The document discusses disaster nursing and defines key terms related to disasters and disaster management. It begins by defining what constitutes a disaster and discusses different types of disasters including natural disasters like earthquakes, floods, and cyclones, as well as man-made disasters such as terrorism, war, and industrial/chemical accidents. It then defines disaster nursing and outlines the roles and responsibilities of nurses in disaster preparedness and response. The document also discusses the various phases of disaster management and the disaster management cycle.

2. DISASTER
NURSING

3. A disaster can be defined as an occurrence causing widespread
destruction and distress. Disaster management does not avert or
eliminate the threats; instead, it focuses on creating plans to
decrease the effect of disasters. Failure to create a plan could lead to
damage to assets, human mortality, and lost revenue. In order to
avoid, or reduce significant losses to a business house, emergency
managers (preferably facility managers) should work to identify and
anticipate potential risks, hopefully to reduce their probability of
occurring.

4. DEFINITION OF DISASTER
A disaster can be defined as any occurrence that cause
damage, ecological disruption, loss of human life,
deterioration of heath and health services on a scale, sufficient
to warrant an extraordinary response from outside the affected
community or area.

5. [ WHO] A disaster can be defined as an occurrence either
nature or man- made that causes human suffering and creates
human needs that victim cannot alleviate without assistance.
[ American Red Cross] A disaster can be defined as ‘any
occurrence that causes damage, ecological disruption, loss of
human life or deterioration of health services on a scale
sufficient to warrant an extraordinary response from outside
that affected community or area’.

6. DEFINITION DISASTER NURSING
Disaster nursing can be defined as the adaptation of
professional nursing knowledge, skills and attitude in
recognizing and meeting the nursing, health and emotional
needs of disaster victims.

7. [ WHO] Disaster nursing can be defined ‘as the
adaptation of professional nursing skills in recognizing
and meeting the nursing, physical and emotional needs
resulting from a disaster. The overall goal of disaster nursing
is to achieve the best possible level of health for the people
and the community.

8. TYPES OF DISASTERS
Natural disasters
Man-made disasters

9. Natural disasters
Natural disasters often strike without warning, though
most areas know what is normal for their areas and
prepare for such occurrences. Assessing is done by
reviewing the history of the region, looking at what weather
and other disasters have occurred in the past.

10. Man-made disasters
There are some man-made disasters that occur or can occur
with some warning such as knowing that a dam is weak and
without proper mitigation, it will break, releasing a flood.
However, most of the serious man-made disasters are the
result of accidents or deliberate act of terrorism.

11. NATURAL DISASTERS
Earthquakes An earthquake (also known as a quake, tremor or temblor)
is the result of a sudden release of energy in the Earth’s crust that
creates seismic waves. Earthquakes are recorded with a
seismometer, also known as a seismograph. The moment magnitude
(or the related and mostly obsolete Richter magnitude) of an
earthquake is conventionally reported, with magnitude 3 or lower
earthquakes being mostly imperceptible and magnitude 7 causing
serious damage over large areas. Intensity of shaking is measured on the
modified Mercallis

12. Management
Most injuries are sustained during impart and, thus, there is
the greatest need for emergency care occurring in few hours.
When quality and severity of injuries is overwhelmed, wealth
facilities at different levels must be adopted.

13. Precautions: Before entering a building:
•Observe the construction of the building and be careful for
possible hazards, which may occur from weak structure.
•When entering a damaged building: Use a helmet, work in pairs, listen
for the possible sounds and keep calling.
•While moving inside a damaged building: Do not ignite fire, keep close
to walls and do not pull anything projecting out from the collapsed
structures. People affected need psychological support as they have lost
their near and dear ones and property also.

14. Cyclone
Cyclone is an area of closed, circular fluid motion rotating in the same direction as the
earth. This is usually characterized by inward spiraling winds that rotate
counter-clockwise in the Northern Hemisphere and clockwise in the Southern Hemisphere
of the Earth. Most large-scale cyclonic circulations are centered on the areas
of low atmospheric pressure. The largest low-pressure systems are cold-core polar
cyclones and extratropical cyclones which lie on the synoptic scale. Warm-core cyclones
such as tropical cyclones, mesocyclones, and polar lows lie within the smaller
mesoscale. Subtropical cyclones are of intermediate size. Upper-level cyclones can exist
without the presence of a low surface, and can pinch off from the base of the Tropical
Upper.

15. Floods
Water is a source for all life forms. Without water, no life is sustainable. But
when water is in the form of floods, it takes away thousands of humans and
cattle life. Bangladesh is a riverine country, where recurrent flooding is both
common and necessary. Every year large areas are submitted during the
monsoon season and fertilized by deposit of fresh aluminium. The soil is
deposited by moving water. However, if water remains stagnant for too long,
these beneficial floods become a major disaster. Most vulnerable things which
are affected due to floods are homes, buildings, and huts made from biomass
materials like bamboo leave.

