DISASTER NURSING
----Laveena Aswale
OBJECTIVES-
⚫ Definition of disaster nursing.
⚫ Explain the types of disaster.
⚫ Discuss levels of disaster.
⚫ Explain key elements of disasters.
⚫ Explain disaster nursing, goal and principle.
⚫ Know health effects of disasters.
⚫ Discuss phases of a disaster.
⚫ Explain disaster management cycle.
⚫ Explain disaster triage.
⚫ Discuss role of nursing in disasters.
⚫ Discuss role of disaster timeline and nursing
action.
⚫ Know legal issue and The Disaster Management
Act,
Disaste
r and that from Old Italian disastro,which in turn comes
The word disaster is derived from Middle French désastre
from the Ancient Greek pejorative
Prefix δυσ-, (dus-) "bad"
and ἀστήρ (aster), "star".
BADSTAR
DISASTER ALPHABETICALLY MEANS..
D-
DESTRUCTION I
- INCIDENTS
S - SUFFERINGS
A- ADMINISTRATIVE, FINANCIAL
FAILURES S - SENTIMENTS
T - TRAGIDIES
E - ERRUPTION OF COMMUNICABLE
DISEASES R- RESEACH PROGRAMMEAND
ITS IMPLEMENTATION
Definition of Disaster
“An occurrence, either natural or manmade
that causes human suffering and creates
human needs that victims cannot alleviate
without assistance.
- The American Red Cross.
Definition of Disaster
⚫ WHO defines Disaster as "any occurrence that
causes damage, ecological disruption, loss of human
life, deterioration of health and health services, on a
scale sufficient to warrant an extraordinary response
from outside the affected community or area."
TYPES OF DISASTER
Natural disaster
Hurricanes Tornado Blizzards Floods
s
Earth quacks Volcanic eruption
Man Made disaster
Conventional Explosions Pollution
Warfare
Transportation accidents Terrorist attacks
1.Natural
disaster:
Hurricanes Drought
Tornados Mudslides
Floods Volcanic
Earth eruption
quacks Communicable
Blizzards diseases epidemics
Cyclones
Hurricane:
A hurricane is a tropical storm with winds that have
reached a constant speed of 74 miles per hour or
more.
Tornados
Tornado - A violently rotating column of air
touching the ground, usually attached to the base of
a thunderstorm.
Floods
Flooding is an overflowing of water onto land that is
normally dry. Floods can happen during heavy rains,
when ocean waves come on shore, when snow melts
quickly, or when dams or levees break.
Earth quacks
Any sudden shaking of the ground caused by the
passage of seismic waves through Earth’s rocks.
Seismic waves are produced when some form of
energy stored in Earth’s crust is suddenly released,
usually when masses of rock straining against one
another suddenly fracture and slip.
Blizzards
A storm with large amounts of snow or blowing
snow
Cyclones
A cyclone is a large air mass that rotates around a
strong center of low atmospheric pressure
Drought
A prolonged dry period in the natural climate cycle
that can occur anywhere in the world.
Mudslides
Landslides occur when masses of rock, earth, or
debris move down a slope.
Volcanic eruption
A volcanic eruption is when lava and gas are
released from a volcano—sometimes explosively
Man made disaster
Conventional
Warfare Explosions
Civil unrest (riots)
Transportation
accidents Fires
Pollution
Terrorist
attacks
Conventional Warfare
Conventional warfare is a form of warfare
conducted by using conventional weapons and
battlefield tactics between two or more states in
open confrontation.
Explosions
A substance which can be made to explode,
especially any of those used in bombs or shells
Civil unrest (riots)
Civil unrest is fighting between different groups of
people living in the same country
Transportation accidents
A transport accident is any accident (or incident)
that occurs during any type of transportation,
including accidents occurring during road transport,
rail transport, marine transport and air transport.
Fires
A chemical process of combustion, releasing heat,
light, and various reaction products.
Pollution
Pollution is the introduction of harmful materials
into the environment.
Terrorist attacks
The unlawful use of violence and intimidation,
especially against civilians, in the pursuit of political
aims.
LEVEL OF DISASTER
⚫ Goolsby and Kulkarni (2006) further classify disasters
according to the magnitude of the disaster in relation
to the ability of the agency or community to respond.
