DISASTER

NURSING
DISASTERS

• Any catastrophic situation in

which the normal patterns of
life (or ecosystems) have been
disrupted and extraordinary,
emergency interventions are
required to save and preserve
human lives and/or the
environment
HAZARD

• Rare or extreme event in the

natural or man-made
environment that adversely
affect human life, property or
activity to the extent of causing
disaster
Phenomenon that poses
threat (s) to people
structure or economic
asset that may cause a
disaster either…
-human introduces or
-naturally occurring in
the environment
VULNERABILITY

• Extent to which the

community, structure,
service or geographic
area is likely to be
damaged or disrupted by
the impact of a particular
hazard
HAZARD+VULNERABILIT
Y/CAPACITY=DISASTER
RISK
PHYSICAL
VULNERABILITY
• Extent of likely
damage/disruption on account
of nature/construction and
proximity to man-made
environment (buildings and
natural environment, forest,
aquaculture)
CAPABILITIES

• Resources and skills people

posses, can develop,
mobilize and have access to
which allow them to have
more control over shaping
their future
TYPES OF DISASTERS

According to
CAUSE/OCCURRENCE

• Natural-caused by forces of
nature
• e.g. earthquake, typhoons,
volcanic eruptions
• Man-made- caused by errors of
man
• e.g. war, civil strife or other
conflicts
• Technological
• e.g. air crashes, pollution,
nuclear accidents, explosions
According to
PREDICTABILITY

• Sudden Onset- no warning

issued
• Slow Onset-disasters that come
with warnings
• e.g. typhoons, volcanic
eruptions
According to EXTENT OF
DAMAGE

• Large scale-effects not

solely limited to the
impact area
• Small scale-effects are
localized;limited only
to the impact area
HEALTH SERVICE

Concept of Operations
1. An emergency of
disaster necessitates the
mobilization of all
medical resources in
order to protect and
preserve human lives
DISASTER
MANAGEMENT
• A collaborative term used to
encompass all activities
undertaken in anticipation of
the occurrence of a potentially
disastrous event, including
prepareness and long term risk
reduction measures
EMERGENCY RESPONSE

• The period immediately

following a disaster when the
exceptional measures have to
be taken to search and find
survivors as well as meet their
basic needs for shelter, water,
food and medical care
REHABILITATIONS

• Operations and decisions taken

after the disaster with a view to
restoring a stricken community
to its formers living conditions
while encouraging and
acilitating the necessary
adjustments caused by the
disaster
AIM:

• Immediate repair and initial

efforts to re establish the
essential services associated
with social and economic
functions of a community
ALERT PERIOD

• Refers to the time when a

disaster is developing and when
it has not yert hit the
community. Threats are
detected, warnings are issued
and evacuation is facilitated.
Evacuation can take 3 forms:
FORCED/VOLUNTARY/DISPLACE
D
DISASTER NURSING

• The adaptation of Professional

Nursing KNOWLEDGE , Skills
and ATTITUDE in recognizing
and MEETING the nursing and
MEDICAL NEEDS of DISASTER
VICTIMS
BASIC PRINCIPLES IN
PLANNING FOR DISASTER
NURSING
• N- ursing Plans should be integrated
and coordinated
• U- pdate physical and Psychological
preaparedness
• R- esponsible for Organizing,
Teaching and Supervision
• S- timulate Community Participation
• E- xercise Competence
BASIC PRINCIPLES OF
NURSING CARE for
DISASTER VICTIMS
• A- daptation of Skills to
Situation
• C- are for Disaster Victims
• C- ontinuous Awareness of the
patient’s condition
• T- each AUXILLARY personnel
• S-election of Essential Care
ROLES and
RESPONSIBILITIES of a
DISASTER NURSE
• D- isseminate information on the
prevention and control of
environmental Hazards
• I- nterpret health laws and
regulations
• S- erve yourself of self-survival
• A- ccepts directions and take orders
from an organized authority
• S- erve the best of the MOST
• T- each the meaning of warning
signals
• E- xercise leadership
• R- efer to appropriate agencies
NURSING PROCESS

• -a deliberate problem-solving
approach that requires
cognitive, technical and
interpersonal skills and directed
to meeting the needs of the
client
Te chnical sk ill s

