk generation within development isn't effectively addressed.
• Managing disasters requires understanding the trade-offs, benefits (reduced poverty/inequality), environmental sustainability, economic development, and social progress.

Philippine Islands

• Consists of 7,641 islands and 82 provinces.

Riskscape

• The Philippines is prone to natural hazards, experiencing approximately 20 earthquakes daily due to its location.
• Positioned on the typhoon belt/superhighway in the Pacific, it faces frequent extreme weather events, averaging 20 typhoons annually.
• Broad coastlines make it susceptible to tsunamis, sea level rise, and storm surges, leading to secondary issues like flooding, landslides, heavy monsoons, rains, and drought.

Earthquake

• The Philippines experiences frequent seismic and volcanic activity as it lies along the Pacific Ring of Fire.
• Smaller magnitude earthquakes occur regularly due to the convergence of major tectonic plates.

Latest Major Earthquake

• A 5.9 magnitude earthquake struck off the central Philippines on January 23.
• PHIVOLCS (Philippine Institute of Volcanology and Seismology) monitors such activity.

Modified Mercalli Intensity Scale

• It measures earthquake effects at a specific location.
• Developed in 1931 by American seismologists Harry Wood and Frank Neuman.
• The scale comprises 12 levels, from imperceptible shaking to catastrophic destruction, denoted by Roman numerals.

Richter Scale

• Developed by Charles Richter in 1935, this logarithmic scale measures the magnitude of earthquakes.
• It quantifies energy released to understand intensity and potential impact.

Richter scale values

• Minor: < 2.0, usually unfelt but recorded.
• Light: 2.0-2.9, often felt, rarely causes damage.
• Moderate: 3.0-3.9, can be felt; infrequent damage.
• Strong: 4.0-4.9, noticeable shaking indoors; slight damage.
• Major: 5.0-5.9, potential for significant damage.
• Great: 6.0-6.9, can cause severe damage.
• Massive: 7.0+, major earthquakes causing widespread destruction.

Liquefaction

• Saturated sand and silt behave like liquid during intense earthquake shaking.
• Liquefaction requires loose, granular sediment, water saturation, and strong shaking.

Volcanic Eruptions

• The archipelago has 24 active volcanoes out of 300 total.
• The Philippine plate and smaller micro plates subduct along the Philippine Trench (east) and Luzon/Sulu trenches (west).
• Lahars (mudflows) are common because of heavy rains.
• Tsunamis often accompany eruptions.

Flooding

• Torrential rain leads to flooding due to overflowing rivers, saturated soil, low-lying areas, and poor drainage.
• The greatest loss of life and economic costs derive from flooding.
• Environmental issues (deforestation), uncontrolled urban growth, poor land use, reduced protected forests/riverbanks, poor waste disposal, and clogged waterways worsen flood/landslide risks.

Disaster

• A catastrophic situation disrupts normal life, requiring extraordinary measures.
• Ecological disruptions result in deaths, injuries, illness, and property damage that cannot be managed with routine procedures, needing outside assistance.

Concepts and types

• Natural disasters are caused by forces of nature (extreme temperatures, fires, floods, earthquakes, storms, epidemics).
• Man-made disasters are caused by human errors such as riots, bioterrorism, war, and accidents.
• Technological disasters result from technological failures like building collapse, hazardous material incidents, fires/explosions, transportation accidents, and industrial accidents.
• Civil and Political Disorders include demonstrations and strikes, riots, mass shootings, hostage taking, and terrorism.

Internal Disasters

• Events within a facility that disrupt care.
• Examples: fires, utility failures, workplace violence, storms, flooding, bomb explosions, terrorism.

External Disasters

• An event impacts a facility when service demand exceeds resources.
• Examples: plane crashes, major train derailments, severe storms, flooding.

Natural Disasters

• Geophysical hazards originate from the solid earth (earthquakes, landslides, volcanic activity).
• Meteorological hazards are caused by extreme weather (rain, drought, extreme temperatures).
• Hydrological hazards are caused by the occurrence, movement, and distribution of water (floods, avalanches).
• Climatological hazards are caused by climate variability (droughts, El Niño, La Niña).
• Biological hazards involve disease, disability, or death (malaria, dengue, COVID-19).

Trends and Patterns

• Growing population and infrastructure increase exposure to natural hazards.
• The top 3 natural disasters affecting the country are floods, storms, and volcanoes.

Disaster Management

• Collaborative activities anticipate disastrous events, including preparedness and long-term risk reduction.

