Disaster Nursing

1. TYPES OF DISASTER & ROLE
OF NURSE IN DISASTER
MANAGEMENT
E

2. DISASTER

3. MEANING OF DISASTER
Disasters are "traumatic events that
are so extreme or severe, so powerful
harmful, or threatening that they
demand extraordinary coping efforts”
Disaster means that any occurrence
that causes damage, ecological
disruption, loss of human life or
deterioration of health and health
services on a scale sufficient to
warrant and extraordinary response
from outside the affected community
or area (WHO 1995)

4. Disaster management

5. ‘DISASTER’ MEANING
D – Destructions
I – Incidents
S – Sufferings
A - Administrative, Financial Failures.
S – Sentiments
T – Tragedies
E - Eruption of Communicable diseases.
R - Research programme and its implementation

6. Common Causes of Disasters
High Wind Flow
Phenomena-
Lightning
Hurricane
Tornadoes
Blizzards
Nature’s fury like
High Wind Flow
Phenomena
Earthquakes
Floods
Epidemics
Manmade
Causes
Fire
Explosion
Transport
Accidents
Modern
Technical Causes
Thermonuclear
Disaster
Biological
Warfare
Chemical
Warfare

7. Types of Disasters
 Disasters can be further classified in many different
forms. Broadly speaking there are two types of
Disasters-
 Natural Hazards
 Man-made Hazards

8. Natural Hazards
Geophysical: earthquakes, landslides, tsunamis and
volcanic activity
Hydrological : avalanches and floods
Climatological : extreme temperatures, drought and
wildfires,
Meteorological : cyclones and storms/wave surges
Biological :disease epidemics and insect/animal plagues.
These are naturally occurring physical phenomena caused either by
rapid or slow onset events which can be-

9. Man-made/Technological Hazards
Sudden disasters- Bhopal Gas Tragedy
Insidious disasters- Release of radio active
substances
Wars and civil conflicts- Attack on twin
buildings of World Trade Centre in New York
Disasters also can be caused by humans. These are mostly caused
due to certain human activities. The disasters which are caused as
a result of human activities are termed as Man-Made Disasters-

10. Magnitude of Disasters
Local Disasters- Floods and forest fires
Regional Disasters- Hurricane, Katrina,
Earthquakes, Droughts and Crop Failures
National Disasters- Economic Depression,
Severe Stock Market Crash Or Collapse of the
Currency
Global Disasters- Affect the entire planet. US
dollar acting as the major reserve currency for
most of the world, a collapse of the currency
would be disastrous for nearly every nation

11. Environment
Host
Disaster
Agent
Epidemiological Triad of Disaster

12. 1. Agent
1. Primary Agents:
It includes falling of buildings, heat wind rising
waters and smoke.
2. Secondary Agents:
It includes bacteria and viruses that produce
contamination or infection after the primary agent
has caused injury or destruction

13. 2. Host
In the epidemiological frame work as applied to
disaster the host is human-kind. Host factors are those
characteristics of humans that influence the severity of
the disaster effect. Host factors include-
 Age
 Immunization status
 Degree of mobility
 Emotional stability

14. 3. Environmental Factors
 1. Physical Factors:
Weather conditions, the availability of food, time when
the disaster occurs, the availability of water and the functioning
of utilities such as electricity and telephone service.
2. Chemical Factors:
Influencing disaster outcome include leakage of stored
chemicals into the air, soil, ground water or food supplies.
Eg: - Bhopal Gas Tragedy.
3. Biological Factors:
Are those that occur or increase as result of contaminated
water, improper waste disposal, insect or rodent proliferations
improper food storage or lack of refrigeration due to
interrupted electrical services.

15. CONT....
4. Bioterrorism: Release of viruses, bacteria or other
agents caused illness or death
5. Social Factors: are those that contribute to the
individual social support systems. Loss of family
members, changes in roles and the questioning of religious
beliefs are social factors to be examined after a disaster.
6. Psychological Factors:
Psychological factors are closely related to agents,
host and environmental conditions. The nature and
severity of the disaster affect the psychological distress
experienced by the victims.

