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disaster and its management

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  1. 1. Disaster Management
  2. 2. Disaster plan at Hospital
  3. 3. Disaster plan  Hospital disaster manual is the written statement of disaster plan which need to be activated at the time of disaster. Aim  To provide prompt and effective medical care to the maximum possible in order to minimize morbidity and mortality.
  4. 4. Objectives  To optimally prepare the staff and institutional resources for effective performance in disaster situations.  To make the community aware of the sequential steps to be taken at individual and organizational levels.
  5. 5. DISASTER DRILL A disaster drill isan exercisein which peoplesimulatethecircumstancesof a disaster so that they havean opportunity to practicetheir responses.
  6. 6. First Aid and sorting ( Triage ) Priority level Management Color of ribbon Action needed 1 Immediate Rescuscitation. Red Em. OT/ICU/ICCU 2 Urgent surgery Yellow Em. Ward 3 First aid and possible surgery Green First Aid 4 Brought dead Black Mortuary
  7. 7. Disaster plan Drugs and equipments  Air way devices  Shock management  Drugs, Blood  Medical equipments  Linen & blankets  Stretchers & wheel chairs, O.T. tables  Protective personal kit
  8. 8. Disaster plan  The key should be available with the Sister- in charge on duty and also with DNS & ANS of casualty.  As an immediate measure buffer stock should be used.  Medical & surgical stores should be opened immediately.  Essential drugs , crystalloids etc should be issued.  Medical supplies , basic equipments should be kept prepared , and properly labeled and updated.
  9. 9. Disaster plan  Operation theaters  Emergency blood bank  Clinical services ( lab, radiology )  Linen stores  Documentation center : special record for each victim  Information services  General section ( CSSD, Ambulance)  Maintenance service (Water, electricity)
  10. 10. Disaster plan-duties of staff Chief Nursing Officer -CNO  In a major disaster she will do the Administrative functions.  Responsible for notifying all Dept. heads and alternates .  Responsible to see that families of victims are notified as soon as possible.  She can take help from Social Worker . Nursing supervisor  Attempt to find out adequate number of nursing personnel.  Organization of medical and surgical items required for the treatment.
  11. 11. Disaster plan – Pre Hospital  Quick Response Medical Team ( QRMT) Will be formed to be deployed in case of crisis situation ranging from natural disaster to complex humanitarian emergencies Functions  Primary first aid at the site  Stabilization of the casualties  Triage  Casualty evacuation
  12. 12. Disaster plan – mitigation  Physical aspect Sanitation officer and the administrators ensure proper sanitation and waste management .  Psychological aspect Psychiatrist and psychiatric nurses work to reduce the effect of PTSD.
  13. 13. Internal Hospital disaster plan Evacuation plan  The evacuation of patients , visitors & staffs should be made safely.  All the fire escape routes & emergency exit doors should be clearly marked with luminated paints.  Keys of all emergency exit doors should be kept in the box near the door. One key will be with sister on duty.
  14. 14. Internal Hospital disaster plan  Large display boards will be placed at prominent places showing display roots in case of fire.  The locks of the emergency doors should open by one master key which will be kept in the central fire control room.  Evacuation can have either vertical or horizontal flow to move the patient to a safer area.  Blankets can be used as improvised stretcher.  Details of evacuation plan need to be discussed with fire people.  Activation of disaster plan as for external disaster.
  15. 15. Mental health services to victims Critical Incident Stress Defusing It is an abbreviated form of CISD and it takes place as soon as possible after the critical incident is finished. The process typically last for 1 hr.  Problem solving : help to identify specific concerns, problem solving and decision making  Advocacy : Help the survivors in contacting appropriate support services
  16. 16. Role of nurse in D.M Planning  Preparation of area for patient triage, morgue, relatives and media .  Provide current information regarding the number of available beds, nursing staffs and locations & type and quantities of supplies available.  Assess the state of patients for potential discharge and transfer .  Arrangements for extra staffing and period of duty ( 12 hrs)  Accurate inventories and supplies to be established.  Activate a telephone cascade system.
  17. 17. Guidelines for hospital nursing personnel  Remain calm .  Inform patients and family of disaster situation & request co-operation.  Notify on – duty staff & call off – duty staff as needed.  Obtain initial account of available beds.  Reallocate the resources to the treatment areas.  Conserve supplies and resources left on the unit.  Avoid use of lifts and telephone except for disaster activities.
  18. 18. Rehabilitation Physical Rehabilitation  A disaster can leave many people handicapped amidst the panic and fear, many of the victims either loose any of their limbs or sight or may go for severe forms of handicaps.  The nurse can teach such people to return to their normal life style by using prosthesis and cope with it for the rest of the life.  The victims should be encouraged to go on with life.
  19. 19. Rehabilitation Social rehabilitation  Explain them that all others are in the same situation.  Help the individual to identify his roles in the society and indulge in him a spirit of well being by encouraging him often of the potentials he has.  Discuss with the victim, how he can create a normal life again, how to use his potential.  Educate about the community sources which are available.
  20. 20. Rehabilitation Vocational rehabilitation  Assess the physical strength attention, and concentration.  Make them to perform various activities like weaving, basket making, stitching ,gardening and sell these products to earn their living.    
  21. 21. HISTORY OF DISASTER MANAGEMENT IN INDIA 1. High Powered Committee set up in August 1999. 2. Until 2001 – Responsibility with Agriculture Ministry, 3. Transferred to Ministry of Home Affairs in June 2002. 4. National Disaster Management Authority established. 5. Disaster Management Act passed in December 2005
  22. 22. Central Government National Disaster Management Authority Chairman: PM State Disaster Management Authority Chairman: CM State Government District Administration Panchayats s Municipalities MHA District Disaster Management Authority Co-Chairmen DM/Chairman ZP DMD National Executive Committee State Executive Committee NIDM NDRF Disaster Management Act 2005
  23. 23. VISION  To build a Safe and Disaster Resilient India by developing a holistic, proactive, multi-disaster and technology-driven strategy through a culture of prevention, mitigation, preparedness and efficient response.