16. Management
In floods, fractures, injuries, bruises, drowning and various
infections can occur:
• Tinned cans, barrels, tubes, etc. must be used for floating to
prevent people from drowning.
• Food, shelter and medical care facilities are provided to the
people from drowning.

17. MAN-MADE DISASTERS
Man-made disasters are human-caused events which, either
intentionally or by accident-cause threats to public health and
well-being.

18. Chemical Weapons
• Chemical emergency occurs when a hazardous chemical has
been released and the release has potential for harming people’s
health.
Radiation Emergency
• Emission of radiation from radioactive materials, for
example, reactors, radioactive substances (uranium) and medical
supplies (radium).

19. Bioterrorism
•Bioterrorism is terrorism by intentional release or
dissemination of biological agents (bacteria, viruses or toxins);
these may be in a naturally-occurring or in a human-modified form.
Pandemics and Disease
•A global disease outbreak
•Influenza virus causes various illnesses
•Spread is from person to person.

20. War and Civil Conflicts
•In all wars, the group(s) experiencing the need to dominate other
group(s) are unable and unwilling to accept or permit the possibility
of a relationship of fundamental equality to exist between the
groups who have opted for group violence (war). The
aspect of domination that is a precipitating factor in all wars, i.e.,
one group wishing to dominate another, is also often a precipitating
factor in individual one-on-one violence outside of the context of
war, i.e., one individual wishing to dominate another.

21. Terrorism
Terrorism refers only to those violent acts which are intended
to create fear (terror), are perpetrated for an ideological goal
(as opposed to a lone attack), and deliberately target or
disregard the safety of non-combatants (civilians). The word
'terrorism' is politically and emotionally charged, and this
greatly compounds the difficulty of providing a precise
definition.

22. Types of Terrorism In early 1975, the Law Enforcement
Assistant Administration in the United States formed the
National Advisory Committee on Criminal Justice Standards
and Goals. One of the five volumes that the committee
wrote was entitled Disorders and Terrorism, produced by the
Task Force on Disorders and Terrorism under the direction of
HHA. Cooper, Director of the Task Force staff. The Task
Force classified terrorism into six categories:

23. Civil disorder: A form of collective violence interfering with the peace,
security and normal functioning of the community.
Political terrorism: Violent criminal behavior designed primarily to
generate fear in the community, or substantial segment of it, for political
purposes.
Non-political terrorism: Terrorism that is not aimed at political
purposes but which exhibits conscious design to create and maintain
ahigh degree of fear for coercive purposes, but the end is individual or
collective gain rather than the achievement of a political objective.

24. Quasi-terrorism: The activities incidental to the commission of
crimes of violence are similar in form and method to genuine
terrorism but nevertheless lack its essential ingredient. It is not the main
purpose of the quasi-terrorists to induce terror in the immediate victim
as in the case of genuine terrorism, but the quasi-terrorist uses the
modalities and techniques of the genuine terrorist and produces similar
consequences and reaction. For example, the fleeing felon, who takes
hostages is a quasi-terrorist, whose methods are similar to those of the
genuine terrorist but whose purposes are quite different.

25. Limited political terrorism: Genuine political terrorism is
characterized by a revolutionary approach; limited political terrorism
refers to acts of terrorism which are committed for ideological or
political motives but which are not part of a concerted campaign to
capture control of the state.
Official or state terrorism: It refers to the nations whose rule is
based upon fear and oppression that reach similar to terrorism or such
proportions' It may also be referred to as Structural Terrorism defined
broadly as terrorist acts carried out by governments in pursuit of
political objectives, often as part of their foreign policy.

26. Primary Prevention against Man-made Disaster
• Prevention of occurrence of the disaster must be done to prevent not only
the consequences but also the occurrence of fire, explosion crashes and sudden chemical
and radiation exposure.
• These include tighter regulation of chemical plants and other hazardous
facilities and insistence that the chemical plants be built away from the densely
populated area.
• Appropriate engineering and technological measures like building codes, dam design
containment of toxic materials. Protection against human error.
• The world has turned towards efforts to stop arms race and prevent nuclear war.

27. DISASTERS IN INDIA
•The 1974 smallpox epidemic in India. Bhopal gas disaster: December 2-3,1984,
the plant released methyl isocyanate (MIC) gas and other toxins.
•In 1994, total 693 suspected bubonic or pneumonic plague cases were reported
to WHO by the Government of India.
•1996: Amarnath Yatra tragedy in Jammu and Kashmir state in India.
•The Kargil War between India and Pakistan between May and July 1999 in the
Kargil district of Kashmir.
•July 2000: Mumbai landslide.

