EDUCATION

1. Common disasters and disaster
management
GUIDED BY:
DR. RAJEEV YADAV,
ASSISTANT PROFESSOR,
P.S.M. DEPARTMENT.
BY:
DR. PRIYANKA KAPOOR,
RESIDENT,DEPT. OF PSM,
SMS MEDICAL COLLEGE.

2. INTRODUCTION
DISASTER:
It is defined as any occurrence that causes
damage, ecological disruption, loss of human
life or deterioration of health and health
services on a scale sufficient to warrant an
extraordinary response from outside the
affected community or area. (WHO)

3. Hazard
 Any phenomenon that has the potential to cause
disruption or damage to people and their
environment.
 When hazard involves elements of risks,
vulnerabilities and capacities, they can turn into
disasters.
 Hazards may be inevitable but disasters can be
prevented.
“A hazard is natural event while the disaster is its
consequence. A hazard is perceived natural event
which threatens both life and property…… A disaster
is a realization of this hazard.”
-JohnWhitlow

4. CLASSIFICATION OF DISASTERS
DISASTERS
NATURAL
DISASTERS
MAN-MADE
DISASTERS
DISASTERS

5. BENEATH EARTHS
SURFACE(TECTONIC)
• a) earthquake
• b) tsunamis
• c) volcanic
eruptions
AT EARTHS SURFACE
(TOPOLOGICAL)
• a) landslides
• b) avalanches
ABOVE EARTHS
SURFACE
• a) meteorological
(hydrological)
• b) biological

6. ABOVE EARTH’S SURFACE:
METEOROLOGICAL BIOLOGICAL
 WINDSTORMS :
> cyclone
>Typhoon
> Hurricane
 TORNADOES
 HAILSTORMS
(SNOWSTORMS)
 SEA-SURGES
 FLOODS
 DROUGHTS
 EPIDEMICS OF DISEASES
 LOCUST SWARMS (
group of insects or bees)

7. BY WARFARE
• CONVENTIONAL
• NUCLEAR
• BIOLOGICAL
• CHEMICAL
BY ACCIDENTS
• Vehicular
• drowning
• Collapse of building
• Explosions
• Fires
• Biological
• Chemical including
poisons

8. NATURAL DISASTERS

9. TYPES OF NATURAL DISASTERS
 Avalanches:
 It is a mass of snow which is set in motion by its own
weight through a violent disturbance in equilibrium.

10. Earthquakes
 An earthquake is the result of a sudden release of energy in
the Earth's crust (7 major plates) that creates seismic waves. It manifests
by vibration, shaking and sometimes displacement of the ground.
 The underground point of origin of the earthquake is called the focus.
The point directly above the focus on the surface is called the epicenter.
Earthquakes by themselves rarely kill people or wildlife. It is usually the
secondary events that they trigger, such as building collapse,
fires, tsunamis (seismic sea waves) and volcanoes, that are actually the
human disaster.
 UNDP has selected ALWER and BIKANER ( seismic zone) for DRR
( disaster risk reduction) project. http://www.ndma.gov.in/en/hazard-risk-response.html

11. Volcanic eruptions
 Volcanic eruption itself may cause harm following the explosion
of the volcano or the fall of rock.
 Second, lava may be produced which destroys many buildings
and plants it encounters.
 Third, volcanic ash generally meaning the cooled ash - may
form a cloud, and settle thickly in nearby locations. When mixed
with water this forms a concrete-like material. In sufficient quantity
ash may cause roofs to collapse under its weight but even small
quantities will harm humans if inhaled.

12. Floods
o A flood is an overflow of an expanse of water that submerges
land.
o It may result from the volume of water within a body of water,
such as a river or lake, which overflows or breaks levels, with the
result that some of the water escapes its usual boundaries.
o Reasons includes a steep increase in population, rapid
urbanization growing developmental and economic activities in
flood plains coupled with global warming, inadequate carrying
capacity of rivers, drainage congestion and erosion of river-
banks. Cyclones, cyclonic circulations and cloud bursts also
cause flash floods

13. Droughts
 If a particular area has no rainfall or less rain than normal for a
long period of time is called drought.
 it is not only lack of rainfall that causes drought, hot dry winds,
very high temperature and evaporation of moisture from the ground
can result in conditions of drought.

