1. DISASTER MGMNT
2. DISRUPTIONINDUCEDSITUATIONAFTERSEVERETRANSFORMATION
OFECOLOGICALRESPONSE
3. WHAT IS DISASTERDISASTER- French word,(Des-bad & Astre -star)W.Nick carter
defined:“An Event, Natural/ Manmade, Sudden/Progressive,which impacts with such severity
that the community hasto respond taking exceptional Measures.”2.It is a phenomenon involving
extensiveecological disruption leading risk to life,property and health to an extent
warrantingextra ordinary response from outside theaffected area.
4. 8 natural Highly disaster prone country MAJOR DISASTERS IN INDIA 5 fold increase
in the frequency of disastersduring last calamities /yr Cyclones (AP) Bhopal gas
tragedy. 30yrs.& Earthquake in Orissa. Uttarkashi in 1990,latur .1993,Gujarat 2001. Skkim
Bomb blasts in Delhi and Mumbai Train accidents. Tsunami,2004. 2011
5. TYPES OF DISASTER • Aircrash• Flood • Sinking ship• Cyclone • Train accidents•
Earthquake • Building collapse• Volcanic eruption • Bridge collapse• Epidemics • Bomb
blasts•Tsunami • Warfare (conventional, chem. bio, nuclear)
6. DISASTER MANAGEMENT PRE HOSPITALPLANNING HOSPITAL DISASTER
MANAGMENT OFF HOSPITAL
7. DISASTER MANAGEMENTPredict RescuePrevent ReliefPrepare Rehabilitation
8. DISASTER MANAGEMENT PLANNING
9. 1.PLANNING
10. Measures for efficient forecasting and A.PREDICT Developing GIS for early detection
and warningsystems Information Technology for effective warning Pro-active measures for
disaster preparedness communicationnetwork. andmitigation – administrative, financial,
Legislative &techno- Developing public awareness to build up society‟sstrength to face legal
Emphasis National networking for immediate medical response disasters. on risk reduction,
mitigation & awareness,while strengthening response.
11. B.PREVENT-Evoke existing system of response mechanism in the wake ofnatural and
man-made disasters at all levels of government andsteps to minimize the response time through
effectivecommunication & measures to ensure adequacy of reliefoperations.- Develop strategies
for inclusion of disaster reductioncomponents in the on-going plan/ non – plan schemes.-Prepare
the community to face the challenge and respond in caseof impending disaster-Lay stress on
preparedness including prevention/ mitigation ofChemical Industrial Disasters while
strengthening their emergencyresponse.-Stay up to date with the latest international best
practices andrecent developments within the country-Highlight the salient gaps evaluated based
upon the critical reviewof the present status for future action.
12. C.PREPARE
13. PREPARE DISASTER ACTION PLANIt is planned and systematic approach
towardsunderstanding and solving the disaster to minimize theeffect.• The approach should be
multi sectoral.• Plan should be realistic and easily adoptable• Plan should be clearly laid down
defining the role andresponsibility of different agencies.• Should be exercised in between to
evaluate it.• It should be prepared at the country, state, district andinstitutional level.• National
disaster management authority(NDMA) facilitatestate with support and advice while plan and
implementationby SDMA
Creation of trained Medical First 14. CAPACITY DEVELOPMENT Initiation of training of
paramedics for Response Teams Creation of detection, decontamination disastermanagement.

2. Uniform Causality Profile and Classification facilities. Proper Casualty Risk Inventory and
Resources Inventory. ofCasualties. Mobile Hospitals/ Crisis Management Plan at
Hospitals. Treatment Kits. Psychosocial Care Medical Response to Long Term
Effects. Mobile Teams . Issues related to for management of communitybehavior and response
. public health response and medicalrehabilitation and harmful effects on Efficient transport
system the environment.
