disaster management

1. Disaster
Management
Supervised by: Presenter:
Prof. GN Mandal Sushila Hamal
Medical Surgical Nursing M.Sc. Nursing 1st year
BPKIHS BPKIHS

2. Objective of this session
At the end of this session, the participant will
be able to;
• Definition of Disaster
• Types of Disaster
• Impacts of Disaster
• Principles of Disaster Management
• Disaster Management Cycle
• Role of Nurses Before, During and After
disaster
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3. Hazard Vs Disaster
• Hazard is an event that has potential for causing
injury/ loss of life or damage to property/environment.
• Disaster is an event that results in loss or damage to
life, property or environment.
3

4. Example: Hazard Vs Disaster
• Imagine you are in the desert and earthquake occurs.
Since in open desert it does not cause damage to you.
No threat to your life. So it does not become disaster. It
remains as a hazard. Here earthquake is a hazard.
• Now imagine earthquake in a city. There buildings
collapse, people die or are injured, normal life is
disrupted. This is a disaster situation.
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5. Hazard and Disaster
• Hazard is only event (potential to cause loss)
• Disaster is consequences of event which
causes loss of life and property.
• It is the people who matter most, and without
the people we have no disaster.
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6. Disaster
• Dis = Bad
• Aster = Luck
• Disaster is a sudden incident which cause huge
loss of life and property and environment.
This Loss is beyond the coping capacity of local
affected population/society and therefore
requires external help.
6

7. Definition of Disaster
1. Disaster is an event, natural, or manmade,
sudden or progressive, which impacts with
such severity that the affected community has
to respond by taking exceptional measures.
2. The WHO has defined disaster as “any
occurrence that causes damage, ecological
disruption, loss of human lives, or deterioration of
health and health services on a scale sufficient to
warrant an extraordinary response from outside the
affected community or area”.
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8. Definition of Disaster
Common to both definitions are
• Occurrence of events with high magnitude.
• Loss of lives and property
• Need extra ordinary response from outside
8

9. Types of Disaster
• Earthquake
• Tsunami
• Flood
• Landslides
• Epidemics
• volcanic eruptions
• Avalanche etc---
Natural
• War (terrorism )
• Industrial accident
• Explosion
• Fires
• Accident
Man-
made
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10. 10

11. Earthquake- 2072
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12. Earthquake- 2072
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13. Landslide
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14. 14
Highway in Nepal
Photo: Padma Khadka

15. Flood
GN Mandal 15

16. Tsunami
GN Mandal 16

17. Man-Made Disasters
Building Collapse 17

18. GN Mandal 18
Airplane Accident

19. Fire
GN Mandal 19

20. Impact of Disaster
1. Physical Impact: Injuries, Burns, Physical disabilities, Traumatic
amputation, miscarriage
2. Mental(psychological) Impact : Distress, Flashbacks, Insecurity,
Grief, Lack of trust, Helplessness, Hopelessness, Insomnia,
Depression
3. Social Impact : isolation, theft, crime, domestic violence, sexual
abuse, migration etc
4. Economical impact : loss of property, loss of crops, loss of public
infrastructure, unemployment.
5. Environmental impact : pollution, climate change, food and
water scarcity, Eruption of communicable diseases.
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21. Principles of Disaster Management
• Prevent the disaster
• Minimize casualties
• Prevent further casualties
• Rescue the victims
• First aid
• Medical care
• Evacuate
• Reconstruction
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22. 1. Mitigation
2.
Preparedness
3. Response
4. Recovery
22
Disaster
Mgmt Cycle

