Disaster Nursing Lecture Introduction PDF

[NUR81028] Disaster Nursing Lecture: ​ MAIN FEATURES OF DISASTER Un...

[NUR81028] Disaster Nursing Lecture: ​ MAIN FEATURES OF DISASTER Unpredictability INTRODUCTION TO DISASTER NURSING ○​ E.g. Even if we have some instruments that can help 4NUR-4 | Asst. Prof. Warren Kemuel M. Pan, MAN, RN. predict the impending disaster, we don't know when it BY: ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL will happen ○​ we can know the magnitude, and monitor the DISASTER progress of the storm but the moment it will strike, it ETYMOLOGY is unpredictable ​ Greek words ​ Unfamiliarity ○​ Dus (bad) ○​ E.g. Even if we know that there is typhoon, eruption ○​ Aster (star) and disaster, but you still don’t know what would be ○​ Calamity due to the bad positioning of a planet or a the effect of this to the community star ○​ lack of awareness of the magnitude of the disaster ​ Sometimes they would look at the shape, color, and (when a typhoon occur, different impact from a well brightness of the moon (e.g. full bright moon, red moon) develop community then a less develop and ​ Evolved: unprepared community ○​ Disastro (Italian) ​ Speed ○​ Desastre (French) → Disaster ○​ “Gaano ba kabilis dumating sa atin?” ○​ talking about the onset, duration and the impact DEFINITION ​ Urgency UN OFFICE FOR DISASTER RISK REDUCTION ○​ How urgent are we supposed to be when there’s a ​ a serious disruption of the functioning of a community or disaster? a society at any scale due to hazardous events interacting ○​ How fast can we response and prepare for the with conditions of exposure, vulnerability and capacity impending disaster for us to mitigate the impact leading to one of more of the following: human, material, ○​ the more casualties, more victims economic and environmental losses and impacts ​ Uncertainty ○​ disaster will occur if you have been exposed to a ○​ sense of doubt if you can do it (if they are resilient) hazard (any condition - man-made or natural that ○​ It will influence the decision making of the causes danger to a community) with low capacity of community. If they are certain, they can decide the persons immediately ○​ exposure to hazard of a vulnerable community may ​ Threat lead to disaster ○​ possible threats: ○​ hazard is the phenomenon, it cannot be prevented ​ loss of human lives ​ missing person ​ destruction of properties AMERICAN RED CROSS ​ disruption in the economy ​ It is an occurrence either natural or man-made that causes human suffering and creates human needs that victims cannot alleviate without assistance TRUE OR FALSE? 🤔 ​ Assistance will come from outside resources (agency or organizations): red cross, US Aid, NDRRM, LGUs, DISASTERS ARE PREVENTABLE? ○​ NDRRM: main agency of the government when it ​ Increased vulnerability, low capacity and ??? comes to disaster and rehabilitation ​ Hazards are the phenomenon and it cannot be prevented but disaster is prevented WORLD HEALTH ORGANIZATION ○​ increase the coping capacity and decrease the ​ Any occurrence that causes damage, ecological vulnerability disruption, loss of human life, deterioration of health and ​ if you are vulnerable with low capacity: disaster will health services on a scale, sufficient to warrant an always occur extraordinary response from outside the affected ​ TRUE: disasters are preventable but it is inevitable that community or area (WHO) hazards will occur ○​ Sudden event that causes deterioration of health of ○​ Disaster pertains to the effect, we can lessen the society → illness and shortage of food effect DICTIONARY MEANING THE DISASTER RISK EQUATION ​ It is a sudden accident or natural event that causes great damage or loss of life W. NICK CARTER ​ It is an event, natural or man - made, sudden or ​ The risk of a disaster increases as the frequency or progressive, which impacts with such severity that the severity of hazards increases, people’s vulnerability community has to respond taking exceptional measure increases and people’s vulnerability increases and people’s capacity to cope (ability to cope with the consequences) is REPUBLIC ACT 10121 OF 2010​ decreased (SECTION 2) ​ A serious disruption of the functioning of a community or VULNERABILITY a society involving widespread