Module 206.1 en

Editor's Notes

1. Note to the educator: This slide is intended to introduce the topic of managing diabetes during disasters. The key message of the slide is that all people are responsible for the well-being of the most vulnerable. In a disaster, people with chronic conditions are vulnerable. Their health is already compromised, they may have difficulty accessing lifesaving medications, food and water. By educating people with diabetes and health care professionals on how to prepare for a disaster, people with diabetes may reduce their risk and potential for adverse events during a disaster.
2. This module will focus on what can be done to mitigate the impact of a disaster for people with diabetes. First we will discuss the definitions for a disaster and provide examples. This will be followed by the practical steps that people can take to prepare for a disaster and manage during a disaster. Health professionals can advocate on behalf of people with diabetes to ensure diabetes is included in national and international disaster plans and create appropriate resources such as emergency kits and educating disaster response teams on diabetes care.
3. It is not easy to define “disaster’’. These definitions are relevant to the information in this module. Personal misfortunes such as being caught in a blizzard, a house fire, or an accident are very distressing but do not usually qualify as a disaster and are not specifically covered in the module Disasters: Preparedness and Mitigation - Issue No. 005 - September, 1980 (PAHO) Red Crescent www.rcrc.org
4. Different actions are needed to cope with/manage the various stages of a disaster
5. Preplanning - build infrastructure and partnerships to help with planning in the advent of a disaster Preplanning would include having an idea of the prevalence of diabetes in the area; how to distribute insulin; etc.
6. Note to the educator: The activity can be undertaken as a group or in small groups Preplanning and prevention activities need to be relevant to the area, e.g. in Australia in summer bushfires are common. Prevention and preplanning includes removing flammable materials, planting fire resistant and fire retardant plants close to the house, keeping plants away form power lines, clearing gutters, having appropriate fire fighting equipment and clothing ready. Having a survival kit ready.
7. Being prepared is essential. There are a number of activities that can be done in advance of a disaster in order to be better prepared. People should find out what kinds of disasters are most likely to occur in the region where they live. For instance if they live on the Atlantic coastline they may be at risk of hurricanes or ice storms. Help participants understand the importance of establishing methods of communication and a communication plan. Those that are more vulnerable may need support to make decisions about whether they should evacuate the area or not. A plan for how families will communicate with each other is important. By using any and every available communication method, people with diabetes should be able to get the information they need to take decisions as to how to proceed. Have participants understand the importance of an emergency radio or television or radio broadcast and to know what frequency to tune into if normal services are disrupted.
8. It can take time for emergency services to reach people after disasters. Being competent to provide basic first aid can save lives e.g. CPR, stopping bleeding, managing emotional distress and panic, managing burns and managing hypo and hyperglycaemia. It is important that people consider their own safety when trying to assist others. e.g. assisting an electrocuted person. The capacity to stay or return home will depend on the nature of the disaster, ability to access the area e.g. in a bush fire roads are often cut, smoke obscures vision and is disorientating as well the physical effects of smoke inhalation, power lines can be down etc.. Everybody needs to know and practice the plan so it can be enacted automatically. Important documents should include consent to treat forms, especially in a family with children who have diabetes and a list of all prescribed medications. Being forewarned is helpful so subscribing to services that monitor and communicate disaster information is an important part of planning. The Australian Red Cross website has a good example of an emergency RediPlan that can be download without charge; it does not have a specific section for diabetes management but these could be included.
9. Having people with diabetes make a medicine chart may help prevent medicine errors. Also, as many people have low literacy skills, a chart with pictures may it make it easier to understand that pills are taken in the morning or in the afternoon or in the evening.
10. If possible a supply of medicine should be in the disaster kit. There should be enough to last at least a few weeks, in case pharmacies or their supplies have been disrupted by the emergency. Insulin for use in an emergency should be kept refrigerated. It may be necessary to keep a pen filled with a cartridge of fast acting insulin, however this cartridge will have to be replaced as it expires. Strips for testing blood glucose levels need to be checked on a regular basis as these can give false readings if outside of their expiration date.
11. Drink enough to stay hydrated, but drinking too much can induce hyponatraemia, which might not be recognised or mistaken for hypo or hyper; this is under-recognised and not uncommon. Heavy sweating removes vitamins and minerals from the body. The best way of replacing the lost vitamins and minerals is to sip drinks with electrolytes. Very important for supply kit to contain electrolyte replacement sachets.
12. Note to the educator: This activity should be done in groups. 15 minutes for developing plans and kits and then 15 minutes to present to the group.