28. EFFECTS OF DISASTER
Impact
A. Direct: It is different according to the geographical area as well
as type of disaster. direct impact of flood will be different from the
direct impact of earthquake.
B. Indirect: All natural disasters have more or less the same indirect
impact, i.e., loss of life, loss of shelter, disruption of water and food
and communication, epidemics and psychological illness.

29. Effects
• Everybody in the community may not be affected equally
• There are members of the community who are more at risk of being affected by the disaster, e.g.,
in flood-prone areas, people; whose homes are in lower-lying areas are more likely to be affected
by rising waters of the flood
• There are groups of people in the community who are more vulnerable when disaster strikes,
e.g., during a flood, elderly and sick or handicapped people who cannot swim are more likely to
drown
• Pregnant women and children are also more vulnerable during disaster
• While preparing for disaster, it is important to identify those who are at risk of the effects of the
disaster and those who are more vulnerable as they require special preparedness and response.

30. Phases of Disaster
•Warning phase: Some disasters give warning of their
approach. In this, certain precautionary measures are undertaken
to handle the disaster situation efficiently and effectively.
•Threat phase: This is critical decision-making period when
one’s activity is directed towards the survival action.
•Impact phase: When disaster strikes, people may at first be
stunned. Then they begin to realize the magnitude of the effects of
disaster such as injury, death, destruction, etc.

31. Inventory phase: During this phase, one tries to find out what has actually
happened to him. Victim may exhibit fear, anger, sorrow, depression, anxiety
and other emotions.
•Rescue phase: During this period the victim help each other to cope and begin
to help with the rescue provide comfort to others and to re-establish shelter and
other needs.
•Remedy phase: The morale of victim usually picks up during this period as
they work together with rescue personnel to get the community back to its feet.
This phase is the longest post disaster period when reconstruction takes place.

32. •Restoration period: In this phase, the individuals regain the
stability that they enjoyed prior to the disaster. The time
required for a community to reach the state of equilibrium
depends upon the nature and intensity of disaster and disaster
relief available.

33. DISASTER MANAGEMENT
Definition Disaster management can be defined as the
organization and management of resources and responsibilities
for dealing with all humanitarian aspects of
emergencies, in particular preparedness, response and
recovery in order to lessen the impact of disasters. [ IFRC]

34. DISASTER CYCLE AND MANAGEMENT
The General Assembly of the United Nations to proclaim 1990s as the
International Decade for Natural Disaster Reduction (IDNDR)
through a resolution 44/236 of December 22,1989 to focus on all
issues related to natural disaster reduction. In spite of IDNDR, there had
been a string of major disaster throughout the decade. Nevertheless, by
establishing the rich disaster management-related traditions and by
spreading public awareness, the IDNDR provided required stimulus for
disaster reduction. It is almost impossible to prevent the occurrence of
natural disasters and their damages.

35. There are three fundamental aspects of disaster management:
a. Disaster response
b. Disaster preparedness.
c. Disaster mitigation.

36. These three aspects of disaster management correspond to different phases in the
so-called ‘disaster cycle' as shown in below:
• Disaster impact
• Mitigation
• Preparedness
• Reconstruction
• Rehabilitation
• Response
• Recovery phase after a disaster.

37. FOUR PHASES OF DISASTER MANAGEMENT
Disaster (Emergency) management is a comprehensive
approach dealing with all four phases of disasters:
1. mitigation/prevention
2. preparedness
3. response
4. recovery

38. DISASTER MANAGEMENT CYCLE
Goal of disaster management
•The goal of disaster management is the safety and sustainability of
human lives
•Safety is related to avoiding death and injuries to human
lives during a disaster
•Sustainability is related to livelihood, socioeconomic, cultural,
environmental and psychological aspects

39. PRINCIPLES OF DISASTER MANAGEMENT
•Disaster management is the responsibility of all spheres of
government.
•Disaster management should use resources that exist for a day-to-day purpose.
•Organization should function as an extension of their core business.
•Individuals are responsible for their own safety.
•Disaster management planning should be focus on large scale events
•Disaster management planning should recognize the difference between
incidents and disasters

40. Role of a care provider in preparedness
•For preparedness of disaster, a prompt, collective, coordinated relief effort.
•It is important to know the resources, like District Collector is
responsible for coordinating all disaster relief efforts. It is important for
community representatives to seek the assistance from Collectors office staff.
•Coordination with NGOs and voluntary agencies is also required.
•Self-help is very important and must be relied upon to the maximum level.
•The provider should work along with others at all stages of disaster.

41. DISASTER NURSING
The adaptation of professional nursing knowledge, skills and
attitude in recognizing and meeting and meeting the nursing
and medical needs and medical needs of disaster victims.