human, material, economic DEFINITION FROM UNISDR (2004) or environmental losses and impacts, which extends the ​ Having the conditions determined by physical, social, ability of the affected community or society to cope using economic and environmental factors or processes which its own resources increase the susceptibility of a community to the impacts ​ often described as a result of the combination of the of hazards exposure to a hazard; the conditions of vulnerability that ​ Physical vulnerability: are present; and insufficient capacity or measures to ○​ who is more vulnerable in floods: those living in reduce or cope with the potential negative consequences low-lying areas ○​ Capacity → different solutions/ strength that the ○​ who is more vulnerable: those who are living within community has to mitigate whatever hazard may the danger zone of a volcanic eruption come ​ Social vulnerability: ○​ elderly, persons with disabilities, marginalized individuals [NUR81028] Disaster Nursing Lecture - TOPIC​ ​ ​ ​ 1​ ​ ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  ​ Economic vulnerability ○​ below marginalized (since they cannot afford or purchase the materials that is needed to be prepared for a disaster) ○​ a community with few funds that does not have enough technology to predict a disaster ​ Environmental Factor ○​ pollution ○​ deforestation: prone to flooding, landslides, erosion HAZARD DEFINITION ​ Is any phenomenon that has the potential to cause disruption or damage to people and their environment ○​ only a threat: has the potential (it will cause damage) ○​ low coping capacity and high vulnerability individual Source: Understanding Disaster Risk ○​ hazards are not preventable, but you can decrease one’s exposure TO DECREASE EXPOSURE TO HAZARD ​ a perceived natural event which threatens both life and property ​ evacuation, alerting the citizens and the community using ​ It is a natural event, while disaster is its consequence text blasts to reduce the exposure to hazards ○​ The impact is not the same DISASTER RISK REDUCTION CAPACITY/COPING CAPACITY ​ Is viewed as a concept and practice of reducing disaster DEFINITION risks through systemic efforts to analyze and manage the ​ Refers to the ability of people, organizations, and systems, causal factors of different disasters using available skills and resources, to deal with and ○​ Ask the community what are the common disasters manage conditions such as hazards, emergencies, or ​ ex. low-lying areas=flooding disasters ​ Is the community prepared and if they have ​ To increase the coping capacity: Mitigation and resources preparedness ​ It aim to reduce the damages caused by natural hazards ○​ Education like earthquakes, droughts, and cyclones, through ○​ Training preventive measures (UNISDR) ○​ Increase resources: advanced technology, ​ E.g.. PDRRMC, NDRRMC preparedness equipment ○​ robust: resilient infrastructure and facilities WAYS TO REDUCE DISASTER RISK REDUCTION ○​ Collaboration, networking, linking with other entities ​ Reducing exposure to hazards (for assistance) ○​ emergency evacuation plan ○​ community empowerment: if the community is ​ lessening vulnerability of people and property self-reliant and maximize the resources ○​ reduce vulnerability: assess what factors influence ○​ health system is robust and resilient the vulnerability (physical, social, economical and ​ 6 Building blocks: manpower, machine, environmental) technology, governance, availabilities of ​ wise management of land and the environment vaccines and medication ○​ Include the plan of where to evacuate ​ “The strength of the community” ○​ e.g., landslide prone area: they assess the land with ○​ Talks about the resilience and mitigation of the the use of equipment - they put signage as notice - it community will discourage people to build houses there ​ Resources: materials, manpower ○​ e.g., fault line - a developer will not place any buildings in fault lines but if they do, they will make it earthquake proof and follow codes SUMMARY ON DISASTER: ​ Improving preparedness for adverse events ​ In capsule, disaster occurs when hazards meet ○​ e.g. training, education,awareness-building vulnerability ​ Disaster is a crisis situation that exceeds the DISASTER NURSING capabilities (Duarantelli, 1985) ​ An adaptation of professional nursing knowledge, skills ○​ Which gives reason as to why external help is and attitude in recognizing and meeting the nursing, health being given by the LGU, province or national and emotional needs of disaster victims disaster response team ○​ Not only material needs but also psychological needs - e.g. death in the family, lost of properties → DISASTER RISK debriefing ​ is the product of the possible damage caused by a hazard ○​ Encompasses medical-surgical, emergency, and due to vulnerability within a community (Dar, 2014) psychiatric nursing - e.g. fractures, contusions, ○​ Risk = associated with the degree to which humans cardiac arrest cannot cope (lack of capacity) with a particular ​ utilization of the nursing process in assisting, helping, situation (e.g. natural hazard). providing aid in disaster victims ​ the Philippines, is no. 1 in terms of disaster risk. ​ how to provide services in disaster related conditions ○​ Which is why we need to equip ourselves ​ e.g., if someone is injured, as a nurse, how will you ○​ E.g. risk assessment intervene? (This is disaster nursing) Assess the patient ​ Disaster Risk = (Hazard x Vulnerability) / Capacity first, utilize ADPIE ​ Hazard + Vulnerability → Not prevented → DISASTER ○​ udies TYPES OF DISASTERS NATURAL DISASTERS ​ Those caused by natural or environmental forces ​ Results of ecological disruption or threat that exceeds the adjustment capacity of the affected community (WHO by Lechat, 2979) ​ affects impact on climate change, global warming, [NUR81028] Disaster Nursing Lecture - TOPIC​ ​ ​ ​ 2​ ​ ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4 TOP 10 NATURAL DISASTERS GLOBALLY DURATION (gaano katagal nanalasa) ​ Examples: cyclone, earthquake, tornado, volcanic eruption, ​ Short and long as well tsunami, flood, wildfire, drought, avalanche, landslide FACTORS THAT INFLUENCE IMPACT OF DISASTER ON MAN MADE OR ANTHROPOGENIC COMMUNITY ​ Human made disasters ​ Nature of event ​ Principal direct causes are identifiable human actions, ○​ What kind/type of disaster? deliberate or otherwise (Jah, 2010) ○​ If an earthquake, what is the intensity? How long? ​ HUMAN ERRORS How fast? ​ May be intentional or not: ​ Time of the day or year ○​ Intentional: arson, war terrorism, genocide ○​ What would be time? Morning or evening? ○​ e.g.: biological and biochemical terorrsim, chemical ​ more casualty if it happens at night spills, radiological (nuclear events), fire, explosions ○​ Harder to prepare for the event if evening (chemical, firecrackers), transportation accidents, ​ e.g. Lahar flow in Pampanga which happened in armed conflicts, and acts of war the evening ○​ if a community had consecutive disasters that COMPLEX EMERGENCIES happened, there are consequences ​ SEVERAL FACTORS ​ e.g., bicol, naga (prone to typhoons, most of the ​ Situations where populations suffer significant casualties time they experience it) as a result of war, civil strife or other political conflict ​ the impact of this: they can be resilient and ​ Disasters are the result of combination of forces such as be prepared for all the disasters, but they drought, famine, disease, and political unrest that displace can also be overwhelmed millions of people from their homes ​ Health and age characteristics of population affected ​ Examples: humanitarian disasters, civilian fleeing ○​ The young and the old are most vulnerable genocide, refuges displaced by conflicts, syrian war (if ○​ if the affected community is mostly elderly, children, they evacuated, poor situation despite being evacuated) PWDs, pregnant = they cannot evacuate immediately ○​ common in evacuation area: WASH diseases (water, ○​ they need special care and specialization (for the sanitation and hygiene diseases) vulnerability) ​ cholera, typhoid, diarrhea ○​ more vulnerable = more casualties ○​ if they are populated = more casualties TECHNOLOGICAL DISASTERS ​ Evacuation areas are overwhelmed ​ Availability of resources ​ Large number of people, property, community ○​ Lack of food, shelter, resources especially in infrastructure, and economic welfare are directly and provinces adversely affected by major industrial accidents, ○​ infrastructures, hospital resources and services