Disasters are classified by the following levels:
⚫ 1) Level I: If the organization, agency, or community
is able to contain the event and respond effectively
utilizing its own resources.
⚫ 2)Level II: If the disaster requires assistance from
external sources, but these can be obtained from nearby
agencies.
⚫ 3)Level III: If the disaster is of a magnitude that
exceeds the capacity of the local community or region
and requires assistance from state-level or even
federal assets.
KEY ELEMENT OF DISASTER
⚫ Disasters result from the combination of hazards,
conditions of vulnerability and insufficient capacity or
measures to reduce the potential negative consequences
of risk.
Hazards
⚫ Hazards are defined as “Phenomena that pose a threat
to people, structures, or economic assets and which
may cause a disaster. They could be either manmade or
naturally occurring in our environment.”
⚫ Hazard is a potentially damaging physical event,
phenomenon or human activity that may cause the loss
of life or injury, property damage, social and economic
disruption or environmental degradation.
⚫ Vulnerability
⚫ Vulnerability is the condition determined by physical,
social, economic and environmental factors or processes,
which increase the susceptibility of a community to the
impact of hazards
⚫ Capacity
⚫ Capacity is the combination of all the strengths and
resources available within a community, society or
organization that can reduce the level of risk, or the
effects of a disaster. Capacity may include physical,
institutional, social or economic means as well as skilled
personal or collective attributes such as 'leadership' and
'management.' Capacity may also be described as
capability.
⚫ Risk
⚫ Risk is the probability of harmful consequences, or
expected losses (deaths, injuries, property,
livelihoods, economic activity disrupted or
environment damaged) resulting from interactions
between natural or human-induced hazards and
vulnerable conditions.
Disaster nursing
Disaster nursing can be defined as ''a
adaptation of professional nursing skills
in recognizing and meeting the nursing physical
and emotional needs resulting from the disaster.''
GOALS OF THE DISASTER NURSING
1. To meet the immediate basic survival needs of populations
affected by disasters (water, food, shelter, and security).
2. To identify the potential for a secondary disaster.
3. To appraise both risks and resources in the environment.
4. To correct inequalities in access to health care or
appropriate resources.
5. To empower survivors to participate in and advocate for
their own health and well-being.
6. To respect cultural, lingual, and religious diversity in
individuals and families and to apply this principle in all
health promotion activities.
7. To promote the highest achievable quality of life for
survivors.
Principles of Disaster Nursing
• Rapid assessment of the situation and of nursing care needs.
• Triage and initiation of life-saving measures first.
• The selected use of essential nursing interventions and the
elimination of nonessential nursing activities.
• Evaluation of the environment and the mitigation
or removal of any health hazards.
• Prevention of further injury or illness.
• Leadership in coordinating patient triage, care,
and transport during times of crisis. The
teaching, supervision, and utilization of
auxiliary medical personnel and volunteers.
• Provision of understanding, compassion and
emotional support to all victims and their
families.
HEALTH EFFECTS OF DISASTER
⚫ Disasters may cause premature deaths, illnesses,
and injuries in the affected community, generally
exceeding the capacity of the local health care system.
⚫ Disasters may destroy the local health care
infrastructure, which will therefore be unable to respond
to the emergency. Disruption of routine health care
services and prevention initiatives may lead to long-term
consequences in health outcomes in terms of increased
morbidity and mortality.
⚫ Disasters may create environmental
imbalances, increasing the risk of communicable
diseases and environmental hazards.
⚫ Disasters may affect the psychological, emotional,
and social well-being of the population in the affected
community.
⚫ Disasters may cause shortages of food and cause
severe nutritional deficiencies.
⚫ Disasters may cause large population movements
(refugees) creating a burden on other health care systems
and communities..
Phases of a Disaster
• Pre-impact phase
• Impact phase
• Post-impact phase
PRE-IMPACT PHASE
• It is the initial phase of disaster, prior to the actual
occurrence.A warning is given at the sign of the
first possible danger to a community with theaid
of weather networks and satellite many
meteorological disasters can be predicted.
• The role of the nurse during this warning phase is to assist
in preparing shelters and emergency aid stations and
establishing contact with other emergency service group.