  24. 24. D.M in India  State Crisis Management Group: This is chaired by the state relief commissioner or chief secretary.The committee develops various contingency plan to deal with various types of disasters .  District administration : Revenue department and the Relief department are responsible.District collector, SDO, Tehsildar and village officers are involved.
  25. 25. Role of various agencies in D.M  The central Government plays a supportive role in terms of provision of financial and other resources.  The Ministry of Home affairs is the nodal agency for disaster management.  The Central Relief Commissioner in the DAC coordinates the relief operations.
  26. 26. Various agencies in D.M  National Disaster Management Authority  National Centre for D.M  Ministry of Agriculture.  Disaster Risk Management Programme  National Disaster Management Framework  Calamity Relief Fund  National Calamity Contingency Fund(NCCF)
  27. 27. International agencies Every country is a potential source of health humanitarian assistance for some other disaster striken country.  United Nations Office for the Co ordination of Humanitarian Affairs(OCHA)  World Health Organization (WHO)  Food and Agricultural Organization  International Committee of Red Cross  International Council of Voluntary Agencies.
  28. 28. Recommendations  Enactment of Disaster Management policy and Act  Undertake large scale awareness measures/campaigns  Review and amendment of existing building codes and by laws  Inclusion of DM elements in school curriculum  Safe housing atlas (earth quake resistant reconstruction in J&K).  Seismic zoning map  National core group for disaster mitigation
  29. 29. Recommendations  Decentralization of the disaster management process  Development of warning manual  Faculty members of civil engineering to undergo 6 week course in earth quake engineering  Special training in IPS,IAS…..  Special training for women in first aid, shelter, management, water, sanitation, rescue and evacuation.
  30. 30. Recent advances  Thermal imaging : This is a sophisticated sensor with wires are pushed into the rubble. Body temperature of humans provides thermal images of survivors caught under the rubble.  Sniffer dogs : Trained to bark when they detect any living person.  Multiple sensors : These sense very low sound waves from the rubble and hence spot trapped people.  Electronic resources of information : Internet connectivity and web utilization enhance resource availability.
  31. 31. Promoting Global and Regional Cooperation in disaster Reduction  India worked closely with International Strategy for Disaster Reduction in developing the Asian Strategy for Disaster Reduction at the Beijing Conference.  India took proactive role in developing SAARC Regional Framework for Disaster Risk Reduction in South Asia  India is hosting SAARC Disaster Management Centre at New Delhi.
  32. 32. Some recent disasters…..  Earthquake in Pakistan – 2005  Earthquake and tsunami in the Indian coast - 2004  Gujarat Earthquake - 2001  Floods in Mumbai, West Bengal  Flash flood in Uttrakhand  Cyclone: Rita, katrina , phalian etc…..  Fire: Kumbakonam, Dabwali  Terrorist attack: Mumbai And the list goes on and on……………
  33. 33. Government of India initiatives: 1) Inclusion of disaster management in school curriculum  Introduction of DM in Class VIII, IX and X as part of the frontline curriculum by CBSE.  Many of the state Boards have already introduced DM in school syllabi.
  34. 34. Disaster management bill -2005  Disaster management bill 2005 under the article 51( A) of the constitution has been put up for implementation.  In this, mandatory training for all youth above 18 years to be implemented by training institutes like Panchayats, Municipal bodies .  All organizations and hospitals should have Disaster Management plan for managing all type of casualties.
  35. 35. Challenges ahead…  Recent disasters like Tsunami and Mumbai floods have demonstrated that much needs to be done.  Growing economy and urbanization have exposed more areas, assets and people to risks.  Enforcement of building codes and zonal regulations in rural and urban areas still a huge task.  Communicating early warning to the last mile.  Diversifying livelihood opportunities in disaster prone areas.
  36. 36. Indian aspect  Every year 2nd October has been designed as world Disaster Reduction Day as part of International Decade for Natural Disaster Reduction activities.(1980-1990)  Indian Meteorological Department (IMD) plays a key role in forewarning the disaster. Disaster warning System receivers have been installed primarily in the coastal areas of Tamil nadu and A.P.  The Snow and Avalanche Study Establishment(SASE) in Manali has been issued warning to people about avalanches 24 to 48 hours in advance.
  37. 37. Research inputs Dr. R.B Mathur “Disaster preparedness of major Delhi hospitals” (2001,AIIMS)  No written disaster plan in major hospitals except for some few .  No written plan for evacuation during internal disasters in hospitals other than AIIMS.  No plan for creating extra beds during disasters in many hospitals except for AIIMS and Delhi Govt. Hospital.
  38. 38. Summarization  Disaster – introduction  Types  Disaster management  Triage  Disaster plan at hospital  Disaster management act 2005  Resaerches
  39. 39. References  P.K .Dave et al .Emergency Medical services & Disaster Management - A holistic approach,Jaypee,2001  S.Seliger et al .Emergency Preparedness -Disaster planning for health facilities,Aspen,1986  Peter Basket et al Medicine for disasters.Wright,1988  David E et al Disaster Medicine ,LWW,2002  Stanthope et al Foundations of community health Nursing ,Mosby,2002  Suzane C Smelter et al Medical surgical Nursing  K. Park. Preventive and social medicine,2004  Disaster management plan – AIIMS ,2006
  40. 40. ThankThank YouYou