A disaster is a sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources.
2. INTRODUCTION
The word derives from
Greek pejorative prefix dus = "bad" + aster = "star".
The root of the word disaster ("bad star" in Greek)
comes from an astrological theme in which the
ancients used to refer to the destruction or
deconstruction of a star as a disaster.
The ancient people believed that the disaster is
occurred due to the unfavorable position of the
“planets” or “Act of God”. Gradually they understand
the mysteries of nature.
3. DISASTER
D -detection
I - incident
S - safety & security
A - assess hazards
S - support
T - triage & treatment
E – evacuation
R - recovery
4. Definition
4
Disaster –
•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.(WHO)
•A disaster can be defined as an occurrence either
nature or man made that causes human suffering
and creates human needs that victim cannot
alleviate without assistance.
(American Red Cross)
6. Disasters occur in varied forms
•Some are predictable in advance
•Some are annual or seasonal
•Some are sudden and unpredictable
Floods
Earthquakes
Cyclones
Droughts
Days and weeks
Seconds/minutes
Days
Months
7. 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.''
8. C l a s s i f i c a t i o n o f D i s a s t e r s
8
Natural
Disasters
Meteorological
T
opographical
Environmental
Man made
Disasters
T
echnological
Industrial
Warfare
10. T
echnological
• Transport
failure
• Public place
failure
• Fire
Industrial
• Chemical
spills
• Radioactive
spills
Warfare
10
• War
• Terrorism
• Internal
conflicts
• Civil unrest
• CBRNE
11. TYPES OF DISASTER
1. Natural Disaster – tornados, hailstorms,
tsunami, floods, Earthquakes,
communicable disease etc.
2. Man-Made Disaster- fires, explosions,
toxic materials, pollution, terrorist attack,
transportation accidents etc.
12. DISASTER dimensions
– Disruption to normal pattern of life, usually
severe and may also be sudden, unexpected
and widespread
– Human effects like loss of life, injury, hardship
and adverse effect on health
such as
– Effect on social infrastructure
destruction of or damage to government
systems, buildings, communications and
essential services
– Community needs such shelter, food,
clothing, medical assistance and social care.
13.
14. Goals of the Disaster Nursing
• To meet the immediate basic survival needs of
populations affected by disasters.
• To identify the potential for a secondary
disaster.
• To appraise both risks and resources in the
environment.
• To correct inequalities in access to health care
or appropriate resources.
15. Contd..
• To empower survivors to participate in and advocate
for their own health and well being.
• To respect cultural, lingual, and religious diversity
in individuals and families and to apply this
principle in all health promotion activities.
• To promote the highest achievable quality of life for
survivors.
16. PRINCIPLES OF DISASTER
Minimize the casualties.
Prevent further casualties.
Rescue the victims.
First aid.
Medical care.
Reconstruction.
Disaster management is the responsibility of all
spheres of govt.
Disaster management should use resources
that exist for a day-to-day purpose.
17. 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.
18. Contd..
• 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.
19. Contd..
• The teaching, supervision, and utilization of
auxiliary medical personnel and volunteers.
• Provision of understanding, compassion and
emotional support to all victims and their
families.
20. Health Effects of Disasters
• Disasters may cause premature deaths, illnesses, and
injuries.
• Disasters may destroy the local health care
infrastructure.
• Disasters may affect the psychological, emotional,
and social well being of the population.
21. Contd…
• Disasters may cause shortages of food and cause
severe nutritional deficiencies.
• Disasters may create large population movements.
• Disasters may create environmental imbalances.
23. Phases of a Disaster
• Pre-impact phase
• Impact phase
• Post-impact phase
24. 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 the aid 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.
25. 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
tears 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.
26. 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 emotional
response.
• 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.
27. Contd..
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.
29. A CONTINUOUS AND INTEGRATED PROCESS OF PLANNING,
ORGANISING, COORDINATING AND IMPLEMENTING MEASURES
WHICH ARE NECESSARY OR EXPEDIENT FOR:
i) Prevention of danger or threat of any disaster.
(ii)Mitigation or reduction of risk of any disaster or its
severity or consequences.
(iii)Capacity-building.
(iv)Preparedness to deal with any disaster;
(v)Prompt response to any threatening disaster situation or
disaster.
(vi)Assessing the severity or magnitude of effects of any
disaster; evacuation, rescue and relief.
(vii)Rehabilitation and reconstruction.
(Disaster Management Act, 2005)
30. • Prevention
• Mitigation
• Preparedness
• Response
• Rehabilitation
• Reconstruction
Six elements that defines the complete approach to
Disaster Management.
33. Integrated
Disaster
Management
Prepared-
ness
Response
Recovery
Mitigation
Activities prior to a disaste
• Preparedness plans
• Emergency exercises
• Training,
• Warning systems
Activities that reduce
effects of disasters
• Building codes &
zoning
• Vulnerability
analyses
• Public education
Activities following a
disaster.
• Temporary housing
• Claims processing
• Grants
• Medical care
Activities during a
disaster.
• Public warning
systems
• Emergency
operations
• Search & rescue
34. Disaster preparedness
Preparedness should be in the form of
money, manpower and materials
🞇 Evaluation from past experiences about risk
🞇 Location of disaster prone areas
🞇 Organization of communication, information
and warning system
🞇 Ensuring co-ordination and response
mechanisms
35. 🞇 Development of public education
programme
🞇 Co-ordination with media
🞇 National & international relations
🞇 Keeping stock of foods, drug and other
essential commodities.