Disaster Preparedness
Phase
Activities prior to a disaster
It is an on going multi sectoral
activity
Example :
Preparedness plans
Emergency exercise
Training
Warning
IMPACT PHASE
• The impact phase occurs when the disaster actually happens. It is
a time of enduring hardship or injury end of trying to survive.
• This is the time when the emergency operation center is
established and put in operation. It serves as the center for
communication and other government agencies of health care
healthcare providers to staff shelters. Every shelter has a nurse as
a member of disaster action team. The nurse is responsible for
psychological support to victims in the shelter.
POST – IMPACT PHASE
• Recovery begins during the emergency phase ends with
the return of normal community order and
functioning. The victims of disaster in go through
four stages of emotionalresponse.
• 1. Denial – during the stage the victims may deny
the magnitude of the problem or have not fully
registered.
• 2. Strong Emotional Response – in the second stage,
the person is aware of the problem but regards it as
overwhelming and unbearable.
3.Acceptance – During the third stage, the
victim begins to accept the problems caused
by the disaster and makes a concentrated
effect to solve them.
4.Recovery – The fourth stage represent a
recovery from the crisis reaction. Victims
feel that they are back to normal.
DISASTER MANAGEMENT
CYCLE
RESPONSE
The response phase is the actual
implementation of the disaster plan.
response activities need to becontinually
monitored and adjusted to the changing
situation.
•A hospital, healthcare system, or public
health agency take immediately during,
and after a disaster or
emergency occurs.
Disaster Response Phase
Activities During a
disaster Example:
Search ,rescuer and first
aid Field Care
Triage
Taggin
g
Identifi
cation
of
RECOVERY
Once the incident is over, the organization and staff needs to
recover. Invariably, services have been disrupted and it takes
time to return to routines.
•Activities undertaken by a community and its components
after an emergency or disaster to restore minimum services
and move towards long-term restoration.
• Care and Shelter
• Damage Assessments
Disaster Recovery phase
Activities following a
disasterExample:
Provision of
supply
Transportation
Storage
Vaccinatio
n Nutrition
Temporary housing
Long medical
care Counselling
Evaluation/ Development
Often this phase of disaster planning and response
receives the least attention. After a disaster,
employees and the community are anxious to return
to usual operations. It is essential that a formal
evaluation be done to determine whatwent well
(what really worked) and what problems were
identified. A specific individual should be charged
with the evaluation and follow-through activities.
Mitigation
These are steps that are taken to lessen the
impact of a disaster should one occur and can be
considered as prevention and reduction
risk measures.Examples of mitigation
include installing and maintaining activities
generator power to mitigate the effects of a backup
power
failure or cross training staff to perform other
tasks to maintain services during a staffing crisis
that is due to a weather emergency.
Prevention Mitigation
phase
Activities that reduces the effects of
disaster
Examples:
Improved building codes
Reduction and protection of vulnerable population
Public education
Flood mitigation works
Principles of Disaster
Management
1) prevent the occurrence of disaster
whenever possible.
2) provide first aid to the injured
3) provide definitive medical care
4) disaster management is the responsibility of
all sphere of government
5)disaster management should use resources that
exist for day-to-day purpose
6) individual are responsible for their own safety
7)disaster management planning should focus on
large scale events.
8)disaster management planning should not
recognize the different between incident and
disaster.
DISASTER TRIAGE
•It is an Rapidly classifying the injured on the
basis of their injuries.
•Triage is the only approach that can provide
maximum benefit to the greatest number of
injured in a major disaster situation.
•Triage colour coding system:
1. Red - Indicates High Priority treatment
colour and transport
2. Yellow -Medium priority
colour -Ambulatory patients
3. Green colour -Dead patients
4. Black colour
ADVANCED TRIAGE CATEGORIES
CLASS I (EMERGENT) RED IMMEDIATE
– Victims with serious injuries that are life threatening but has a high probability of survival if they received immediate care.
– They require immediate surgery or other life-saving intervention, and have first priority for surgical teams or transport to advanced
facilities; they “cannot wait” but are likely to survive with immediate treatment.
“Critical; life threatening—compromised airway, shock, hemorrhage”
CLASS II (URGENT) YELLOW DELAYED
– Victims who are seriously injured and whose life is not immediately threatened; and can delay transport and treatment for 2 hours.
– Their condition is stable for the moment but requires watching by trained persons and frequent re-triage, will need hospital care (and
would receive immediate priority care under “normal” circumstances).