• which includes knowledge and

skills needed to properly and
safely manipulate and handle
appropriate equipment needed
by the patient in performing
medical or diagnostic
procedures, such as vital signs,
and medication administrations.
[
DISASTER
HEALTH
ASSESSMENT
OUTLINE*
1. BACKGROUND ON
THE DISASTER
• Type of disaster,
occurrence
• Immediate effects in the
areas
• Nature and extent of
damage on population
• Properties and environment
• Affected population
• Changes from pre-disaster
period (area map, indicating
the affected areas, existing
hazards and location of
affected population could be
presented)
2. HEALTH EFFECTS &
INITIAL RESPONSE

• Water supply availability,

adequacy and distribution
• Sanitation conditions and
existing sanitation facilities
• Psychological stress brought
about by the disaster and
mental health services provided
Evaluation and using
health info
• RECORD all relevant information
received, noting source and
origin/date
• EVALUATE all health
information “consistent?
Biases?influencing reports?”
• Establish specific purpose and
evaluation
• Decide who will evaluate
• Fix time schedule: results
should be produced quickly in
order to be useful
PLANNING TO MEET
DISASTER HEALTH
NEEDS & PROBLEMS
Definition of terms

• Need/s- any material/provision

that will sustain survival if such
is lacking, either physical, or
psychological, disequilibrium
and ambivalence will result
• Problem-an unmet need
Need/Pr oble m:
INJ URI ES
• Objectives:
• Minimize further injury and
prevent complications
• Relieve pain and discomfort
• Provides means of transport to
a safer area
Interventions:

• Provide immediate and

appropriate treatment
• Proper handling and positioning
• Immediate evacuation to
nearest medical facility
• Provide psychological support
Need/Problem: DEATH

• Objectives:
• Provide care of the dead
• Provide supportive care to the
bereaved family
Interventions:

• Proper identification and

disposal
• Notification of relatives
• Spiritual blessing to the dead
• Proper mark of the grave’s site
must be done
Need/Problem:
EPIDEMICS
• Objectives:
• Control of epidemics
• Interventions:
• Initiate preventive measures
(isolation, immunization,
environmental sanitation)
• Treatment of cases
• Record and report known cases to
proper authorities
• Accomplishment of terminal
disinfections
Interventions:

• Initiate preventive measures

(isolation, immunization,
environmental sanitation)
• Treatment of cases
• Record and report known cases to
proper authorities
• Accomplishment of terminal
disinfections
Need/Problem: POOR
SANITATION
Objectives:
• Maintenance of sanitary
environmental condition
conducive to healthful living
Interventions:
• Early identification of signs and
symptoms indicative of stress
• Provide diversional, occupational
and recreational activities
• Encourage hope. Trust in God’s
steadfast love
• Refer to minister own faith
MODULE 7

•MANAGEMENT OF
MASS CASUALTIES:
RESCUE,TRANSFER,
TRIAGE and
TAGGING
Objectives

• -Illustrate the application of

triage and tagging procedures
in the management of mass
casualties
• -Understand the priorities in
triage and tagging, and orders
of evacuation
MASS CASUALTY
MANAGEMENT

• MCMS is a multi-sectoral
coordination system based on
daily utilized procedures,
managed by skilled personnel in
order to maximize the use of
existing
resources;provide prompt and
adapted care to the
victims;ensure emergency
services and emergency
services and hospital return to
routine operations as soon as
possible
IMPORTANCE OF MCI
MANAGEMENT
• Victims of MCI can be
efficiently TRIAGED, TREATED
and TRANSPORTED in a
properly COMMANDED,
CONTROLLED,
COMMUNICATED,
COORDINATED and orderly way
that all tasks are carried out
MASS CASUALTY
INCIDENT
• -produces several patients
• -as few as six or as many as
several hundred
• -affects local hospitals
• -patients are greater than
resources of the initial
responders
PREPARATION FOR
MASS CASUALTY
• -Pre-planning and training is
critical
• -Establish guidelines and
procedures
• -Early implementation of
incident command
• -First five minutes will
determine next five hours
MASS CASUALTY
MANAGEMENT
• Simple
• Triage
• And
• Rapid
• Treatment/transport
TRIAGE