unplanned release of nuclear energy, and fire or explosions ​ Location from hazardous substances (fuel, chemicals, or nuclear ○​ Are you near the sea? Are you near the edge of the materials) mountain? ​ caused by human made systems (errors) - humans are ○​ low lying areas? Within the danger zone? = more blamed prone to be affected in the disaster ○​ E.g. explosion from machines, dam failure, nuclear plant ○​ Car accidents MEDICAL/HEALTHCARE DISASTER ​ Natural and human made disaster trigger each other → ​ catastrophic event that results in casualties that secondary disaster (synergistic disasters) overwhelm the healthcare resources in the community ○​ E.g. earthquake → chemical plant explosion (Al-Mahadri, Keller, 1997) ○​ E.g. nuclear plant meltdown ○​ e.g., staffing, resources (machines, beds) ​ May result in sudden unanticipated surge of the patients, SYNERGIC DISASTER change in standards of care and need to allocate scarce resources ​ NA-TECHs (combination of natural and technological ○​ e.g. pandemic, stroke huwag na daw maglechon, disasters) which can have some secondary effect asthma ​ Natural and human made disaster trigger each other causing a secondary disaster ​ “Two disasters” HOSPITAL OR HEALTHCARE FACILITY DISASTER TYPES ​ E.g., earthquake → dam failure, chemical spills, chemical plant explosion (nuclear power plant in Bataan) External ​ Outside the hospital, more on the staff and the resources CATEGORIES OF DISASTER: BASED ON ONSET, IMPACT, AND of the hospital, overwhelmed DURATION ​ Do not affect hospital infrastructure but tax hospital resources due to number of patients or type of injuries Onset (how fast an disaster can occur) ​ No problem with the hospital internally but it lines with the surge and demand of the patients in a community ​ Rapid - short, sudden impact or events ○​ E.g. surge of patients during the pandemic, massive ○​ e.g. storm surge, earthquake, tornado, hurricane accidents lahat pumunta eamc, stampede ​ Gradual/chronic (creeping disasters) - gradual and long ​ Overwhelmed because of too many casualties duration, prolonged and developed overtime ○​ e.g. effects of radiation exposure → change in cells Internal resulting in cancer ○​ Drought or famine which makes the farmlands barren ​ “Within the hospital” and with no crops ​ Cause disruption of normal hospital function due to injuries or death of hospital personnel or damage to the Impact (gaano ka severe or magnitude) facility itself ○​ E.g. hospital fire (oxygen tank combustion), power ​ Sudden/rapid - “one strike” effect failure affects those in ventilators, chemical spill, ○​ e.g. storm surge, flash flood, tornado nurses and doctors that became sick and died, lack ​ Prolonged - gradual of resources ○​ e.g. effects of virus such as the COVID pandemic, ○​ e.g. war in Palestine where Israel is famine, drought, nuclear explosion, hiroshima and bombing/attacking hospitals in Gaza nagasaki explosion ​ Damage in actual infrastructure/hospital personnel [NUR81028] Disaster Nursing Lecture - TOPIC​ ​ ​ ​ 3​ ​ ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  ○​ hopelessness, lack of power to intervene EFFECTS AND PSYCHOLOGICAL REACTIONS TO DISASTER HEALTH EFFECTS OF DISASTER ​ Despair 😥 ○​ TIMESTAMP: 1:13:00 T.T ​ Cause premature deaths, illness, and injuries ○​ In the affected community, generally exceeding the ​ Depression 🫥 ○​ lost of life, lost of property, missing persons ○​ prolonged sadness capacity of the local health care system ​ E.g. those who drowned, cardiac arrest due to ○​ decision making and concentration will be impaired, fear ○​ detachment from social activities ○​ Life expectancy in the philippines is 72 years old ​ Destruction of local health care infrastructure - > COMMON REACTIONS OF DISASTER SURVIVORS 🤯 disruption of routine healthcare services EMOTIONAL REACTION ○​ Unable to respond to the emergency ​ Shock, feeling numb ○​ Long-term consequences in health outcomes in ○​ Overwhelmed with what transpired and occurred terms of increased morbidity and mortality ○​ E.g. hospital can be destroyed; who will be responsible for the patients now? ​ 😥 ○​ Still in disbelief of what happened Fear ○​ fear of the unknown 😱 ​ Environmental imbalances, ○​ fear that you wouldn't be able to survive after the ○​ increasing the risk of communicable diseases and environmental hazard ​ 😕 Grief disaster ○​ E.g. loss of home → needs be protected with the evacuation centers ○​ e.g. exposure to WASH diseases ​ ​ ☹️ ○​ loss of lives and properties 😡🤬 Sadness Anger ​ Affect psychological, emotional and social well-being of ○​ Part of the emotional response the population in the affected community ○​ E.g. PTSD cases, depression (grieving) ○​ YUNG FIRST MUJI BALLPEN KO TANGINA (stages of ​ 😞 Guilt and Shame ○​ wala kang nagawa 🫣 ○​ disappointment of the people to the government grief: anger) nawalan ng ballpen ○​ Being powerless, unable to prepare ○​ Patients need to be debriefed to help cope mentally with the disasters ​ Cause shortages of food and cause severe nutritional ​ ○​ nangyari lahat Feelings of helplessness 😔 ○​ you are affected by the disaster deficiencies ○​ E.g. not enough resources reaching the affected INTERPERSONAL REACTIONS individuals → insufficient food ​ Distrust ○​ hoarding, farms and root crops destroyed, all sources ○​ sense of betrayal from politicians will be damaged ○​ e.g. nangako ng bigas tas pagtapos wala ○​ wala ng goods, bads ​ Conflict ​ Cause large population movements ○​ pamilya nagaaway-away for resources ○​ (refugees) creating a burden on other health care ​ Withdrawal systems and communities ○​ detachment from community affairs ○​ E.g. people migrating from an area to another area ​ Work or school problems for safety and more resources ○​ d/t anxiety, depression, despair, hard to concentrate ○​ Marawi siege: displacement of the community ​ Irritability ​ Loss of intimacy FACTORS INFLUENCING DISASTER RESPONSE ○​ loss of relationship from parents, friends ○​ not wanting to connect with anyone because of GLOBALIZATION feeling of distrust ​ countries are more connected and interrelated ​ Feeling rejected or abandoned ​ (interdependence with other countries for assistance) ​ sharing of goods and commodities (assistance during COGNITIVE REACTIONS calamities) ​ Confusion ​ e.g., more financial grants and assistance is given, duty ○​ disoriented free ​ Indecisiveness ○​ feeling hopeless CHANGING WORLD DYNAMICS ​ Worry ​ frameworks and relationships between countries and that ○​ do not decide during extreme emotions will affect ​ Shortened attention span ​ changing economic, environmental, landscape ○​ can't focus frameworks ​ Trouble concentrating ○​ can't focus kaya naglalaro na lang si sean disaster SOCIAL INEQUALITY natalo HAHAHA ​ (unequal provision of resources during disaster) PHYSICAL REACTIONS SOCIODEMOGRAPHIC TRENDS ​ Tension, edginess ○​ muscle tension (back, shoulder, neck) from fear and ​ (including age, economic status, conditions) stress ​ Because of urbanization, mega-cities are existent = more ○​ everyday disaster kasi everyday stressed people in the area, the more it will overwhelm, evacuation ​ Fatigue, insomnia ​ may be harder ○​ too many things running through the mind ○​ Mika and her every night sleep paralysis POSSIBLE EFFECTS OF A DISASTER TO AN INDIVIDUAL ​ Body aches, pain, nausea 😰 Psychological Reactions ○​ tau na may scolio ​ Panic ​ Easily startled ○​ you are panicking because you are afraid of what is ○​ because of the sense of fear happening (the hazard and disaster) ○​ very sensitive because of anxiety ○​ However it may impair decision making and is contagious ​ Hysteria 🥵 ​ ○​ 🏁💗 Racing heartbeat ○​ because of sympathetic response ○​ AAAAHHHHH ​ Appetite changes ○​ more severe form of panic: panic, screaming [NUR81028] Disaster Nursing Lecture - TOPIC​ ​ ​ ​ 4​ ​ ORIGENES, PABICO, PALAD A., PANTI, PEREZ, PIL | 4NUR-4  ○​ can't concentrate due to sense of emotions DISASTER TRIAGE SYSTEMS ​ Sexual drive changes ​ START ○​ Andami dami mo na iisipin ​ JumpSTART ○​ Syempre -chez, 2025 ​ SLART/SAVE ○​ TANGINA MO MIKA coping mechanism nyu haa ​ SALT DISASTER TRIAGE "START" (simple triage and rapid transport and treatment) ​ developed in 1983 by the staff members of Hoag Hospital DISASTER TRIAGE and Newport Beach Fire Department in California ​ common algorithm used with adult pre-hospital triage ​ a process which places the right patient in the right place ​ Based on a person's ability to respond verbally and at the right time to receive the right level of care ambulate