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Introduction
In the past two decades, there have been many natural and man-made disasters in India.
Natural disasters like floods, earthquakes, cyclones, droughts and human made such as terrorist acts,
Nuclear or chemical war, fires and industrial accidents. Disasters can significantly lead to a
degradation of social and economic progress achieved over decades of initiatives by the people. 80%
of countries geographical area is disaster prone and the majority of people live at or below the poverty
line.
India has been devastated by three major disasters in last five years- Super Cyclone in Orissa,
earthquake in Gujarat and now the latest one the tsunami in the Andaman and Nicobar Islands,.
Tamilnadu, Andrapradesh and Kerala. Each disaster brought a great deal of miscarry to the affective
population.
Definition of disaster
Disaster is any occurrence arising with little or no warning, which causes ecology disruption,
loss of human life, & deterioration of health services on a scale sufficient to warrant an extraordinary
response from outside the community or area. ------ According to W.H.O.
Types of disaster
1. Natural disaster ,
2. Manmade disaster,
3. Hybrid disaster.
Directly due to impact of drowning during floods, injuries during earth quake.
b) Secondary agents:-include bacteria &viruses that produce contamination or infection after primary
agents has caused injury or destruction.
Host:-Human kind
Age, sex, immunization status, preexisting health degree of mobility emotional stability.
Environment:-Physical factor e.g. Shelter ,food
Morbidity which can results from a disaster situation can be classified into four types:-
1. Injury
2. Emotional stress.
3. Epidemic of disease.
Levels of disaster
Level 3- considered a minor disaster. These are involves minimal level of damage.
Level 2- considered a moderate disaster. The local & community resources has to manage this
situation.
Level 1- considered a massive disaster- this involves a massive level of damage with severe
impact.
Phases of disaster
Prevention phase- Identify community preparedness for a disaster is only as high as the
people & organization in the community make it.
Response phase- The level of disaster varies & the management plans mainly based on the
severity or extent of the disaster.
Recovery phase During this action are taken to repair, rebuilt, or reallocate damaged homes
& business & restore health & economic vitality to the community.
Psychological recovery must be addressed .Both victims & relief workers should be offered
mental activities & services.
Disaster process
Disaster situation is a process with different phases. IN each phase, the information, the action
required, the problems uncounted & people involved may be quite different. Each type of phase will
vary according to the type of disaster events.
Disaster Cycle
Prepare Disaster
dness impact
Mitigati
Relief
on
Reconst
ruction
Dimensions of Disaster
Disasters have different dimension like predictability, frequency, controllability time and scope
or intensity. These dimensions influence the nature and possibility of preparation planning as well as
response to the actual event.
Predictability:-
Some events are easily predicted .Examples for predictable disasters is weather related
disasters like tornadoes, floods, hurricanes etc.
Frequency:-
The natural disaster appears more often in certain geographical location. E.g. California
residents are at greater risk for earthquakes.
Controllability:-
Some situations allow for pre-warning and control measures. That can reduce the impact of
disaster, E.g.in case-of flood redirecting the water etc.
Time:-
There are several characteristics of time which relates to the impact of disaster, the speed of
outlet of disaster time available for warming the population, actual length of time of the impact phases
etc.
A disaster may be concentrated on very small area or large, affecting may people. Disaster can
be very intensive & distracting causing many injuries, death, and property damage.
Personal Preparedness-
o Conflict between family & work related responsibilities abound. The nurse assisting in disaster
relief efforts must be as healthy as possible both physically & mentally.
o One change of clothing & footwear per person & one blanket or sleeping person.
o An Extra set of car keys & credit cards, cash or travelers cheese.
o Sanitation supplies, including toilet paper soap feminine hygiene items & Plastic garbage bags.
Professional preparedness
Adequately prepared nurses can function in a leadership capacity & assist towards smoother
recovery phase; Personal items that are recommended for nurses preparing to help in a disaster include
the following-
o Cash
o Disaster management is not high field work; including shelter management requires that nurses
be creative willing to improvise in developing care.
o Disaster relief such as building retaining walls to divert flood water away from a reside once.
o Advocacy such as supporting actions & efforts for effective building codes & prudent land use.
Disaster management
1. Personnel.
4. Communications
5. Supervision
6. Transportation
The key to effective disaster management is pre disaster planning & preparation disaster.