Contd….
38. Disaster mitigation
🞇 Thisinvolveslessening the likelyeffects of emergencies.
🞇 These include depending upon the disaster, protection of
vulnerable population and structure.
Eg. improving structural qualities of schools, houses and such other
buildingsso that medical causalities can be minimized.
🞇 Similarly ensuring the safety of health facilities and public health
services including water supply and sewerage system to reduce the
costof rehabilitation and reconstruction.
This mitigation compliments the disaster preparedness and disaster
response activities.
39. DISASTER-EFFECTS
🞇 Deaths
🞇 Disability
🞇 I
ncrease in communicable disease
🞇 Psychological problems
🞇 Food shortage
🞇 Socioeconomic losses
🞇 Shortage of drugs and medical supplies.
🞇 Environmental disruption
40. DISASTERRECOVERY
🞇 Successful Recovery Preparation
🞇 Be vigilant in Health teaching
🞇 Psychological support
🞇 Referrals to hospital as needed
🞇 Remain alert for environmental health
🞇 Nurse must be attentive to the danger
41. E.g.: Indian Meteorological department (IMD) playsa keyrole
in forewarning the disaster of cyclone-storms by detection tracing. Ithas
5 centres in Kolkata, Bhubaneswar, Vishakapatanam, Chennai &
Mumbai. In addition there are 31 special observation posts setup a long
the east coast of India.
The International Agencies which provides humanitarian assistance to the
disaster strike areas are United Nation agencies.
Office for the co-ordination of Humanitarian Affair (OCHA)
World Health Organization (WHO)
UNICEF
World Food Programme (WFP)
Food & Agricultural Organisation (FAD)
E.g.: Non Governmental Organizations
🞇 Co-Operative American Relief Every where (CARE)
🞇 International committee of Red cross
🞇 International committee of Red cross
43. ⚫Derived from a French word ‘triar’ which means
‘to separate out’
⚫A method of quickly identifying victims who have
immediately life-threatening injuries and who
have the best chance of surviving
⚫Use when the quantity severity of injuries
overwhelm the operative capacity of health
facilities .
44. ⚫The principal of “first come” “first treat” is not
followed in mass emergencies
⚫Processing of determining the priorities patients
treatment based on their severity
⚫It consist of rapidly classifying the patients as
per the severities as High priorities
Low priorities
45. The goal of managing a mass casualty
incident
⚫Priorities for transportation to the hospital
⚫Priorities for care in the field
46. 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”
47.
48.
49.
50. ⚫ Created in the 1980’s by Hoag Hospital and the
Newport Beach CA Fire Dept
⚫ Allows rapid assessment of victims
⚫ It should not take more than 15 sec/ Pt
Once victim is in treatment area more detailed
assessment should be made Clasificación is
based on three items
⚫ Respiratory
⚫ Perfusion (bld loos)
⚫ Mental status evaluation(neuro)
51. Organizing an effective
Disaster System
The nurse must be familiar
with the personnel at the
disaster scene and their roles
and functions. A disaster scene
is usually broken up into three
zones-
53. 1.Disaster zone:
•It is the actual location of the incident from
where patient are to be removed as soon as
possible. Majority of disaster personnel are
sent to this zone initially.
54. 2.Treatment zone:
Nurses spend most of their time in their
zone during a disaster, where equipment
and personnel to carry out patient care are
concentrated. Activities carried out in this
zone includes.
- Assessment of each patient
- Treatment of injuries
- Preparation for transport.
55. 3.Transportation zone:
•It should be situated directly next to the
treatment zone so that ambulances and
other vehicles can load patient and leave
for hospitals. delivering appropriate
patient care:
56. Triage area must be equipped
with the following
Wheelchairs
Stretchers
Backboards
IV poles
Splints, bandages
Emesis basins
Disaster tags
Pens
Adhesive tape
Oral airway
Scissors
Blankets
Stethoscope
Emergency trolley
with equipment
57. MAJOR ROLES OF NURSE IN
DISASTER
1. Define health needs of the affected groups
2. Establish priorities and objectives
3.Identify actual and potential public health
problems
58. Contd..
5. Determine resources needed to respond to the
needs identified
6.Collaborate with other professional
disciplines, governmental and non-governmental
agencies
7. Maintain a unified chain of command
59. CONCLUSION
Hardly a day now passes without news about a
major or complex emergency happening in
some part of the world. Disasters continue to
strike and cause destruction in developing and
developed countries about their vulnerability
to occurrences that can gravely affect their day
to day life and their future. Nurses in any
location will be on the frontline as care giver
and managers in the event of damaging
disaster.
60. Contd..
• So they need to have adequate knowledge and
framing to work in such a unique, chaotic
stressful situations and to identify and meet the
complex, multifarious health needs of victims
of disaster.
61. SUMMARY/EVALUATION
• Define the term Disaster and Disaster
Nursing.
• Explain the type of disaster.
• Enlist the goals of disaster nursing.
• List down the principles of disaster nursing.
• Explain about phases of disaster.
• Explain disaster Management cycle and
how to organize an effective disaster
system
• Discuss about major roles of nurse in
disaster.