• -process used in sorting

patients or victims into
categories of priorities
for care and transport
based on the severity of
injuries and medical
emergencies
• Tria ge (pronounced is a process of
prioritizing patients based on the
severity of their condition so as to
treat as many as possible when
resources are insufficient for all to
be treated immediately.
• The term comes from the French
verb trier, meaning to sort, sift or
select..
• There are two types of triage:
simple triage and advanced
triage
Sim ple t ria ge

• Simple triage is used in a scene of

mass casualty, in order to sort patients
into those who need critical attention and
immediate transport to the hospital and
those with less serious injuries.
• This step can be started before
transportation becomes available.
• The categorization of patients based on
the severity of their injuries can be aided
with the use of printed triage tags or
colored flagging.
• S.T.A.R.T. (Simple Triage and
Rapid Treatment) is a simple
triage system that can be
performed by lightly-trained lay
and emergency personnel in
emergencies. It is not intended
to supersede or instruct
medical personnel or
techniques.
Triage separates the injured into four
groups:
• The deceased who are beyond help
• The injured who can be helped by
immediate transportation
• The injured whose transport can be
delayed
• Those with minor injuries, who need
help less urgently
• However, these descriptive words are by no means
standard; different regions use different designations.
• In the UK and Europe, the triage process used is similar
to that of the United States, but the categories are
different:
• Dead - those who are pronounced as such by a medically
qualified person or paramedic who is legally qualified to
pronounce death
• Immediate - patients who have a trauma score of 3 to 10
(RTS) and need immediate attention
• Urgent - patients who have a trauma score of 10 or 11
and can wait for a short time before transport to
definitive medical attention
• Delayed - patients who have a trauma score of 12
(maximum score) and can be delayed before transport
from the scene
Eva cuation

• Simple triage identifies which people need

advanced medical care. In the field, triage also sets
priorities for evacuation to hospitals. In S.T.A.R.T.,
casualties should be evacuated as follows:

• Deceased are left where they fell, covered if

necessary; note that in S.T.A.R.T. a person is not
triaged "deceased" unless they are not breathing
and an effort to reposition their airway has been
unsuccessful.

• Immediate or Priority 1 (red) evacuation by

MEDEVAC if available or ambulance as they need
advanced medical care at once or within 1 hour.
These people are in critical condition and would die
without immediate assistance.
• Delayed or Priority 2 (yellow) can have
their medical evacuation delayed until all
immediate persons have been transported.
These people are in stable condition but
require medical assistance.

• Minor or Priority 3 (green) are not

evacuated until all immediate and delayed
persons have been evacuated. These will
not need advanced medical care for at
least several hours. Continue to re-triage in
case their condition worsens. These
people are able to walk, and may only
require bandages and antiseptic.
Ad vanced triage

• In advanced triage, doctors may decide

that some seriously injured people should
not receive advanced care because they
are unlikely to survive. Advanced care will
be used on patients with less severe
injuries. Because treatment is intentionally
withheld from patients with certain
injuries, advanced triage has ethical
implications. It is used to divert scarce
resources away from patients with little
chance of survival in order to increase the
chances of survival of others who are more
likely to survive.
• Principles:
• CARDINAL RULE: “Do the greatest
good for the greatest number”
• Preservation of life takes
precedence over preservation of
limbs
• immediate threats to life:
HEMORRHAGE
TRIAGE CATEGORIES

• FIRST PRIORITY
-immediate, red tag
-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.
SECOND PRIORITY
-intermediate,
observationyellow tag
-victims who are seriously
injured and whose life are not
immediately threatened
-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).
LOW PRIORITY
Wait (walking wounded)
-delayed, green tag
-patients/victims whose care
and transport can be delayed
until last.
-hold care; can delay transport
up to 3 hours
• They will require a doctor's care
in several hours or days but not
immediately, may wait for a
number of hours or be told to go
home and come back the next
day (broken bones without
compound fractures, many soft
tissue injuries).
LOWEST PRIORITY
Dismiss (walking wounded)
-patients/victims who doesn’t require
care
They have minor injuries; first aid and
home care are sufficient, a doctor's
care is not required. Injuries are
along the lines of cuts and scrapes,
or minor burns.
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.
END of DISASTER
NURSING
TENK YOU!!! 

UP NEXT

UNIT EXAMINATION 