Emergency Preparedness


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Emergency Preparedness

  1. 1. Emergency Preparedness What you need to know
  2. 2. Objectives: <ul><li>After completing this learning module you will be able to: </li></ul><ul><li>Identify what constitutes an all hazards plan. </li></ul><ul><li>Discuss the nurse’s role in disaster planning. </li></ul><ul><li>Discuss the triage system, it’s patient organization, and assessment procedures. </li></ul>
  3. 3. Driving Factor <ul><li>The bombing of the Okalahoma City Federal building, the September 11 attacks, anthrax cases, and natural disasters such as Hurricane Katrina have prompted new federal, state, and local standards for safety and public preparedness. </li></ul>
  4. 4. National Preparedness: <ul><li>Homeland security established the National Preparedness Goal </li></ul><ul><li>Federal, state, and local agencies collaborate in bioterrorism preparedness </li></ul><ul><li>Includes the term &quot;all-hazards preparedness&quot;, and refers to the preparedness for domestic terrorist attacks, major disasters, and other emergencies </li></ul><ul><li>Requires hospitals to confirm successful training of hospital staff </li></ul>
  5. 5. Defining Quote <ul><li>“ The goals of disaster preparedness are to anticipate, mitigate, and rehabilitate. All health professionals can and should contribute to this process. Among the most essential competencies are the ability to locate your institutional or office disaster plan, to understand your role in an emergency; and to know how to communicate with patients, ancillary staff, and governmental agencies during an emergency”( DiMaggio, et al 2005 ). </li></ul>
  6. 6. Disaster preparedness plan: <ul><li>Formal plan of action </li></ul><ul><li>Coordinates the response of the health care agency staff in the event of a disaster in the health care facility or surrounding community </li></ul>
  7. 7. Nurses role in disaster planning:
  8. 8. Personal and professional preparedness: 1-3 <ul><li>The nurse makes personal and family preparations, e.g.: family meeting place, evacuation plan, food and water supplies, etc. </li></ul><ul><li>Is familiar with the emergency plan at place of employment and within the community </li></ul><ul><li>Maintains certification in disaster training and participates in mock disaster drills </li></ul>
  9. 9. Personal and professional preparedness: 4-6 <ul><li>Is familiar with the triage system of the health care facility in which he or she is employed </li></ul><ul><li>Is aware of the clinical and public health responses to emerging infectious diseases such as H1N1, SARS, and the West Nile virus ( DiMaggio, et al 2005 ). </li></ul><ul><li>Recognizes and responds to chemical, biological, radiological, nuclear, and explosive threats a.k.a. C.B.R.N.E. </li></ul>
  10. 10. CBRNE: <ul><li>Chemical </li></ul><ul><li>Biological </li></ul><ul><li>Radiological/Nuclear </li></ul><ul><li>Explosive agents </li></ul>
  11. 11. Chemical agents <ul><li>Nerve agents: sarin, sobin, tabun, and vx gasses </li></ul><ul><li>Choking agents: chlorine gas and phosgene </li></ul>
  12. 12. Biological agents <ul><li>Anthrax </li></ul><ul><li>Botulism </li></ul><ul><li>Plague </li></ul><ul><li>Small pox </li></ul>
  13. 13. Radiological/Nuclear <ul><li>Dirty bombs are a true threat </li></ul><ul><li>Decontamination process is lengthy </li></ul><ul><li>High mortality rate appeals to terrorists </li></ul><ul><li>Has the potential for mass casualties and structural damage </li></ul>
  14. 14. Explosive agents <ul><li>Materials are easily accessible </li></ul><ul><li>Potential for chemical and or radiologic contamination </li></ul><ul><li>Mass casualties and heavy structural damages are likely </li></ul>