42. Roles and responsibilities of a disaster nurse
D: Disseminate information on the prevention and control of environment
I: Interpret health laws and regulations
S: Serve yourself of self- survival
A: Accept directions and take directions and take orders from an organized authority
S: Serve the best of the most
T: Teach the meaning of warning signals
E: Exercise leadership
R: Refer to appropriate

43. GERIATRIC CONSIDERATIONS
IN NURSING

44. Introduction
Aging, the normal process of time –related change, begins with birth and
continues throughout life. Geriatric nursing is a nursing sub field involves caring
for older adults. Older adults have special needs which can become very
complex, making employments prospects in the field of geriatric nursing very
well. Aging, the normal process of time related change, begins with birth and
continues throughout life. Gerontologic nursing is provided in acute care, skilled
and assisted living, community and home setting. The nurse helps the older
person to maintain dignity and maximum autonomy despite physical, social and
psychological losses.

45. Meaning
Geriatrics-the study of old age thatincludes the physiology,
pathology, diagnosis and management of the disorders and
diseases of older adult.

46. Definition
“The branch of medicine concern with the diagnosis, treatment
and prevention of disease in older people and the problem
specific to aging.”

47. Gerontology: -gerontology is the study of the social, cultural,
psychological, cognitive and biological aspect of aging.
Geriatric nursing: - “nursing care of the aged patient given in
the home, in hospital, or special institutions such as nursing
homes, psychiatric institute etc.”

48. Principles of Gerontological nursing
•Aging is a natural process common to all living organisms.
•The elderly share similar self-care and human needs with all other
human beings.
•Gerontological nursing strives to help older adults achieve
optimum level of physical, psychological and social and spiritual
health so that they can achieve wholeness.
•Various factors influence the aging process.

49. Diet menu planning: Meal Food stuff Quantity, Early morning breakfast Tea,
• Poached egg, toast with butter, apple 1 cup, 2
• Mid-morning Coffee + biscuit 1 cup, 2 slice
• LunchChapatti Palak saag, dal Salad Fruit custard. 2 slice 1 serving
• 1 serving Evening Vegetable upma Tea 1 serving
• 1 cup Dinner Lauaki kofta curry Potato & cauliflower Chapatti / rice
• Daal / boond iraita 1 serving
• 2slice/ 1 serving
• 1 serving at bed time milk 1 glass

50. Factors affecting nutritional status of the elderly
1.Changes in normal physiology: - dental problems, changes in taste
and smell and disability to digest and absorb nutrients can be affect
both quality and quantity of food consumed and overall suboptimal
nutritional status.
2.Increased prevalence of chronic disease: - obesity, accidents,
trauma, heart disease, cancer, arthritis, osteoporosis, DM, senile
dementia and the use of prescription drugs can result in physician-
oriented changes in the diet.

51. 3.Socio- economic, psychological, and cultural factors: - low
income, beliefs and superstitions regarding food and dietary habits,
social isolation, depression and loneliness from spouse, family and
friends can decrease the quality and quantity of the diet.
4.Alcoholism and use of therapeutic drugs: - when alcohol is
substituted for nutrition, it may interfere with absorption of some
nutrients notably folic acid.
5.Other factors: loss of taste, loss of interest in food, poor appetite,
constipation, difficulty-in chewing.

52. LEGAL ASPECTS OF CARE.
Nursing is also guided by legal parameters. the practice of nursing is
regulated in each state through the individual state governments.
•Negligence and malpractice: Negligence is a legal term for
performing an action that causes harm to another person or
neglecting to perform an act that would have prevented harm
malpractice is a form of negligence that implies failure to act as a
‘’reasonably prudent nurse’’ the standard of care of any nurse must
be comparable to that of a nurse who is reasonable and prudent.

53. ◦Informed consent: Before any care is given. The person must agree to
the treatment or procedure. The person receives a full explanation of all
facts need to make an intelligent and informed decision. include in this
explanation are the risks and benefits involved.
◦Medical directive to physician: In some states, the natural death act
allows a person to request the withholding or withdrawal of artificial
measures to prolong life.in the event of terminal illness. this document
is called a medical directive to physician or living will.

54. ◦Patient self –determination ACT: In 1990.federal law established the
patient self-determination ACT(PSD) under the omnibus budget
reconciliation act (OBRA) of 1987, this federal law mandates the right
of all individuals to be involved in making decisions concerning their
medical care the PSD. Act is intended to assist people in making
decisions about them. Health care before they are faced with the trauma
of life. threatening situations under his law the patient has the right to
refuse or accept the treatment and to formulate advance directives. this
allows individuals to make treatment desires carried.

55. Responsibilities of Gerontological nurse
The main objective of Gerontological nursing is to improve
the quality of life of older people. The nurse has fulfilled the
following role in Gerontological nursing.

56. As a care giver
Health educator
Coordination of health services.
Promoting good nutrition and activity & exercise.
Protection from unhealthy environment
Protect from physical and mental injuries, threats.
Provide rehabilitation services
Provide psychological support