Natural and Man-Made Disaster PDF

Natural and man made disaster  Identify the types of disaster  Discuss the caharacteristics of disaster  Describe the stages of disaster  Discuss the stages of disaster management.  Discuss the impact of disaster on a community.  Describe the role and responsibilities of nurses in relation to...

Natural and man made disaster  Identify the types of disaster  Discuss the caharacteristics of disaster  Describe the stages of disaster  Discuss the stages of disaster management.  Discuss the impact of disaster on a community.  Describe the role and responsibilities of nurses in relation to disaster. MEANING Disaster means that any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant and extraordinary response from outside the affected community or area (WHO 1995) To know more….. Ecologic disruption or emergencies resulting in death, injuries, illness or property management that cannot be effectively managed by the application of routine procedures We can think disaster in an epidemiological frame work. DISASTER AGENT  Primary agents include falling buildings, heat, wind, rising water and smoke.  Secondary agents include bacteria and viruses that produce contamination or infection after the primary agent has caused injury or destruction. HOST  Human kind.  Age, sex, immunization status, pre-existing health, degree of mobility, emotional stability, ENVIRONMENT  PHYSICAL FACTORS include the weather conditions,     availability of food and water and the functioning of utilities such as electricity and telephone service. CHEMICAL FACTOR include leakage of stored chemicals into the air, soil, ground water or food supplies. BIOLOGICAL FACTORS include contaminated water, improper waste disposal, insect or rodent proliferation, improper food storage, or lack of refrigeration owing to interrupted electrical services. SOCIAL FACTORS are those that contribute to the individual's social support systems, loss of family members, changes in roles, religious beliefs, social factors to be examine after disaster. PSYCHOLOGICAL FACTORS distress of victim to the disaster site. TYPES NATURAL DISASTERS MAN-MADE DISASTER Disasters can be natural or man-made. Natural disasters include droughts, earthquakes, tsunamis, forest fires, landslides and mudslides, blizzards, hurricanes, tornadoes, floods and volcanic disruptions. Disasters can be man-made includes hazardous substance accidents (e.g., chemicals, toxic gases),radiologic accidents, dam failures, resource shortage (e.g., food, electricity and water), structural fire and explosions and domestic disturbances (e.g., terrorism, bombing and riots), Bioterrorism. Explosions: Fires, Toxic materials, Pollution, Civil unrest (e.g., riots, demonstrations), Terrorists’ attacks Throughout history natural and man-made disasters have disrupted food and water supplies and salutation causing communicable diseases, injury, illness and death Natural disasters: Major natural disasters:  Flood  Cyclone  Drought  Earthquake Minor natural disasters:  Cold wave  Thunderstorms  Heat waves  Mud slides  Storm Man-made disaster: Major man-made disaster:  Setting of fires epidemic  Deforestation  Pollution due to prawn cultivation  Chemical pollution. Minor manmade disaster:  Wars  Road / train accidents, riots  Food poisoning  Industrial disaster/ crisis  Environmental pollution. What are the factors…..  Nature of the event  Time of the year or day  Health and age characteristics of population effected  Availability of the resources Impact……..  Earthquake and tornadoes: rapid onset sudden impact on the community  Hurricane & volcanic eruption: sudden impact on the community but there is some advance warning  Bioterrorism : sudden and unanticipated , sudden and prolonged impact on the community  Drought & famine: gradual onset or chronic genesis (so called “creeping "disaster) and prolonged impact  Disaster as a result of war, draught, diseases, and political unrest resulting displacement of million s of people from their homes.  Community infrastructure and economic welfare are directly and adversely affected by major industrial accidents, unplanned release of nuclear energy, fires or explosion from hazardous substance. External……  Sometimes may not affect the hospital infrastructure (building and personal), but you can use hospital resources due to number of patients or type of injuries. Internal……  Cause disruption of normal hospital function due to injuries or death of hospital person or damage to physical plant as with a hospital fire power failure or chemical spill.  That time you have to use another options. PHASES OF A DISASTER Pre-Impact Phase:  It is the initial phase of the disaster, warning is given prior to the actual occurrence,  Emergency centers are opened ,  Communication , radio and television,  Community must be educated. PHASES OF A DISASTER Impact Phase:  This occurs at the time of disaster,  The impact phase continues until the threat of further destructions has passed and the emergency plan is in effect.  Emergency Operation Center (EOC) has been established.  