16. Effects of Disaster
Increase in mortality
Increase in Morbidity-Injuries; Emotional stress,
Epidemic of disease, increase in indigenous diseases.
Financial & infrastructural loss
Environmental damage
Health care burden
National loss.

17. Principles of Disaster Management
It must be understood that disaster management should be a multi-
sectoral and well coordinated effort. It is impossible for a single agency
such as health sector to undertake this task all alone. The following
principles should be observed while managing disasters:
Pre-disaster preparedness
Strong emphasis on isolation and rescue phase
Multidisciplinary and coordinated approach
Inter-sectoral liaison
Maintaining communication
Triage
Post impact stage

18. 1. Pre-disaster preparedness
 It is very important to draw up contingency plans to tackle
disasters during the “inter-disaster” phase.
 First of all, an assessment of risk due to particular type of
disaster in different areas should be done (risk analysis)
followed by an analysis of which population groups and
geographical areas are prone to damage (vulnerability
analysis).
 Based on these analysis, a “contingency plan” should be
chalked out. These plans should be discussed by all the
departments and administrators.
 Once developed, these contingency plans should be
rehearsed periodically to identify the problem areas and to
ensure that every person clearly knows his or her task.

19. 2. Strong emphasis on isolation and rescue phase
 Most deaths and serious injuries occur during the
isolation phase in the early stage of impact of the
disaster.
 It is therefore very important to be well prepared
for quick evacuation of the affected population.

20. 3. Multi-disciplinary and coordinated approach
 As mentioned earlier, the entire contingency plan as well
as the actual implementation of the plan during the
disaster should be very well coordinated between all
agencies (local administrative authority, public works
department (PWD), Public health engineering department,
health department, food and civil supplies, police and fire
department, food and civil supplies, police and fire
department, road and aviation departments, etc.).
 Second, this inter-sectoral teamwork should be ensured at
all levels, such as state, districts, block, and village.

21. 4. Inter-sectoral liaison
 The DHO should maintain close liaison with the DC,
superintendent of police, superintending engineer,
district telecom officer, PWD, Public health engineer,
and district civil supplies officer.
 Similarly, the medical officer in charge of primary
health center (PHC), the block development officer,
and Gram Panchayat should also work as a team.

22. 5. Maintaining communications
It is very important to ensure that the latest
situation and problems/equipments are promptly
communicated and discussed “vertically” up and down
(i.e., from accredited social health activist or multipurpose
workers to medical officer in charge of PHC to DHO and
vice versa) and “horizontally” ( e.g., between DHO, DC
and telecommunication department).

23. 6. Triage
 The word ‘triage’ is derived from the French term “trier”
which means to separate or select.
 Triage means sorting out the casualties.
 Triage consists of rapidly classifying the injured on the basis
of the severity of their injuries and the likely hood of their
survival with prompt medical intervention.
 It must be adopted to locally available skills.
 Higher priority is granted to victims whose immediate or
long-term prognosis can be dramatically affected by simple
intensive care

24. 7. Post Impact Phase
Post Impact Phase
•Recovery beings during the
emergency phase and end with
the return of normal community
order and functioning. For
persons in then impact area
this phase may last a lifetime
(e.g., victims of the atomic
bombing of Hiroshima).
•Recovery is the process by
which communities and nations
are assisted in returning to their
normal level of functioning
following a disaster.

27. TRIAGE (Categorizing)
• Red - Most Urgent, First Priority
• Yellow - Urgent, Second Priority
•Green – Third Priority
•Black - Dying Dead

28. RED - MOST URGENT, FIRST PRIORITY
• Life-threatening injuries
• Shock, chest wounds, internal hemorrhage, head
injuries producing increased loss of consciousness,
partial-or full-thickness burns over 20% to 60%
of the body surface, and chest pain
• Poor chance of survival

29. YELLOW - URGENT, SECOND PRIORITY
• Injuries with systemic effects and complications but
yet not in shock , withstand 30 to 60-minute
• Category include multiple fractures, open fractures, spinal
injuries, large lacerations; Partial- or full- thickness burns
over 10% to 20% of the body surface and medical
emergencies such as diabetic coma, insulin shock; and
epileptic seizure, observed closely

30. GREEN- THIRD-PRIORITY
• Minimal injuries unaccompanied by systemic
complications.
• Wait several hours for treatment.
• Closed fractures, minor burns, minor lacerations,
sprains, contusions, and abrasions.