“Major illness or injury;—open fracture, chest wound”
CLASS III (NON-URGENT) GREEN MINIMAL
– “Walking wounded,” the casualty requires medical attention when all higher priority patients have been evacuated, and may not
require monitoring.
– Patients/victims whose care and transport may be delayed 2 hours or more.
“minor injuries; walking wounded—closed fracture, sprain, strain”
CLASS IV (EXPECTANT) BLACK EXPECTANT
They are so severely injured that they will die of their injuries, possibly in hours or days (large-body burns, severe trauma, lethal radiation
dose), or in life-threatening medical crisis that they are unlikely to survive given the care available (cardiac arrest, septic shock, severe
head or chest wounds);
They should be taken to a holding area and given painkillers as required to reduce suffering.
“Dead or expected to die—massive head injury, extensive full-thickness burns”
The Nursing Role in Disaster
Management
Assess the Community Diagnose Community Disaster
Threats
ROLE OF
NURSE
Evaluate Effectiveness of Disaster Community Disaster Planning
Plan
Implementation Disaster Plan
THE NURSING ROLE OF DISASTER MANAGEMENT
⚫Nurses work in all phases of disaster management. Some of
community disaster strategy for nurses include:
1.Assess the Community:
⚫ -Is there a current community disaster plan in place?
⚫ -Previous disaster experiences?
⚫formation(
-How is the local terrain conductive to disaster
hurricanes, tornados, blizzards)
⚫--What are local industry?
⚫ What personnel are available for disaster
interventions?
(Nurses, doctors)
⚫ -What are local agencies and
organization? (hospital, schools, Red
cross)
2. Diagnose Community Disaster Threats:
•Determine actual and potential
disaster threats.(eg. toxic
waste,explosions,road
accidents,hurricanes,
tornandos,floods,earthquicks)
3 Community Disaster Planning:
•Develop a disaster plan to prevent or deal
with identified disaster threats.
•Identify a local community communicable
system.
•Set up of an emergency medical systems
and chain for activation.
4.Impliment Disaster plan:
⚫Focus on primary prevention activities to
prevent occurrence of man made disaster.
⚫Practice using equipments, obtaining and
distributing supplies.
5.Evaluate effectiveness of Disaster plan:
⚫Critically evaluate all aspects of disaster
plan and practical drills for speed,
effectiveness, gaps and revision.
⚫Evaluate the disasterimpact on
community and surrounding
regions.
⚫Evaluate response of personnel involved
in disaster relief efforts.
INTERNATIONAL
AGENCIES
1.World health organisation(WHO.)
2.UNICEF
3.World Food programme (WFP.)
4.United Nation office for the co-ordination of
Humanitarian affairs.
5.Food and agriculture organisation (FAO.)
6.Organisation of America State (OAS.) 7.Cambridge
Disaster Emergency Response Agency. 8.Co-
operative for American Relief
Everywhere(CARE)
9.International committee of Red Cross.
10.International council of Voluntary agency.
Disaster Management Act & Its Provisions
2016632004.
Disaster Management
Act Art.53
The Disaster Management Act, 2005, (23 December 2005)
No. 53 of 2005, was passed by the Rajya Sabha, the upper
house of the Parliament of India on 28 November, and by
the Lok Sabha, the lower house of the Parliament, on 12
December 2005.
It received the assent of The President of India on 9
January 2006. The Disaster Management Act, 2005
has 11 chapters and 79 sections.
The Act extends to the whole of India. The Act provides
for "theeffective management of disasters and for
matters connected therewith or incidental thereto
Authorities
National Authority
State Disaster Management Authority
District Disaster Management
Authority
National Disaster Response Force
(NDRF)
BIBLIOGRAPLY
⚫ K PARK 24TH EDITION TEXT BOOK OF
PREVENTIVE AND SOCIAL MEDICINE BHANOT
PUBLICATION PAGE NO
⚫ K.K. GULANI 2ND EDITION TEXT BOOK OF
COMMUNITY HEALTH NURSING PAGE NO
⚫ Basavanthappa. B.T, Community Health Nursing,
First Edition,Jaypee Brothers, Mumbai, 2008,
Importan
t October
⚫ World disaster Reduction Day 2 nd Wednesday of