14. Tsunamis
 Tsunamis are caused by undersea earthquakes. Tsunamis
generally consist of a series of waves with periods ranging from
minutes to hours, arriving in a so-called "wave train".
 Wave heights of tens of metres can be generated by large events.
 The 2004 Indian Ocean tsunami was among the deadliest natural
disasters in human history with over 2,79,000 people affected in 14
countries bordering the Indian Ocean, 10,749 deaths , 5,640 persons
missing , 11,827 hectares of crops damaged , 300,000 fisher folk lost
their livelihood. http://www.ndma.gov.in/en/hazard-risk-response.html

15. Tornadoes
A tornado is a violent, dangerous, rotating column of air that is in contact
with both the surface of the earth and a cumulonimbus cloud or, in rare
cases, the base of a cumulus cloud.
 They are often referred to as a twister or a cyclone, although the
word cyclone is used to name any closed low pressure circulation.
Tornadoes come in the form of a visible condensation funnel, whose
narrow end touches the earth and is often encircled by a cloud
of debris and dust.

16. cyclones
 Cyclones are caused by atmospheric disturbances
around a low-pressure area distinguished by swift and
often destructive air circulation. Cyclones are usually
accompanied by violent storms and bad weather.
 Cyclones are given many names in different regions of
the world –They are known as
Typhoons in the China Sea and Pacific Ocean;
Hurricanes in theWest Indian islands in the Caribbean Sea
and Atlantic Ocean;
Tornadoes in the Guinea lands ofWest Africa and southern
USA.;
Willy -willies in north-westernAustralia and tropical
cyclones in the Indian Ocean.

17. MAN-MADE DISASTERS
"anthropogenic/ man made disasters" means threats having an
element of human intent, negligence, or error; or involving a failure
of a man-made system.
Airplane crashes and terrorist attacks are examples of man-made
disasters: they cause pollution, kill people, and damage property.

18. Mumbai,
Floods
July 2005
Mumbai
Terrorist
Attacks
(26/2011)
Flood,
Assam &
Bihar 2004
MAJOR DISASTERS IN INDIA (1982-2013)
June 2013, Uttrakhand Heavy
Rainfall & Floods
Earthquake, Bhuj
Jan 2001
Earthquake,
Latur Sept 1993
Tsunami
Dec 2004
Bhopal Gas
Disaster, Dec
1984
Earthquake, Oct
2005, cloud burst
2010, flood 2014 Kosi Floods,
Aug, 2008
Cyclone Aila,
West Bengal,
2009
Avalanche Feb
2005
Odisha super
cyclone,
1999,PHAILIN
Cyclone 2013
SIKKIM
EARTHQUAKE,
2011

19. VULNERABILITY PROFILE OF INDIA
(2013)
 More than 58.6 per cent of the landmass is
prone to earthquakes .
 over 40 million hectares (12%) of its land is
prone to floods and river erosion.
 close to 5,700 kms, out of the 7,516 kms long
coastline is prone to cyclones and tsunamis.
 68% of its cultivable area is vulnerable to
droughts.
 Hilly areas are at risk from landslides and
avalanches. http://www.ndma.gov.in/en/vulnerability-profile.html
Last Updated onThursday, 26 September 2013 16:55

20. DISASTER MANAGEMENT
“AN APPLIED SCIENCE WHICH SEEKS,
BY THE SYSTEMATIC OBSERVATION AND ANALYSIS
OF DISASTERS,
TO IMPROVE MEASURES RELATING TO PREVENTION,
PREPAREDNESS , RESPONSE AND RECOVERY.”