31. BLACK - DYING OR DEAD
 Hopelessly injured patients or dead victims
 Crushing injuries to the head or chest
 Would not survive under the best of
circumstances.

32. DISASTER NURSING
Definition-
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.”

34. GOALS OF THE DISASTER NURSING
The overall goal of disaster nursing is to achieve the best possible level
of health for the people and the community involved in the disaster.
Role of Nurse in Disaster nursing are the following-
To meet the immediate basic survival needs of populations affected by disasters (water, food, shelter, and
security).
To identify the potential for a secondary disaster.
To appraise both risks and resources in the environment.
To correct inequalities in access to health care or appropriate resources.
To empower survivors to participate in and advocate for their own health and well-being.
To respect cultural, lingual, and religious diversity in individuals and families and to apply this principle in
all health promotion activities.
To promote the highest achievable quality of life for survivors.

35. Disaster Management Process
• Develop a disaster plan to prevent or deal with identified disaster
threats.
• Identify a local community communication system.
• Identify disaster personnel, including private and professional
volunteers, local emergency personnel, agencies, and resources.
• Identify regional backup agencies, personnel.
Disaster Planning-
• Focus on primary prevention activities to prevent occurrence of
Man-made disasters.
• Practice community disaster plans with all personnel carrying
out their previously identified responsibilities.
• Practice using equipment, obtaining and distributing supplies.
Implement Disaster Plan-

36. HOSPITAL DISASTER PLAN
 The hospital is an integral part of the society and it has
great role to play in the disaster management.
 Every hospital big or small, public or private has to
prepare a disaster plan, and must learn to activate the
disaster plan at the hour of need.
 Disasters in the hospital perspective can be grouped into
two categories:
 1. Internal Hospital disasters like fire, building collapse,
terrorism, etc
 2. External disasters like earthquakes, floods, etc

37. OBJECTIVES OF HOSPITAL DISASTER PLAN
Preparedness of staff, optimising of resources and mobilisation of
the logistics and supplies within short notice
To make community aware about the hospital disaster plan and
benefits of plan
Training and motivation of the staff
To carry out mock drills
Documentation of the plan and making hospital staff aware about
the various steps of the plan

38. DISASTER DRILL
• A disaster drill is an exercise in which people simulate the
circumstances of a disaster so that they have an opportunity to
practice their responses.
Definition-
• On a basic level, drills can include responses by individuals to
protect themselves, such as learning how to shelter in place,
understanding what to do in an evacuation, and organizing meet up
points so that people can find each other after a disaster.
• Disaster drills handle topics like what to do when communications
are cut off, how to deal with lack of access to equipment, tools, and
even basic services like water and power, and how to handle
evacuations.
• It also provides a chance to practice for events such as mass
casualties which can occur during a disaster.
Features-
Benefits -
•Used to identify weak points in a disaster response plan
•To get people familiar with the steps they need to take so that their
response in a disaster will be automatic.

39. Disaster Management Agencies
 IN INDIA-
 National Disaster Response Force
 National Disaster Management Authority
 National Institute of Disaster Management
 International Strategy for Disaster Reduction
 INTERNATIONAL AGENCIES
 Every country is a potential source of health humanitarian
assistance for some other disaster-striken nation. Bilateral
assistance, whether personnel, supplies or cash is probably the
most important source of external aid.
 Several international or regional agencies have established
special funds, procedures and offices to provide humanitarian
assistance.

40. CONT...
 Office for the Coordination of Humanitarian Affairs (OCHA)
 World Health Organization (WHO),
 UNICEF,
 World Food Programme(WFP),
 Food and Agriculture Organization(FAO).
 European Community Humanitarian Office (ECHO),
 Organization of American States (OAS).
 Non-Governmental Organizations-
 CARE,
 International Committee of Red Cross,
 International Council of Voluntary Agendes(ICVA),
 International Federation of Red Cross and Red Crescent
Societies (IFRC) etc.