15. D.ORGANISATIONAL DEVELOPMENTNational Disaster Management Authority
(NDMA)Constituted in Dec 2005 ,DM Act.•NDMA Chairman PM•SDMA are constituted there
after•SDMA Chairman CM•DDMA Constituted CABINATE SECRETARY NDMA
SECRETARIATE•DDMA Chairman DM/ DC DM-I DM-II • MITIGATION • CAPACITY
DEV. • PREPAREDNESS • TRAINING • PLANS • KNOWLEDGE • RECONSTRUCTION
MANAGEMENT • COMMUNITY AWARENESS • FINANCIAL ASPECTS
16. 2. PRE-HOSPITAL PLAN
17. DDMADISTRICT DISASTER COMITTE•Head Local Administration• Representatives
of Police• Representatives of Fire services• Representatives of CATS• Representatives of
Corporate body• Representatives of Voluntaryorganization• Representatives of Media• Hospital
representatives.•Army should be called into action as andwhen required
18. Allocation of adequate Preparation of Action Plan GUIDELINES FOR DDMA Laying
down role and responsibilities Ensure implementation resources Code of
Practices, Regulatory framework. of different services Statutory Inspection, Safety Auditing
and Procedures and Standards. Technical and technological information and Testing of
Emergency Plans. Creation of DDMA Education and Training. Preparedness. Awareness
Generation Capacity Development of all teams. Infrastructure. Networking and Institutional
Framework at all levels. among Public. Research and Medical Preparedness by medical
Teams. Information sharing. Evacuation plan and Response, Relief and
Rehabilitation. Development. Mock drill
Instantaneous instruction for 19. RESPONSE BY DDMA forthwith movement of rescue
team with personal protective equipment Simultaneously, QRMT(Quick Response
Medical (PPE) Team) with PPE on will reach to Mishap site immediately along with
Resuscitation, protection, detection and decontamination equipment and materials.
Decontamination , Resuscitation, triage and evacuation work must be DDMA will immediately
inform State and National done as per SOPs. Disaster Management Authorities appraising about
situation and extent of damage so that SDMA & NDMA can plan to send relief teams and
supports.
20. HOSPITAL DISASTER PLAN
21. HOSPITAL Hospital Disaster plan is prepared to reduce the DISASTER PLAN
pressureon the hospital management when a large number ofcasualties arriving suddenly in the
hospital at a time,requiring different level of The plan should be activated immediately to
provideefficient care care. Mock drill to be conducted to the patients within a short span of
time. The action periodically to acquaint thestaff to meet any eventuality Keeping adequate
storage plan begins with formation of Disastercommittee Keeping disaster SOP in the of
supplies in the emergencydepartment. casualty.
22. HOSPITAL DISASTER ACTION PLAN CARE IN HOSPITALCARE AT THE SITE
23. HOSPITAL DISASTER COMMITTEEEach hospital must have a hospital disaster
committee to giveeffect to the disaster action plan as and when required.CMO I/C CASUALTY

3. •ALL HODS ECRO (Surg,Med,Ortho,Neuro,Lab, Radio)CMO(CASUALTY) • DD(A) •Nursing
Supdt. •Officer I/C TPS SISTER I/C •CMO (store) •Officer I/C Maintain. •Dietician •CPWD
Rep. OTHER PARAMED. STAFF
24. 1.CARE AT THE SITE• Do not allow Golden hour to expire,, 1st hour•It is best if services
can be provided in first 10 minutes (Platinum minute)• BLS ABC= Air way. Breathing.
Circulation• ALS DEF= Defibrillator. ET intubation, ECG . Fluid & electrolyte• Constitute the
field team: 1.Ambulance 2.Anesthetist To be identified and roaster made on daily, 3.OT Tech
Weekly and monthly basis. 4.Bearers 5.Drivers • Dispatch the team to site • Assess the situation
in the site. • Render first aid at the site and during transport • Stabilize the serious cases. •
Transport serious cases to the hospital under direct supervision.
25. 2.INTERNAL DISASTER PLANIt is activated when the hospital buildings are effected
indisaster. Action plan should clearly mention:• Alternate site
(dharmashala,Temple,Schools,Playgroundnearby)• Folding tents, cots, trolleys for temporary
shelters• Identify a nearby tent house to provide beds,blankets• TPT for transportation of cases to
alternate sites or hospital• First aid and drug kits, potable lights.• Portable communication
system.• Identify local voluntary organization, who can provideservices of care,food and water.
26. 3.EXTERNAL DISASTER PLAN (TEN STEPS)• 3.1.DISASTER RESPONSE • 3.7.
PUBLIC RELATION• 3.2. AUTHENTICATE • 3.8. TRAFFIC CONTROL SOURCE •
3.9.PERSONAL• 3.3. ACTIVATION OF PROTECTION DISASTER PLAN •
3.10.CHEMICAL• 3.4. CREATION OF DECONTAMINATION ADDITIONAL SPACE• 3.5.
AUGMENTATION OF SERVICES• 3.6. MAINTENANCE OF RECORD
27. 3.EXTERNAL DISASTER PLAN3.1.DISASTER STEP 1 ONE
CASUALTY RESPONSE: - Approach using normal STEP 2 TWO CASUALTIES - Approach
with caution, procedures consider all options i).Report STEP 3 THREE CASUALTIES or
MORE Do NOT wait on arrival, update control. i).Evoke Disaster action plan ii).Call for
specialist help.Disaster response depends on:• Time available between the first information and
arrival ofcasualties.• Type of preparedness and training of staff.• Accessibility to disaster
manual.• Role played by different category of staff.