23. 1. Mitigation (Prevention/stop or lessen) :
• Taking actions to prevent or reduce the long term impact
and consequences (loss of life or property) of disaster.
• Measures taken before an emergency or disaster occurs.
• The goal of mitigation are
1. Protect people and structure during disaster.
2. Reduce cost of response and consequences.
For example, to protect against sea level rise and increased
flooding, communities might build seawalls or relocate
buildings to higher ground, strengthening of public
infrastructure etc .
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24. 2. Preparedness (Action before disaster)
• Taking certain actions before disaster , a harmful
consequences of disaster can be reduced.
• It includes :
– Planning, Awareness, training and educational
activities.
– Developing disaster preparedness plan for what to do,
where to go, and whom to call for help etc.
– Emergency exercises (Drill) /training
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25. 3. Response (during or immediately after disaster)- Efforts
to minimize the hazards created by a disaster.
It includes:
– Conducting life saving measures : Search, Rescue, First
Aid
– Triage, tag and Transfer /Treat (3T)
– Provision of food, water and emergency health care
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26. 4. Recovery/Reconstruction (After Disaster) -
Returning the community to normal.
– Rebuilding and reconstruction or restoration.
– Rehabilitation
– Rebuilding damaged buildings,
– Providing financial support to people.
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27. Disaster mgmt cycle
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28. What is disaster for the hospital?
• When the work load exceeds the available
resources, it is declared as disaster for the
hospital(usually >30 victims at a time)
• A situation can be disaster for one hospital
may not be disaster for another hospital
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29. Role of Nurses in Disaster Management
(Before, During and After)
Role of Nurses Before Disaster(disaster preparedness)
1. Assess the community for hazards
2. Collect past history of any disaster.
3. Assess the health care facilities/local agencies and
personnel.
4. Diagnose the potential or actual disaster threat.
5. Develop Disaster Plan/Protocol: Helps to provide prompt
and effective medical care to the maximum possible in order
to minimize morbidity and mortality
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30. Elements of disaster plan
• A disaster plan should have the following elements
– Declaration of disaster
– Information system
– Chain of authority
– Lines of communication
– Routes and modes of entry
– Routes and modes of transport
– Routes and modes of evacuation
– Mobilization of resources
– Triage
– Treatment protocol
– Care of dead bodies
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31. 6. Formulate Disaster Management Team/RRT : Every hospital
should have a Disaster Management Team which include:.
• In charge –Head of Department of Emergency and members
are
• Head of Department of Surgery
• Head of Department of medicine
• Head of Department of Anesthesia
• Head of Department of Radiology
• Head of Department of Laboratory
• Head of Department of Neurology
• Head of Department of Orthopedic
• Head of Department of Nursing
• Head of Department of eye/ENT
• Nursing in charge of Emergency
• Administrative Staff
• Security Officer
• Communication Officer
• Police, Forensic Officer, Public relation Officer
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32. 7. Have a disaster stock
• There should be separate disaster stock in each
hospital with all necessary drugs/equipment.
• Key should be available at all the time or should
be available whenever necessary.
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33. 8. Drill exercise
• Mock exercise and drills at regular
intervals are conducted to ensure that all
the staff in the general and those
associated with management of
causalities are fully prepared and aware of
their responsibilities.
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34. Summary (Before disaster)
• Assessment of Risk
• Formulation of Disaster plan
• Formulation of Disaster mgmt Team/RRT
• Drill Exercise
• Have a disaster stock b ready at all the
time
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35. Role of Nurses (Prior to the arrival of
casualty)
1. Identify the source of information/communication
– Receive information from the authorized person about
the type, number of casualties and the seriousness of
injuries
– Communicate information to members of Disaster
Management Team
• For this telephone operator will begin to call persons on the
established list.
• Alarming bell can be used to communicate the message
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36. 2. Preparation of human resources
• Call nurses
– From different wards
– on leave and who stay on hospital hostel.
– Call final year nsg and medical stds
• Alert different departments to remain standby:
operation theatre, all indoor units, laboratory,
radiology, kitchen, maintenance, etc.
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37. 2. Preparation of Equipment and
supplies
– Extra wheel chairs, stretchers, portable beds,
suture materials, etc
– Drugs-emergency drugs, IV fluids, IV cannula,
plaster of Paris, etc
– Others- Triage Tags, police case stamps etc.
– Be ready to receive the casualty
Note:
1. Preparation of resources depend upon the
kinds of disaster.
2. Suspend all other regular hospital activities
except for the critical ones.
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38. Role of Nurses during Disaster
1. Triage and Tag : the most important
2. Postpone all routine activities for certain
period
3. Mobilization of Key Staffs-Time to activate
the team. Nurse incharge then mobilize the key
members of the hospital e.g. shift incharge/ shift
coordinator / Juniors.
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39. 3. Management of Extra Human
Resources
• Pull in Nursing and other health personnel from
other wards leaving only skeleton staff.
• Call Nurses who are on leave, and who stay in
hospital hostel.
• Assignment of work (as per demand/need)
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40. 4. Management of Space
• Admit: Serious victims should be admitted (make more vacant
beds). Patients should be admitted to any vacant bed of any wards.
• Discharge: Minor victims should be given first aid, if necessary
outside the hospital and can be discharged.
• Refer: Serious victims can be refereed to higher center where the
facility is available.
• Create Extra Space:
• Extra places near the hospital can be used.
• If needed, extra beds should be made available even on floor.
• Utility areas to be converted in to temporary wards such as wards
with side rooms, corridors, seminar rooms etc.
• Creating additional bed capacity by using trolleys, folding beds and
floor beds
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41. 5. Management of extra equipment and
drugs: Use your own disaster stock and
borrow from other wards, store and
pharmacy if necessary .
6. Co-ordination: make coordination with
various departments, the police, security,
and ambulance are necessary.
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42. 7. Crowd controlling
• Is extremely important and should be managed in
collaboration with security, police and other
volunteers.
• The main hospital gate should be closed and only
vehicle and individual carrying casualty should be
permitted.
• People from media should be allowed entrance only
as far as the information center or reception area.
• All visitors and other non-hospital staff should be
requested to leave the hospital immediately.
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43. 8. Evacuation
• Minor cases can be discharged
• If necessary, the Red Cross and other
available organization/
institution should be requested to provide
ambulance services to transfer the
patients to other health institution /facilities.
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44. 9. Care of Dead body
• Provide dead body care as institutional
policy.
• Never handover the Dead body to
relatives without post-mortem
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45. Role of Nurses After Disaster
1. Recording and Reporting
–Document all cases with their full details
–Document all cases as Medico-legal Cases
–Collect all Medico-Legal evidences if
possible, e.g.-X-rays, Vomitus, Bullets,
–Keep records of all expired cases.
–Inform to police if cases are discharged
referred, or expired.
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46. 2. Debriefing: report all cases to concerned
authority (number of victims, expenditure of
resources, outcome)
3. Rearrangement: cleanliness of all used
equipment according to the hospital’s
policy, replacement of used items,
rearrangement of disaster inventories.
4. Conduct /participate in post- disaster
meeting
5. Analyze strength and weaknesses
6. Give feedback to the team.
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48. 48