and their respiration perfusion and mental ​ Disaster triage - triage under mass casualty conditions status (RPM) (Rice and Abel, 1992) ​ it is a triage method used by first responders to quickly ○​ Triaging is sorting, trying to assess which is the classify victims during a mass casualty incident (MCI) priority based on the severity of the event ​ Trier (French): which means “to sort out or to choose” ​ Purpose: classify victims during a mass casualty ​ Rapid and effective way (several); used for adult patients ​ Goal is to do the greatest good for the greatest number ​ Sort the victims, then transfer to nearest facilities that can because of the scarcity of the resources give IV or blood transfusion, if available, and help treat ​ “Rapid high tech to the most unstable or acutely ill” to fractures “doing the greatest good for the greatest number” (Auf der ​ Prioritize those who are most likely to live and survive - Heide, 2000) "mas maraming ma-save the better" ​ As the disaster is prolonged, everything is overwhelmed. ○​ Different from emergency triage - since there are Focus is using utilitarianism (doing good for the majority) adequate resources (e.g. ventilator, ET tube), patients ​ Employed when local emergency services are with ABC problems are the priority overwhelmed to the point that immediate care cannot be ​ E.g. in disaster area, px not breathing vs provided to anyone who needs it breathing → px who is breathing comes first ​ Remember CPR takes time, so attend to those FIVE CONCEPTUAL CATEGORIES wounded first and save more lives ​ daily triage ○​ Those with SCI, opened abdomen, bombed off are ○​ Context: routine hospital settings (hospital and less prioritized clinics) ○​ Mass casualty → mass survival is the goal; main ○​ Purpose:prioritize patients based on urgency and basis is the resources, resource person available resources ​ Disaster situation ○​ e.g., ER triage of MI vs. fracture ○​ Number of casualties exceed resource capabilities - ​ incident triage even the resource person, facilities ○​ scene of disasters or large-scale emergencies ○​ sort and treat casualties quickly with available START: COLOR CODES resources ​ 0 - BLACK : Deceased (deceased / expectant)) ○​ mass casualty event like a traffic accident or bombing ○​ No clear airway or spontaneous breathing ​ disaster triage ○​ no signs of life ○​ large-scale natural or man-made disasters ○​ no breathing, no circulation ○​ maximize survival by prioritizing critical cases ○​ R=not breathing ○​ e.g., earthquake responses, sorting patients into ​ RED: PRIORITY 1 (Highest) Threatening (Emergent) Categories (immediate) ​ tactical-military triage ○​ requires action or they won’t survive ○​ Military or combat zones ○​ Treatment immediately or else they will not survive ○​ prioritize soldiers or personnel based on injury, ○​ victims have reasonable chance of survival only if severity and survivability they receive immediate treatment ○​ combat medics prioritizing life-threatening injuries ○​ upon assessment, provide intervention ​ special condition triage ○​ e.g. respiratory insufficiency, cardiac arrest, ○​ vulnerable populations hemorrhage/impaired circulation, severe abdominal ○​ provide specialized care based on unique medical or injury, burns (more than 40% of body surface area), psychological needs impaired circulation ​ epidemic triage* ​ Check for respiration and pulse rate including ○​ During epidemics or pandemics capillary refill and mental status ○​ control ○​ RR= >30 ○​ Capillary refille >2-3 seconds THREE TYPES OF TRIGE ○​ M = doesn’t obeycommands PRIMARY ​ Performed at first encounter with ​ YELLOW: Priority 2 Serious (Delayed) patient ○​ Victims can wait for transportation after they ​ Maybe done by EMS, first responder received initial emergent treatment or hospital staff ​ Treatment can be given within 1 to 2 hours and reassess every 30 to 60 minutes (delayed or SECONDARY ​ Re-evaluation of primary triage after additional assessments and/or urgent) interventions ○​ E.g.: immobilized closed fracture, soft tissue injuries without hemorrhage, burns on less than 40 % of the TERTIARY ​ Performed during ongoing definitive body, asthma without respiratory distress pcare ○​ R = 2 seconds ​ M: doesn’t obey commands Urgent (yellow) ​ R