28. STEP 1 ONE CASUALTY 3.EXTERNAL DISASTER PLAN3.1.DISASTER
RESPONSE: - Approach using normal STEP 2 TWO procedures CASUALTIES - Approach
with caution, consider all options i).Report on arrival, update STEP 3 THREE CASUALTIES or
MORE Do NOT wait control. i).Evoke Disaster action plan ii).Call for specialist help.Disaster
response depends on:• Time available between the first information and arrival ofcasualties.•
Type of preparedness and training of staff.• Accessibility to disaster manual.• Role played by
different category of staff.
29. 3.2. AUTHENTICATE SOURCE OF INFORMATION:•Media, Telephone, Police, CATS
on arrival ofcasualties.• Authenticate the information received.• Try to know the type of disaster,
time ofoccurrence.• Estimate number or type of casualty expected.
30. DISASTER MANAGEMENTNOTIFY KEY PERSONS INITIATE PREPARATION o
All the dept & designated staff get into INITIAL ALERT o readiness to attend casualties Crisis
expansion of hospital beds. (POLICE, TV, o Preparation for decontamination area TELEPHONE
,PATIENT)RESUSCITATION COLLECT MOBILIZATION OF RESOURCES o Manpower:
Disaster Management INFORMATION Team medical , nursing and other INVESTIGATION
Personnel o Material and supply eg: antidotes o Transportation means ICU TRIAGE
TREATMENT DUCUMENTATION OT IN DOOR DECONTAMINATION OPD DEATH
ARRIVAL OF DISCHARGE PATIENT MORTURY

4. 31. 3.3. On confirming about the information the ACTIVATION OF DISASTER PLAN:
MSshould be informed and others to be informedthrough hospital The CMO on duty is
responsible foractivation of the disaster exchange. All the available doctors and staff to
bealerted about the plan. incidence.
32. 3.4. CREATION OF ADDITIONAL SPACE:A. Triage/shorting area:This is the area
where the specialists will be there to categorize the patients as per priority.• Primary treatment
area Resuscitation• Secondary treatment area Stabilization & treatment (Disaster ward)•
Evacuation area First aid To wards & discharge /death• Control room and information center•
Volunteer reception area (porter services)• Relatives waiting area• Media and communication
area• Traffic control
33. TRIAGE/SHORTINGPriority I: Serious cases Red band Resus. ICU.Priority II: operation
Yellow band Resus. OT Ward O U TPriority III: Requiring admission Blue band First aid
WardPriority IV: Minor injuries Green band First aidPriority V: Dead Black band Identification
Morgue
34. 3.5. AUGMENTATION OF SERVICES:•All supporting and utility services to be
augmented.• Staff strength in different areas to be increased.• OTs to run round the clock.•
CSSD, Laundry, Kitchen time to be extended tocompensate• Sanitation & Security services to be
augmented• Continuous supply of electricity and water.• Communication service to run round
the clock(Tel.Exchange)• Medical record section to be augmented.• Investigation services to run
round the clock.•Medical store to be opened round the clok
35. 3.6. MAINTENANCE OF MLC to Proper record of all cases to be made for
identification. RECORD: be made in all cases with name, address, injuriesand treatment All
records to be preserved for future compensation andLegal given. A copy of the list to be handed
over to police and evidence Documentation, follow up and research programs
shouldbe inquirycounter. used as feedback for future improvement and lessonslearnt.
36. An inquiry counter be opened round the clock 3.7. PUBLIC RELATION: Media briefing
to be made by forinformation of public and relatives. Public announcement be made for
voluntary Med. Supdt. Only Information centre displaying information to
public, blooddonation. torelatives of victims and media with warning guidelines,“DOs and
Adequate place for DON‟Ts” and condition of patients in thehospital. waiting relatives, toilet
and drinkingfacilities.
37. 3.8. Adequate This is very essential in a disaster situation TRAFFIC CONTROL: There
should be cle measures to be made to control the trafficar area Necessary arrangement should
be for off loading patientsfrom Ambulances made for VIP visitsAssistance of local police and
volunteers may be short.
