DISASTER MANAGEMENT SIMPLIFIED TRIAGE

1. MRS.ARUNA MANO
MSC (N),MEDICAL SURGICAL NURSING
LECTURER
GANGA COLLEGE OF NURSING
COIMBATORE

2. DISASTER MANAGEMENT
SIMPLIFIED TRIAGE

3. OBJECTIVES:
• Definition
• Classification
• Major disaster in India
• Product B• Out hospital disaster &
management
• In hospital disaster &
management
• Disaster management in
India
• International agencies –
Disaster management

4. Disaster……
It’s not a new thing…In

5. DISASTER
The word comes from, Ancient Greek
DUS - "bad“. and
ASTER - "star“
--- The root of the word
disaster ("bad star" in Greek) comes from
an astrological sense of a calamity blamed on the position of
planets.

6. A disaster is an occurrence
distributing the normal condition of
existence and causing a level of
suffering that exceeds the capacity
of adjustment of the affected
community…
-WHO
DEFINITION:

7. Whenever our need is more than
resources it’s called disaster….
Here,
Resource indicates number of
staffs, medical equipments, resuscitation
things, etc…
Need indicates number of
affected peoples….

8. CLASSIFICATION

9. Disaster classification based on,
1. Causes :
Natural disaster
 Man – made disaster
2. Location :
Out hospital disaster
 In hospital disaster

10. 1. Based on causes:
Natural disaster
Geophysical Hydrological Climatologically Biological

11. Volcanic activity
Tsunami Earthquake
G
E
O
P
H
Y
S
I
C
A
L

12. Flood Avalanche
H
Y
D
R
O
L
O
G
I
C
A
L

13. Droughts
Wild fire Extreme Temperature
C
L
I
M
A
T
O
L
O
G
I
C
A
l

14. Epidemic - Diseases B
I
O
L
O
G
I
C
A
l

15. 2. Man made disaster :
• Man made disaster or Man made
crisis results from,
✓Human intent
✓ Negligence
✓ Error involving a
failure of a man made system

16. Man made disasters

17. Man
Made
Disaster

18. Major disaster in India:
• 2019 Bihar floods
• 2019 India alcohol poisoning
• 2019 Indian floods
• 2019 Karnataka floods
• 2019 Kerala floods
• 2019 Kullu bus accident
• 2019 Mumbai foot over bridge collapse
• 2019 Pune flood
• 2019 Vadodara flood

19. • 2019 Assam alcohol poisonings
• 2019 Bandipur forest fires
• 2019 Bihar encephalitis outbreak
• 2019 Chennai water crisis
• 2019 Delhi factory fire
• Delhi hotel fire
• Dharwad building collapse
• Cyclone Fani
• 2019 heat wave in India and Pakistan
• 2019 Indian Air Force An-32 crash
• Seemanchal Express derailment
• 2019 Surat fire
• Tiware dam failure
• 2020 Uttarakhand forest fires.

20. Locust infestation

21. Out hospital disaster
Management
Disaster happened at the out side of
hospital….like flood, war, droughts, bio –
terrorism
Now,
The management of disaster have
2 phases:
✓ 4 phase
✓ 6 phase

22. 4 phase - cycle

24. 6 phase - cycle

26. STEPS
Pre – preparedness :
It’s a major and foremost step taken in
disaster management phase…This intervention
helps to prevent or Minimize the losses and
damages of the disaster
IT INCLUDES :
✓ Evaluation of risk
✓ Ensure all resources - ready
and easy to mobilized
✓coordinate information with
media

27. ✓ Prepare healthcare workers – In
and out hospital
✓ prepare rescue team members
✓ shift the people’s who all are in
major risk zone
✓ Public education
✓ Training and mock drills
✓ Disaster simulation exercises.

28. Impact stage :
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…..
By mass evacuation, search and
rescue, Emergency medical services,
securing food and water..

29. Response and Rescue :
Before starting a rescue and
response operation ENSURE THE
SAFETY
TRIAD – RESCUE PHASE:
Scene size up
TriageTransport

30. ✓ First and foremost step
taken in disaster management
✓ Set the border around
disaster happened area and restrict the
unnecessary people’s entry
✓ Only health care
professionals, Rescue team members,
Ambulance….
Scene size up:

31. Triage :
TRIAGE word derived from,
TRIER ( French word
) Meaning – To short.
Triage defined as a shortening Of
peoples based on their severity and also
our resources..

32. ✓In disaster area
mass casualty is there…so we
can’t do person by person
assessment…
✓ so here we use
simple ‘SALT’ triage
system….

33. SALT TRIAGE :
S – shortening or global shortening
A – assessment or initial assessment
L – life threatening intervention
T – Transport to definite care

34. Step – 1 -> Shortening:
Categories the people by following
steps :
Able to walk – 3rd priority
Purposeful Movement – 2nd priority
Life threatening – 1st priority

35. Step 2 -> Assessment :
Here for individual assessment, we
use “RPM” formula.
R – Respiration
P - pulse or perfusion
M – Mental status

37. Step 3 -> life threatening
intervention:
life threatening intervention
includes,
CPR( Cardio pulmonary
resuscitation)
Bleeding control
Needle thoracocentesis ( aseptic
manner)

38. Step 4 -> TRANSPORT :
Transport the patient from the
out hospital or disaster area to to definite
care…
It includes,
Air ambulance transport
Road way ambulance.

39. Incidence management – setup:
Incident commenter
|
Public information Officer.
|
Liaison officer
|
|. |. |. |
Planning /
Thinkers
Logistics /
Getter
Operation /
Doer
Finance /
Payers

40. In hospital disaster

41. In hospital disaster :
It occurs when the increased
number of peoples ( mass casualty)
admitted in hospital / more than
resources ( no. Of beds, equipments,
etc..)
causes :
1. Improper identification, triage
2. Lack of supplies
3. Poor communication network

42. Classes :
• Class A – No disturbance in routine
work
• Class B – Minor disturbance, need
some modifications
• Class C – Major disturbance of routine
work

43. MANAGEMENT
Management on,
1. Number of beds :
Here we increase the
capacity by car barking, warrant to wards
and ICUs….; Discharge the admitted
patient who don’t need emergent care in
hospital…

44. IHD – Management :
2. Next , Need of Medicines,
equipments, staffs:
>We can buy medication
and equipments in near by hospital/ near
by district health care facility, stack
hold…
> We can post the
temporary staffs to manage the staff
insufficiency

45. Hospital admission formula:
For occupancy :
No. of cases we have to treat/ hr = 3% of
total hospital beds

46. Post impact phase , Mitigation:
Post impact phase is a disaster recovery
phase
In this,
✓ Displace the people’s from their origin
✓ Reconstruction process
✓ Rehabilitation process ( Financial,
physical, psychological)

47. Mitigation :
Mitigation means reduce the risk of
disaster…..or prevention
Mitigation – Pneumonic:
“ PRE – DISASTER “
P – Planning and practice.
R – Resilience
E – Education

48. International agencies – Disaster management

49. • IAEM – Intervention association of emergency
manager’s
• Non – profit agencies:
• United nations
• Red cross
• World bank
• Europian union