21. PHASES OF DISASTER MANAGEMENT
Disaster Preparedness
Disaster Impact
Disaster Response
Disaster Recovery
Disaster Mitigation

22. Integrated
Disaster
Management
Prepared-
ness
Response
Recovery
Mitigation
Activities prior to a disaster.
• Preparedness plans
• Emergency exercises
•Training,
•Warning systems
Activities that reduce
effects of disasters
• Building codes &
zoning
•Vulnerability
analyses
• Public education
Activities following a
disaster.
• Temporary housing
• Claims processing
• Grants
• Medical care
Activities during a
disaster.
• Public warning
systems
• Emergency
operations
• Search & rescue

23. Disaster preparedness
Preparedness should be in the form of
money, manpower and materials
 Evaluation from past experiences about risk
 Location of disaster prone areas
 Organization of communication, information
and warning system
 Ensuring co-ordination and response
mechanisms

24. Contd...
 Development of public education
programme
 Co-ordination with media
 National & international relations
 Keeping stock of foods, drug and
other essential commodities.

25. E.g.: Indian Meteorological department (IMD) plays a key role in
forewarning the disaster of cyclone-storms by detection tracing. It has
5 centres in Kolkata, Bhubaneswar, Vishakhapatnam, Chennai &
Mumbai. In addition there are 31 special observation posts setup
along the east coast of India.
The International Agencies which provides humanitarian assistance to
the disaster strike areas are United Nation agencies.
 Office for the co-ordination of Humanitarian Affair (OCHA)
 World Health Organization (WHO)
 UNICEF
 World Food Programme (WFP)
 Food & Agricultural Organisation (FAD)
E.g.: Non Governmental Organizations
 Co-Operative for assistance and Relief Every where
(CARE)
 International committee of Red cross

26. Disaster impact

27. RESPONSE
 Taken immediately prior to and following disaster impact.
 Typical measures include :
 Implementation of plans
 Mass evacuation
 Search and Rescue
 Provision of emergency food, shelter, medical assistance
etc.
 Maintenance of law and order
 Survey and assessment

28. Policies related to
emergency/disaster management
1. “First come, first treated” principle will not
be followed during emergencies.
2. Triage protocol
3. ABCDE care is provided
 Airway
 Breathing
 Circulation
 Disability limitation
 Exposure / environmental control

29. Aim of Triage
To achieve the greatest
good for the greatest
number of casualties

30. Basis of Triage
( in Mass Casualty Incident)
 Severity of injury
 Number of injured
 Available resources and
 Survival chances of the
victims

31. Procedures of Triage
 TRIAGE FIRST BEFORE TREATMENT!
 Do not take more than 60 seconds per
patients
 Determine best facility for definitive care in
the emergency department and the field
 The triage categories include
a) Emergent
b) Urgent
c) Non-urgent

32. Emergent Category
 Major trauma
 Acute myocardial
infarction
 Airway obstruction
 Tension pneumothorax
 Flail Chest
 Hypovolemic shock
(Class III and IV)
 Burns with inhalation
injury
management should begin upon
arrival

33. Urgent
 Vertebral and Spine Injury
 Femoral shaft fracture
 Closed head injury
 Burns
 Acute Appendicitis
They all are at risk if not treated in a few hours

34. Non-urgent
 Skin lacerations
 Contusions
 Abrasions
 Upper extremity fractures
 Fever
 Associated medical conditions

35. Triage Protocol/System
Red: High priority for treatment & transfer
Yellow: Medium Priority
Green: Ambulatory patients
Black: Dead or Moribund patients

36. THE GOLDEN HOUR
 Amount of time from injury to the definitive
care.
 Care given within the first hour, mortality and
morbidity is favorably reduced
Aims to correct the main threats to life:
Blocked airways
Severe bleeding
START

37. Procedures of START
(time <60 seconds / patient)
 Respiratory
 assess for RR and adequacy
 not breathing – check for foreign body
obstruction; remove loose dentures; reposition
head with C-spine precautions
 Does not initiate respiratory effort – BLACK
 RR > 30/min – RED
 RR< 30/min – do not tag;
 assess perfusion: pulse or capillary refill

38. Procedures of START
 Perfusion
 assess capillary refill (> or < 2 secs)
 >2 secs – RED
 <2 secs – do not tag yet; assess mental
status
 If capillary refill cannot be assessed
 radial pulse not palpable SBP < 80mmHg
 Control hemorrhage – using walking
patients or self

39. Procedures of START
 Mental Status
 simple commands:
 “open and close your eyes”
 “squeeze my hands”
 cannot follow – RED
 can follow -- YELLOW

41. Hospital Roles in a Disaster
 Duty chart well displayed on notice board.
 Unit head should take round in casualty to evaluate
casualty ward,
 Information to all resident doctors and senior docs of
concerned deptt timely whenever a information of mass
casualty.
 Keeping all medicines & equipments ready to deal the
mass casualty before it reaches.
 Evacuation of crowd that can be hindrance in proper
treatment.
 Follow triage and apply tag on patients according to
seriousness.