49. Research article
• Title: Disaster management and role of academic Institutions in
Nepal: current status and way forward
• Published on: 4 May 2020
• This study attempts to figure out the status and role of Nepalese
academia for the contribution of disaster risk reduction and
management (DRRM). The methodology adopted for the study
is reviewing the literature, policies, and academic documents
including university curricula. Ten major universities of Nepal
have incorporated disaster components including preparedness,
response, recovery, and mitigation-related academic curricula in
their undergraduate and graduate levels academic programs.
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50. RESULTS AND DISCUSSION
• This study depicts the current practices and role of academic
institutions for disaster risk reduction and management
(DRRM) in Nepal. It is found that the disaster research and
innovation in terms of participation, cooperation, innovation,
human and environment centric approaches of higher
educational institutions were just at the satisfactory level in
Nepal. The sustainable management of disaster issues requires
a higher level of knowledge, skills, and capabilities. However,
the academic curricula of many higher educations are still in
remembering, understanding, and recalling phases where they
missed the practical applicability in terms of analysis, research
and innovations.
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51. References
1. Sharma M., Kalpana P., Gautam R. "Essential Textbook of Medical
Surgical Nursing". 2nd ed. Ghattekulo Rautahadevi Marga, Kathmandu:
Samiksha Publication Pvt. Ltd; 2017.
2. Mandal G.N. "Textbook of Medical Surgical Nursing". 6th ed. Baneshwor,
Kathmandu: Safal Publication House Pvt. Ltd; 2019.
3. Chugh S N. "Textbook of Medical Surgical Nursing". 1st ed. New Delhi:
Avichal Publishing Company; 2013.
4. Pant RR, Bishwakarma K, Ghimire A, Shrestha K, Maskey R, Joshi BR,
et al. Disaster Management and Role of Academic Institutions in Nepal:
Current Status and Way Forward. Himal Biodivers. 2020;(May):27–35.
5. Nepal P, Khanal NR, Pangali Sharma BP. Policies and Institutions for
Disaster Risk Management in Nepal: A Review. Geogr J Nepal.
2018;11(1998):1–24.
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