38. PERSONAL PROTECTION PPE, when 3.9A. PPE: decontamination, of specific agents,
diagnosis& immediate management PPE will of chemical incidents, radiationfacts, emergency
contacts. protect you, the patient, and other patients andcolleagues from infection and from other
hazards, but only ifselected, worn, and Remove PPE as you have been instructed in discarded
correctly. For advice on choosing and using PPE contact yourinfection training. control team
(infection hazards) or for chemical/radiation, Health Protection Team
If your hands are 39. 3.9B.HAND HYGIENE: visibly dirty, or contaminated with blood or
body fluids, usesoap and If your hands are not visibly dirty, use an water to clean your hands
Always clean your hands:– alcohol-based hand rub, or soap andwater Before any patient
contact (even if you are „only‟ going to examine them)– Before any clinical procedure– Before

5. you eat– After any patient contact– After completing a clinical procedure– After handling or
touching any contaminated item or equipment (eg bed pan,suction apparatus, toilet flush-
button)– After removing your gloves– After Never try to clean leaving an isolation room– After
using the lavatory visibly soiled disposable gloves by cleaning your glovedhands: it doesn‟t
work. Remove gloves, clean your hands, and reglove
40. Decontaminate according to protocols for 3.10.CHEMICAL DECONTAMINATION:
Decontamination of the clinical, emergency ormass decontamination. injured and emergency
decontamination isled and managed by the Ambulance Removing the casualty from the source
and promptdecontamination Service may be life-saving; as may prompt administrationof the
specific antidotes that are available for some chemicals (egcyanide, Decontamination to be done
by shower jet with plenty organophosphates) Record any treatment given on the triage tag
attached to of water. Feedback relevant information regularly to MIO/Ambulance thecasualty
Ensure that you and your equipment remain in the Control Collect samples and send for
Lab contaminatedarea until decontaminated. test for confirmation of the
41. OFF HOSPITAL
42. POST DISASTER MANAGEMENT
43. Emergency Management at the incident Site: RESCUE •Personal Protective Equipment
will be made available • Temporary decontamination facility Safe • On-Site Triage,
Resuscitation. Evacuation Plans for transportation of the casualties in ALS ambulances
Earmarking of health care facilities able nearby affected communities. to cater differenttypes of
casualties like chemical burns, respiratory Hospital to be informed to initiate
disaster problemsetc. managementplans to deal with mass casualty events caused due to
Preparation of Trained Medical First CBRNdisasters. Identification of Casualty
Profile Responders. & their Risk and Resource Inventories and supplies classification
fortransfer. augmentation.
44. DISASTER ZONES PUBLIC PASSAGEMEDIACOMAND CENTREAMBULANCE
WIND DIRECTION TRIAGE FIRST-AIDDECONTAMINATIO N EVACUATION TEAM
DANGE R ZONE NO ENTRY
45. RELIEF1. Prime responsibility of Public Health authorities.2. They must ensure safe water
supply, clean food availability.3. Maintenance of hygiene and sanitation by proper bio- waste
disposal.4. Water testing and food inspection must be carried out.5. Decontamination of the area,
equipment, vehicles and disposal of left over contaminants.6. Removal of dead bodies from site
has to be carried out in the Post-disaster Scenario and their disposal.7. It also involves restoring
life of victims to normalcy in resettlement colonies.
It 46. 3. REHABILITATION involves providing temporary shelters with minimal
hygienesanitation to the affected, restoring “normalcy” through ensuringresumption of
Psychological impact of chemical family‟s daily living patterns. disaster manifested as
posttraumatic stress disorders (PTSD) in displaced people due lo disaster,needs care by a
psychologist and In post-disaster scenario some of the casualties will psychiatrist. These cases
may need developsequel due to chemical/Radiation injuries. regular follow-up, medical
care,reconstructive surgery and Close monitoring is required to see any long term
health rehabilitation. effects likeblindness, interstitial lung fibrosis and neurological deficiencies
etc.,and need to be treated as well.
47. EFFECTS OF IMPACT Psychological vulnerability and Neuropsychological Sequel
Fear of unknown calamities. Fleeing of affected community. Exponential spread of disaster

6. victims. Over crowding of hospitals by people believing themselves to be affected. Hoarding of
food, water and essential items. Decreased efficiency of system. Collapse of civil management
and lack of essential services.
48. POST DISASTER DOCUMENTATION AND Information will ANALYSIS During
response in hospital an be prepared by a medical administrator. information centre will provide
information to public, to relatives of victims and Warning guidelines, “DOs and DON‟Ts” and
condition media of Dissemination of information to patients in the hospital. electronics and
prints media will also be carried out by medical team. Documentation, follow up and research
programs should be used as feedback for future improvement and lessons learnt.
49. MEDICAL RESPONSE TO LONG TERM EFFECTS1. In post-disaster scenario some of
the casualties will develop sequel due to chemical/Radiation injuries.2. These cases may need
regular follow-up, medical care, reconstructive surgery and rehabilitation.3. Close monitoring is
required to see any long term health effects like blindness, interstitial lung fibrosis and
neurological deficiencies etc., and need to be treated as well.