Phases of Disaster

• Pre-Disaster Phase: Includes risk assessments, training, and program planning to prevent potential disasters.
  • Aim: To inform people about local risks and prepare them for specific responses.
• Alert Period: Time when a disaster is developing but hasn't hit the community.
  • Threats are detected, warnings are issued, and evacuation is facilitated.
  • Aim: Ensure food availability and access for the community.
• Disaster Phase: Immediate response after a disaster.
  • Measures include search and rescue, and meeting basic needs (shelter, water, food, medical care).
  • The National Disaster Risk Reduction Management Council manages the aftermath.
  • Activities: Rapid assessments, establishing medical triage centers, search and rescue, providing medical treatment.
  • Aims: Assess magnitude, immediate impact, health consequences, local resource adequacy, and relief operations.
• Post-Disaster Phase:
  • Rehabilitation focuses on restoring the community and facilitating necessary adjustments.
  • Activities: Evacuation, shelter, food, clean water, mortality/morbidity surveillance, primary healthcare, and nutritional surveys.

Mitigation

• It encompasses all actions taken for long-term risk and hazard reduction after a disaster.
• Social impacts: increased mental health issues, alcohol misuse, domestic violence, chronic diseases, short-term unemployment.
• Physical impacts: increased mortality/morbidity, physical trauma, acute diseases (leptospirosis), and emotional trauma.

Disaster Nursing

• In disaster, disaster nursing involves adapting professional nursing skills to meet evolving medical and nursing needs.
• Nursing plans must be integrated and coordinated, with updated physical and psychological preparedness.
• Nurses are responsible for organizing, teaching, supervising, stimulating community participation, and exercising competence.

Basic Principles of Nursing Care

• Principles for disaster victims include adapting skills, continuous awareness of patient conditions, teaching auxiliary awareness, and selecting essential nursing care.

Roles and Responsibilities of a Disaster Nurse

• Disseminate information on environmental health hazards, interpret health laws, save oneself, accept directions, serve the most vulnerable, teach warning signals, exercise leadership, and refer to agencies.

Roles of a Nurse During A Disaster

• Before the disaster: Regularly attend training, understand emergency procedures, coordinate with officials on safety/evacuation, and ensure a survival kit is available.
• During the disaster: Monitor updates, remain calm, ensure safety, coordinate on evacuation/medical assistance, and assess individual needs for care.
• After the disaster: Coordinate with officials for evaluation, treat injuries, provide first aid, and coordinate additional medical assistance.

Incident Command System/Triage

• The incident command system, also known as incident management system, serves as the triage center of command.
• A triage system provides a management framework for large-scale incidents.

Triage Definition

• From the French "trier" (to sort or choose).
• It quickly identifies victims of mass casualty incidents, separating those with life-threatening injuries from those likely to survive.

Disaster Triage Principles

• Never move casualties backward.
• Never hold critical patients for further care.
• Salvage life over limb.
• Never move a patient before triage.
• Triage goal: identify the sickest patients to provide them with treatment first.

Triage Personnel

• Is performed by trained individuals, paramedical personnel, and medical personnel.

Effective Triage Nurse Qualities

• Clinical experience, good judgment, leadership, calmness, decisiveness, knowledge of resources, anticipation.

START Triage System

• START (Simple Triage and Rapid Treatment) is a simple triage system.
• It is performed by lightly trained lay and emergency personnel in emergencies

START Triage Principles Application

• It is not intended to supersede or instruct medical personnel or techniques.
• It has been taught to California emergency workers for use in earthquakes.
• The system was developed at HOAG Hospital in Newport Beach, California.
• Patients who can walk are categorized as "delayed" (green) and moved to a specific location.
• Remaining patients are assessed using RPM (Respiration, Perfusion, Mental Status)

Triage Color Codes

• Black (Expectant): Casualty is not expected to survive without compromising care for higher priority patients.
• Red (Immediate): Requires immediate medical attention for airway, breathing, perfusion, or neurologic problems.
• Yellow (Delayed): Requires medical attention within 6 hours for injuries that are potentially life-threatening, but can wait until immediate casualties are stabilized.
• Green (Minimal): Requires medical attention when all higher priority patients have been evacuated.

Multi Casualty Incident

• In a Multi casualty incident, an event places excessive demands on personnel and equipment.
• EMS system's ability to respond is challenged
• The number of patients before MCI can be declared varies in practice.

Tagging

• Is an Tagging occurs simultaneously to the primary triage process.
• Patients are tagged for identification by rescue personnel that need to be transported and treated.