Physical and psychological support PHASES OF A DISASTER Post impact Phase:  Recovery beings during the emergency phase and end with the return of normal community order and functioning.  For persons in then impact area this phase may last a lifetime (e.g., victims of the atomic bombing of Hiroshima) PHASES OF DISASTER MANAGEMENT Disaster management Disaster management (or emergency management) is the creation of plans through which communities reduce vulnerability to hazards and cope with disasters. PRINCIPLES OF DISASTER MANAGEMENT (Grab and Eng 1995) 1. 2. 3. 4. 5. 6. 7. 8. Prevent the occurrence of the disaster whenever possible. Minimize the number of casualties if the disaster cannot be prevented. Prevent further casualties from occurring after the initial impact of the disaster. Rescue the victims. Provide first aid to the injured. Evacuate the injured to medical facilities. Provide definitive medical care. Promote reconstruction of lives. Prepradnes…  Proactive planning efforts designed to structure the disaster response prior to its occurrence  Communication plans  Multiagency coordination  Emergency services- emergency shelters with evacuation plans  Supplies and equipments Community Disaster Education Health personel education Resque teams disaster prepradnes Mitigation  Measures taken to remove the harmful effect of disaster  Prevention measures  Require significant amount of forethought, planning and implementation Mitigation  Action within this segment usually takes the form of specific programs intended to reduce the effects of disaster on a nation or community.  For instance, some countries regard the development and application of building codes (which can reduce damage and loss in the event of earthquakes and cyclones) as being in the category of mitigation. Response  Emergency relief such as saving lives, providing first aid, minimizing and restoring damaged systems such as communications and transportation , providing care and basic life requirement to victim  Organized its activities in sectors - fire, police hazardous material management and emergency medical services. Recovery  Stabilizing and returning the community to normal  Rebuilding, repair, relocate, rehabilitate, reconstruct Evaluation Phase that receive least attention To determine the specific problems, issues and challenges Future disaster plan is based on the evaluation What is our role? Nurses provides………….  Psychological care,  Emotional support services,  Treatment for victims and their families Nurses provides…………. ASSESS THE COMMUNITY Is there a current community disaster plan in place? What previous disaster experiences has the community been involved with locally, statewide, nationally? How is the local climate conducive to disaster formation? How is the local terrain conducive to disaster formation? What are the local industries? Nurses provides…………. ASSESS THE COMMUNITY Are there any community hazards? What personnel are available for disaster interventions? What are the locally available disaster resources? What are the local agencies and organizations? What is immediately available for infant care and care of the elderly and disabled? What are the most salient chronic illnesses in the community that will need immediate attention? Are there any diagnose Community Disaster Threats? Determine actual and potential disaster threats Community Disaster Planning  Develop a disaster plan to prevent or deal with identified disaster threats.  Identify a local community communication system.  Identify disaster personnel, including private and professional volunteers, local emergency personnel, agencies, and resources.  Identify regional backup agencies, personnel.  Identify specific responsibilities for various personnel involved in disaster coping and establish a disaster chain of command. Implement Disaster Plan  Focus on primary prevention activities to prevent       occurrence of man-made disasters. Practice community disaster plans with all personnel carrying out their previously identified responsibilities. Practice using equipment, obtaining and distributing supplies. Evaluate Effectiveness of Disaster Plan Critically evaluate all aspects of disaster plans and practice drills for speed, effectiveness, gaps, and revisions. Evaluate the disaster impact on community and surrounding regions. Evaluate response of personnel involved in disaster relief efforts. Evaluate Effectiveness of Disaster Plan  Critically evaluate all aspects of disaster plans and practice drills for speed, effectiveness, gaps, and revisions.  Evaluate the disaster impact on community and surrounding regions.  Evaluate response of personnel involved in disaster relief efforts. PHASES OF DISASTER MANAGEMENT 2. PREPAREDNESS  PERSONAL PREPAREDNESS: stress and conflict among disaster workers.  