IIIYR BSC NURSING

1. PREPARED BY :Mrs Bemina JA
Assistant Professor
ESIC College of Nursing
Kalaburagi

2. Disaster
 Any destructive events that disrupts the normal
functioning of a community.
 Ecologic disruptions or emergencies of a severity and
magnitude that result in
 Deaths,
 Injuries,
 Illness And property damage that cannot be effectively
managed
 using routine procedures or resources that require outside
assistance.

3. CHARACTERISTICS OF DISASTER
 Predictability
 Controllability
 Speed of onset
 Length of forewarning
 Duration of impact
 Scope and intensity of impact.

4. 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.

5.  Organizations should function as an extension of their
core business .
 Individuals are responsible for their own safety.
 Disaster management planning should focus on large-
scale events.
 Disaster management should recognize the difference
between incidents and disasters.
 Disaster management operational arrangements are
additional to and do not replace incident management
operational arrangements.
 Planning must take account of the type of physical
environment and the structure of the population.
 Disaster management arrangements must recognize the
involvement and potential role of non-govt agencies.

6. 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.

7. Types of Disaster
1.Natural- cause by natural or environmental forces.
It includes
 Earthquakes,
 Floods,
 Tornadoes,
 Hurricanes,
 Volcanic Eruptions, Etc.

8. 2.Man Made/Human Generated
 The principal direct causes are identifiable human actions,
deliberate or otherwise.
It has three broad categories:
 Complex Emergencies,
 Technologic Emergencies,
 Disasters That Are Cause By Natural Hazards But Occur
In Natural Settlements.

9.  Complex emergencies: involve situations where
populations suffer significant casualties as a result of war,
civil strife, or other political conflict.
 Technologic emergencies: large number of people,
property, community infrastructure, and economic welfare
are directly and adversely affected by
 Major Industrial Accident,
 Unplanned Release Of Nuclear Energy And Fires Or
 Explosions From Hazardous Substances such as fuel,
chemicals, or nuclear materials.

10.  Medical Disaster-
 Is a catastrophic event that results in casualties that
overwhelm the health care resources in that community

11. 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.
 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.

12. Health Effects of Disasters
 Premature deaths, illnesses, and injuries.
 Destroy the local health care infrastructure.
 Affect the psychological, emotional, and social well
being of the population.
 Shortages of food and cause severe nutritional
deficiencies.
 Create large population movements.
 Create environmental imbalances.

13. Disaster Planning
 Addresses the problems posed by various potential events,
ranging in scale, from mass casualty incidents.

14. Types of Disaster Planning
 1.Agent specific approach
It’s a planning type that focuses on the preparedness on
most likely threats to occur based on their geographic
location.
 2.All hazards approach
Is a conceptual model for disaster preparedness that
incorporates disaster management components that are
consistent across all major types of disaster events to
maximize resources, expenditures and planning efforts

15. Phases of a Disaster
 Pre-impact phase
 Impact phase
 Post-impact phase

16. 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.

17.  DISASTER PREPAREDNESS:-
 Is an ongoing multisectoral activity.
 Integral part of the national system responsible for
developing plans and programs for
 Disaster Management,
 Prevention,
 Mitigation,
 Response,
 Rehabilitation And
 Reconstruction.
 Co-ordination of a variety of sectors to carry out

18. Co-ordination of a variety of sectors to carry out :
 i. Evaluation of risk.
 ii. Adopt standards and regulations.
 iii. Organize communication and response mechanism.
 iv. Ensure all the resources –ready & easily mobilised.
 v. Develop public education programs

19. 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.

20. IMPACT PHASE:
 Search , rescue and first aid.
 Field care
 Triage
 Tagging
 Identification of dead.

21. 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.
 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.

22. POST-IMPACT PHASE:
 I. DISASTER RESPONSE:-
 Immediate reaction to disaster as the disaster is
anticipated , or soon after it begins in order
 To Assess The Needs ,
 Reduce The Suffering,
 Limit The Spread And Consequences Of The Disaster,
 Open Up The Way To Rehabilitation

23.  Mass evacuation
 Search and rescue
 Emergency medical services
 Securing food and water
 Maintenance of law and order
 Implementing the disaster management plan.
 Setting up medical camps and mobilizing resources.
 Providing adequate shelter and sanitary facilities.
 Development of search and rescue team.
 Epidemiologic surveillance and disease control.
 Vaccination.

24. II.REHABILITATION:-
 Water supply
 Food supply
 Basic sanitation & personal hygiene.

 Vector control.

25. iii. Disaster mitigation:-
 This involves lessening the likely effects of the emergencies.
 These include depending upon the disaster, protection of
vulnerable population and structure.
 For ex. Improving structural qualities of the schools , houses
and such other buildings so that medical casualties can be
minimized.
 similarly, ensuring the safety of health facilities and public
health services including water supply and sewerage system
to reduce the cost of rehabilitation and reconstruction.
 This mitigation complements the disaster preparedness and
disaster response activities.

26. 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”

27. 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”

28. 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”

29. 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”

30. 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-
 1. Disaster zone
 2. Treatment zone
 3. Transport zone

31.  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.
 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.
 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:

32. TRIAGE
 Golden hour Immediate or high priority.
 Delayed or medium priority.
 Minor or minimal or ambulatory patients.
 Expectant or least priority.
 Colour code.
 i. Priority – Red band – serious cases.
 ii. Priority – Yellow band – moderately severe cases.
 iii. Priority – Blue band – required admission to ward.
 iv. Priority – Green band – stable cases, first aid
needed.
 v. Priority – Black band – dead.

33. 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

34. 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
 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

35. 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.
 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.

36. 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.