42. Disaster Management Team
 Medical Superintendent
 Additional Medical Superintendent
 Nursing superintendent
 Chief medical officer (Casualty)
 HOD’d of all the dept.s
 Blood bank incharge
 Security officers
 Dietician
 Transport officer
 Sanitary personnel

43. EQUIPMENTS:
 Resuscitation equipment
 IV sets and IV fluids
 Disposable needles, syringes & gloves
 Dressing & suturing materials and splints
 Oxygen delivery devices
 Suction catheter and machine
 ECG monitors, defibrillators and ventilators
 Cut down sets, tracheostomy sets and lumbar
puncture sets
 Linens and blankets

44. Overcrowding
 The less equipped hospitals are especially
vulnerable because of the high risk of
overcrowding even before a disaster occurs.
 During the influx of pts to a hospital, or
situation, temporary pt care areas may have
to be established. Lobby areas and corridors,
Chapels and other prayer areas have been
used.

45. RECOVERY
 Communities and the nation are assisted in returning
to their proper/normal level of functioning following a
disaster.
 It includes:
 Water supply
 Food safety
 Basic sanitation and personal hygiene
 Vector control
 Animal control
 Communicable disease control

46. MITIGATION
 It is the effort to reduce loss of life and property by lessening the impact
of disasters.
 Mitigation is taking action now —before the next disaster.
 To reduce human and financial consequences later (analyzing risk,
reducing risk, ensuring against risk).
Eg. improving structural qualities of schools, houses and such other
buildings so that medical causalities can be minimized.
 Similarly ensuring the safety of health facilities and public health services
including water supply and sewerage system to reduce the cost of
rehabilitation and reconstruction.

47. DISASTER-EFFECTS
 Deaths
 Disability
 Increase in communicable disease
 Psychological problems
 Food shortage
 Socioeconomic losses
 Shortage of drugs and medical
supplies.

48. Institutional Framework
Disaster Management Structure
According to disaster management act 2005, NDMA is
Apex body with Prime Minister as Chairperson.
National Executive Committee - Secretaries of 14 Ministries
and Chief of Integrated Defence Staff.
Centre Level
Central Ministries; National Disaster Management Authority,
National Institute of Disaster Management
National Disaster Response Force (NDRF).
State Level
SDMA headed by Chief Minister.
State Executive Committee (SEC).
District Level
DDMA headed by District Magistrate.
Interface between Govt. and Public.

49. Nodal agencies for disaster
management
 Floods: ministry of water resources , (central water commission)
 Cyclones, earthquakes : Indian meteorological department
 Epidemics: ministry of health and family welfare
 Tsunami: Indian National Centre for Oceanic Information
Services
 Landslides: Geological Survey of India
 Avalanche: DRDO ( Defence research and development
organisation)
 Chemical disasters: ministry of environment and forests
 Industrial disaster: ministry of labor
 Rail accidents: ministry of railway
 Air accidents: ministry of civil aviation
 Fire: ministry of home affairs
 Nuclear incidents: department of atomic energy
 Mine disasters: department of mines

50. Disaster Reduction Day
 NIDM observes "Disaster Reduction Day" on the
Second Wednesday of October.
 UN General Assembly in 2009, designated October 13
as International Day for Disaster Reduction.
 2013 Theme -“Living with Disability and Disasters”.
 Rallies and lectures for awareness for disaster
reduction amongst youth, children and general people.

51.  FOR INFORMATION ON DISASTERS
DIALTOLL FREE No. 1070
 Log on to http://www.ndmindia.nic.in