The principles of disaster planning have been but lined in a publication from civil Defense
preparedness Agency.
A continuous process
A knowledge base
A focus on principles
Anticipatory guidance.
Overcoming resistance.
Government, environmental, technical, & economic resources are involved in pre disaster
preparation. Community education & mock disaster exercises are part certain types of certain types of
disaster especially to man made one.
Triage
o During the disaster, the goal is to maximize the number of survivors by sorting, the treatable
from the untreatable victims.
o Prioritizing of victims for treatment can be done in many ways. American Red Cross (1982)
gives color coding probably the best & most easily understood system is the first- priority,
second priority, third priority, dying or dead system.
These clients have reasonable chances of survival only if they receive immediate treatment.
This include victims with
Respiratory insufficiency
Cardiac arrest
Hemorrhage
These victims can wait for transportation after they receive initial emergency treatment.
Victims include.
Victims in this category are ambulatory have minor tissue injuries & may be treated by non-
professionals & held for observations if necessary.
At the disaster site or primary triage point simple support measures can alleviate the
psychological trauma experienced by survivors. These measures include the following.
Hospital nurses will be needed to care for disaster victims as they are brought in for acute care
problems.
Nurses Role at Emergency Aid
Stations-
Nurses are involved in providing care at emergency aid stations. At least one registered nurse
be present at all times while the emergency aid station is opened.
Arranging with volunteer medical consultant for initial & daily health checks based on the health
needs of shelter residents.
Planning for appropriate transfer of patients to community health care facilities as necessary.
Arranging for secure storage of supplies, equipments records & medications & periodically
checking to see whether materials goods must be ordered.
Requesting & assigning volunteer staff to appropriate duties & providing on the job training &
supervision.
Consultation with food supervisor regarding the preparation & distribution of special diets
including infants formulas.
Planning & recommendation adequate staff &facilities when local health departments initiate an
immunization program for shelter residents.
Arranging with the mass care supervisor for the purchases & replacement of essential prescription
for persons in the shelter.
Mock exercise & drills at regular intervals are conducted to ensure that all the staff in the
general & those associated with management of causalities are fully prepared & aware of their
responsibilities.
Elements of disaster plan
Chain of authority
Lines of communication
Warning
Evacuation
Triage
Treatment
Assessment
The local climate conductive for disaster occurrence, past history of disaster in the community,
available community disaster plans & resources, personnel available in the community for the disaster
plans & management, local agencies & organizations involved in the disaster management activities.
Determine the actual & potential disaster threats (e.g. explosion mass accidents, tornados,
floods, earthquakes etc.)
o Identify disaster personnel, including, private and professional volunteers, local emergency
personnel, agencies and resources.
o Identify specific responsibilities for various personnel involved in the disaster plans.
o Practice community disaster plans with all personnel carrying out their previously identified
responsibilities (e.g. emergency triage, providing supplies such as food, water, medicine ,crises and
grief counseling)
o Critically evaluate all aspect of disaster plans and practice drills for speed, effectiveness, gaps and
revisions.
SUMMARY
Up till now we are discussed about definition of disaster, types of disaster, causes of
disaster and their impact on health, disaster agents, general principles of disaster management,
level of disaster, phases of disaster, disaster process, disaster cycle, dimension of doisaster, nurses
preparation to face disaster, disasater management, triage, nurses role at emergency aid, element of
doisaster plan and disaster management nurses role in community.
CONCLUSION
BIBLIOGRAPHY
o P.K. Dave - Emergency medical services & disaster management. A Holistic Approach.
Jaypee Brothers medical publisher (pvt) ltd. 2001. Page no.116-123.
o Usha Ravindra Nair - Textbook of medical & surgical nursing.2009. Jaypee Brothers
medical publisher (pvt) ltd. 2009. Page no 170-172.
o Suresh Roy - Nurses Role in Disaster management. CBS Publishers & distributers. 2010.
Page no. 11- 76.
o Shebeer - A textbook of advance nursing Jaypee brothers medical publisher (pvt) ltd. 2008.
Page no.735-742.
o http://nursingparadise.blogspot.in/2008/12/disaster-management-and-nurses-role.html
V.S.P.Ms COLLEGE OF NURSING AND RESEARCH
CENTER, NAGPUR.
Nagpur. Nagpur.
SUBMITTED ON
19/01/2017