PROFESSIONAL PREPAREDNESS: license, equipment, personal equipment, such as a stethoscope, a flashlight and extra batteries, Cash, Warm clothing and a heavy jacket (or weatherappropriate clothing), Record-keeping materials, Pocket-sized reference books  COMMUNITY PREPAREDNESS: participation Role in preparedness 1. Within the employing organization: help initiate or update the disaster plan, provide educational programs and material regarding disasters specific to the area, and organize disaster drills. Role in preparedness 2. Community health nurse: provide an updated record of vulnerable populations within the community. Individualized strategies should be reviewed, including the availability of specific resources, in the event of an emergency. Role in preparedness 3. Leader: an intimate knowledge of the institution and familiarity with the individuals who work there. Persons with disaster management training, and especially those who have served on "real" disasters, make valuable members of any preparedness team as well Role in preparedness 4. As a community advocate: should always seek to keep a safe environment. Recalling that disasters are not only natural but also man-made, the nurse in the community has an obligation to assess for and report environmental health hazards. Role in preparedness 5. Others what community resources will be available after a disaster strikes and b. The most important how the community will work together c. what "should" occur before, during, and after the response and his or her role within the plan. d. community health nurse who seeks greater involvement or a more in-depth understanding of disaster management can become involved in any number of community organizations that are part of the official response team, such as the Red Cross, Salvation Army, or Emergency Medical System/ Ambulance Corps. a. PHASES OF DISASTER MANAGEMENT 1. MITIGATION:  Working with local, state and federal agencies in identifying disaster risks and developing disaster prevention strategies through extensive public education in disaster prevention and readiness.  To plan effectively for disaster prevention the nurse needs to have community assessment information, including knowledge of community resources (e.g., emergency services, hospitals, and clinics), community health personnel (e.g., nurses, doctors, pharmacists, emergency medical teams, dentists, and volunteers), community government officials, and local industry. PHASES OF DISASTER MANAGEMENT 3. RESPONSE  It includes community assessment, case finding and referring, prevention, health education, surveillance, and working with aggregates.  Local and regional emergency and public health resources can be readjusted as assessment reports continue to come in. SHELTER MANAGEMENT  Responsibility of the local Red Cross, building of “tent cities”  Assessing and referring, ensuring medical needs, providing first aid, serving meals, keeping patient records, ensuring emergency communications and transportation, and providing a safe environment. PHASES OF DISASTER MANAGEMENT INTERNATIONAL RELIEF EFFORTS  Federation of Red Cross and Red Crescent Societies and the International Committee of Red Cross or as health representatives from the WHO. PSYCHOLOGICAL STRESS OF DISASTER WORKERS:  The degree of worker stress depends "on the nature of the disaster, role in the disaster, individual stamina, and other environmental factors. ENVIRONMENTAL FACTORS  Noise, inadequate work space, physical danger, and stimulus overload, stress, mood swings, frustration and conflict, PHASES OF DISASTER MANAGEMENT DISASTER RECOVERY  Flexibility  Community cleanup efforts  Release of continuing threat  teaching proper hygiene short-term psychological support  alert for environmental health hazards  Home visits How to plan  Effective planning addresses the problem caused by a variety of potential events  Agent specific all hazard Challenges…            Communication problem Triage, transportation Evacuation Leadership issues Distribution of resources Coordination of search Rescue efforts Media issues Distribution of patients in an equitable fashion Destruction of health care infrastructure Management of volunteers, donations &large no. of resources Aid kid help you  Keep a small disaster supplies kit in the trunk of each car  Keep items in airtight plastic bag  Replace stored food ,water  Batteries every six months  Keep emergency medications Types  Disaster supplies kit  Evacuation supplies kit  First aid kit Important documents  Will, insurance policies, contracts  Passports, social security cards, immunization records  Credit cards, account numbers  Important phone numbers  Family records HAZART IDENTIFICATION  Anticipating the events and planning accordingly.  