  15. 15. Disaster Response <ul><li>In the health care facility: </li></ul><ul><ul><li>The emergency response plan is activated </li></ul></ul><ul><ul><li>The nurse responds by following the directions outlined in the plan </li></ul></ul><ul><li>In the community: </li></ul><ul><ul><li>The nurse cares for highest priority patients first </li></ul></ul><ul><ul><li>Once rescue workers arrive, immediate plans for triage should begin </li></ul></ul>
  16. 16. Defining Quote <ul><li>“Triage is a system of sorting clients according to medical need when resources are unavailable for all persons to be treated” (Zerwekh, 2009). </li></ul>
  17. 17. Disaster/Emergency Triage System
  18. 18. Clients are assessed and classified according to: <ul><li>Need and or priority of care </li></ul><ul><li>Type of illness or injury </li></ul><ul><li>Severity of problem </li></ul><ul><li>Resources available </li></ul>
  19. 19. Triage Systems Defined <ul><li>The three-tier triage system and the START triage system utilize color coded triage cards. The colors red, yellow and green are interchangeable between the two triage systems. The three-tier system is most commonly used in the health care setting whereas the START system is more commonly used in the community disaster setting. </li></ul>
  20. 20. Color Codes
  21. 21. Red (Immediate) <ul><li>Priority 1 </li></ul><ul><li>Life threatening injuries; but have a high probability for survival once stabilized </li></ul><ul><li>Examples include: </li></ul><ul><ul><li>Trauma/limb amputation </li></ul></ul><ul><ul><li>Chest pain/severe respiratory distress/cardiac arrest </li></ul></ul><ul><ul><li>Acute neurological deficits </li></ul></ul><ul><ul><li>Chemical splashes to the eyes </li></ul></ul>
  22. 22. Yellow (delayed) <ul><li>Medically stable </li></ul><ul><li>Treated after “immediate” patients, but within one to two hours </li></ul><ul><li>Will require an ongoing evaluation every 30 to 60 minutes prior to medical attention </li></ul><ul><li>Examples include: </li></ul><ul><ul><li>Simple fracture </li></ul></ul><ul><ul><li>Fever </li></ul></ul><ul><ul><li>Abdominal pain </li></ul></ul>
  23. 23. Green (minor) <ul><li>Medically stable </li></ul><ul><li>Treated after “immediate” patients and “delayed” patients </li></ul><ul><li>Can wait several hours for medical attention, but will require an ongoing evaluation every one to two hours prior to medical attention </li></ul><ul><li>Examples include: </li></ul><ul><ul><li>Minor laceration </li></ul></ul><ul><ul><li>Sprain </li></ul></ul>
  24. 24. Black (deceased) <ul><li>Resuscitation attempts are unsuccessful </li></ul><ul><li>Sustained injuries are beyond the scope of medical staff </li></ul>
  25. 25. Client assessment in the triage setting
  26. 26. Primary assessment <ul><li>Primarily objective data </li></ul><ul><li>Using the ABC’s (airway, breathing, and circulation) as a guide to identify immediate or potentially life threatening medical needs </li></ul><ul><li>Assess for head or spinal injuries </li></ul><ul><li>Initiate interventions immediately </li></ul>
  27. 27. Secondary assessment <ul><li>Follows primary treatment and initial medical treatment </li></ul><ul><li>Utilizes objective and subjective data </li></ul><ul><li>Includes: </li></ul><ul><ul><li>General overview </li></ul></ul><ul><ul><li>Health history </li></ul></ul><ul><ul><li>Vital signs </li></ul></ul><ul><ul><li>Neurological assessment </li></ul></ul><ul><ul><li>Pain assessment </li></ul></ul><ul><ul><li>Physical assessment </li></ul></ul>
  28. 28. Defining Quote <ul><li>“ Triage and life saving treatment should never be delayed because of the possibility of radioactive contamination of the victim. In general, the risk of exposure to caregivers is small. Universal precautions effectively protect against radiological secondary contamination of first responders and first receivers” (CDC, 2008). </li></ul>