Hazmat Vulnerability  State of being vulnerable- open to attack, hurt or injury  Analysis should be conducted for each hazards and regularly updated Risk assessment  Use the element of hazard analysis and vulnerability analysis  Necessitate cooperation of corporate and community group Prevention is better  Prevention or removal of hazards  Removal of at risk population  Provision of public information and education  Establishment of early warning system  Mitigation of vulnerabilities  Risk reduction  Enhancing community to respond Core preparedness activities           Theoretical foundations for disaster planning As effective as the assumption upon which is based Must go beyond routine Need assessment Leadership Design for local response Vulnerable population Assistance Training and educational assistance Conduct of damage assessment Cornerstone of the disaster management  Placing the right patient in the right place at the right time to receive right level of care  Doing the greatest good for the greatest number Good triage provider  Clinically experienced  Good judgment and leadership  Calm and cool under stress  Decisive  Knowledgeable of available resources  Sense of humor ₰Creative problem solver  Available  Experienced and knowledgeable regarding anticipated casualties RED - MOST URGENT, FIRST PRIORITY  Life-threatening injuries  Shock, chest wounds, internal hemorrhage, head injuries producing increased loss of consciousness, partial-or full-thickness burns over 20% to 60% of the body surface, and chest pain  Poor chance of survival YELLOW - URGENT, SECOND PRIORITY  Injuries with systemic effects and complications but yet not in shock , withstand 30 to 60-minute  Category include multiple fractures, open fractures, spinal injuries, large lacerations; partial- or fullthickness burns over 10% to 20% of the body surface, and  medical emergencies such as diabetic coma, insulin shock; and epileptic seizure, observed closely GREEN- THIRD-PRIORITY  Minimal injuries unaccompanied by systemic complications.  Wait several hours for treatment.  Closed fractures, minor burns, minor lacerations, sprains, contusions, and abrasions. BLACK -DYING OR DEAD  Hopelessly injured patients or dead victims  Crushing injuries to the head or chest  Would not survive under the best of circumstances. Principles………..  Never move a casualty backward  Never hold a critical patient for further care  Triage providers do not stop to treat patient  Never move patient before triage Psychological triage  Threat to one’s life  Inflection of physical injury  Exposure to the dead and mutilated  Witnessing unexpected or violent death  Learning of the unexpected and violent death of the loved one  Knowledge that infliction of pain and suffering was deliberate Basic disaster life support  Review of all hazardous topics including natural and accidental man made events ,chemical, traumatic, explosive and nuclear events  Role in public health, incident management system  Special needs Disaster paradigm  D: detect  I: incident command  S: scene security and safety  A: assess hazards  S. support  T: triage and tereatment  E: evaluation Advanced disaster life support  Performed by the BDLS provider  ₰Demonstrate competencies in casualty decontamination, specified essential skills and MCI information system  ₰4 skills  ₰MASS triage  ₰Personal protective equipment and decontamination  ₰Disaster skills  ₰Human patient simulator Impact of disaster  Mortality  Injury  Infectious diseases  Chronic diseases  Malnutrition  Health risk and chemical contamination Reaction of children  Be honest and developmentally appropriate explanation should be given  Encourage expression of feelings  Reassure children ₰Encourage daily activities Mass casualty incidence  A mass casualty incident is an unexpected event which stretches the resource of emergency department and this requires the consolidated assistance of the hospital and its support system Disaster drill..  An exercise in which people stimulate the circumstances of a disaster so that they have an opportunity to practice their response  Self protection  Evacuation Challenges for nurses             Leadership Identify the roles and functions Policy development Government organizations Public health Health promotion Disease prevention Quality care Evidence based practice Education Critical thinking Collaboration Looking forward…  IN NURSING EDUCATION development and validation of core competencies provision of continuous education program and material for practicing nurses inclusion of content and clinical experience in nursing curriculum development of teaching resources and material  IN RESEARCH AND DEVELOPMENT related to mass casualty incidence preparedness , response and recovery International level  Focused on poorer countries  According to the culture Communication and transport difficulties  Knowledge and skill National disaster management authority  there may be different rules from country to country.  Nursing association teach and apply these rules  Nursing associations teach and apply these rules as profession Roles and responsibilities  Lay down policies on disaster management  Approve national plan  Approves plan prepared by ministers or departments  Coordinate the implementation  Recommend provision of funds  Provide support to other countries National disaster response force  Multidisciplinary , multiskilled high-tech force of NDMA capable of dealing with all types of natural and man made disasters.  Specialized response to natural and manmade disaster.  There must be personnel including engineer, technicians, medical and paramedical and dog squads.