Registered nurse positioned in an emergency room (ER); responsible for assessing patients,
initiating emergency treatment and
determining their level of need
medical assistance.
Disaster plans in hospitals and health care centersDr. Samir Sawli
Emergencies and disasters can happen at any moment – and, they usually occur without warning. When an emergency strikes, the safety of patients and staff will depend on the existing preparedness of Departments and their staff.
Hospital and Department Disaster Response Plans are developed and written to provide fundamental support and direction to all concerned staff.
These plans are an essential building block of the Hospital’s response to a crisis.
They are part of every Department’s basic health and safety responsibilities; as well as operational continuity and planning
This is an emergency management. this presentation is only for study purpose. it helps to improve the knowledge at the end of session. kindly share this presentations to others.
Disaster plans in hospitals and health care centersDr. Samir Sawli
Emergencies and disasters can happen at any moment – and, they usually occur without warning. When an emergency strikes, the safety of patients and staff will depend on the existing preparedness of Departments and their staff.
Hospital and Department Disaster Response Plans are developed and written to provide fundamental support and direction to all concerned staff.
These plans are an essential building block of the Hospital’s response to a crisis.
They are part of every Department’s basic health and safety responsibilities; as well as operational continuity and planning
This is an emergency management. this presentation is only for study purpose. it helps to improve the knowledge at the end of session. kindly share this presentations to others.
Emergency is the gateway to the hospital, patients with pain and agony, relative emotionally charged enter the emergency department at any hour of the day or night, expecting immediate treatment and solace.
Internal Disaster Preparedness and Management in HospitalsLallu Joseph
This presentation deals on the following
1. Disaster definition- Internal and external
2. Learning from Disasters- Case Studies- AMRI, Chennai Floods
3. Four phases of emergency management
5. Risk assessment
6. 5 steps of emergency preparedness
7. Emergency management and evacuation plan for hospitals
8. Mock drills and how to conduct them
9. Table top exercises
A mass casualty incident is defined as an event which generates more patients at one time than locally available resources can manage using routine procedures. It requires exceptional emergency arrangements and additional or extraordinary assistance.
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
Hello ,
Disaster management is a vast topic which cant be cover in one ppt so i have taken one particular topic which is on Triage in disaster Management . I am trying to elaborate the topics by putting few pictures , if anyone have any problem with understand the ppt ,I have mentioned the reference guide . They can check it .
Thnks
KIRTTI
NABH 5th edition hospital std april 2020anjalatchi
A. National Accreditation Board for Hospitals & Healthcare Providers (NABH) is a constituent board of Quality Council of India (QCI), set up to establish and operate accreditation programme for healthcare organizations.
Mock Drills in Hospitals- How to conduct mock drills?Lallu Joseph
Internal disaster management in hospitals is very critical. Hospitals need to prepared to handle emergencies and conduct regular mock drills to check the protocols, awareness of staff and also the equipment.
Emergency is the gateway to the hospital, patients with pain and agony, relative emotionally charged enter the emergency department at any hour of the day or night, expecting immediate treatment and solace.
Internal Disaster Preparedness and Management in HospitalsLallu Joseph
This presentation deals on the following
1. Disaster definition- Internal and external
2. Learning from Disasters- Case Studies- AMRI, Chennai Floods
3. Four phases of emergency management
5. Risk assessment
6. 5 steps of emergency preparedness
7. Emergency management and evacuation plan for hospitals
8. Mock drills and how to conduct them
9. Table top exercises
A mass casualty incident is defined as an event which generates more patients at one time than locally available resources can manage using routine procedures. It requires exceptional emergency arrangements and additional or extraordinary assistance.
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
Hello ,
Disaster management is a vast topic which cant be cover in one ppt so i have taken one particular topic which is on Triage in disaster Management . I am trying to elaborate the topics by putting few pictures , if anyone have any problem with understand the ppt ,I have mentioned the reference guide . They can check it .
Thnks
KIRTTI
NABH 5th edition hospital std april 2020anjalatchi
A. National Accreditation Board for Hospitals & Healthcare Providers (NABH) is a constituent board of Quality Council of India (QCI), set up to establish and operate accreditation programme for healthcare organizations.
Mock Drills in Hospitals- How to conduct mock drills?Lallu Joseph
Internal disaster management in hospitals is very critical. Hospitals need to prepared to handle emergencies and conduct regular mock drills to check the protocols, awareness of staff and also the equipment.
If you want an exciting career in healthcare, consider becoming an EMT. Click here and watch the exclusive presentation highlighting the various advantages of becoming an EMT.
The presenstion covers Mode of transport, common terminolgies, Various risks, and risk reduction strategies, Pre-Take off, During transport and arrival procedures and protocols, checklist, and algorithm in critically ill patient transport
Toxic shock syndrome is a serious, life threatening illness caused by toxins released by two specific bacteria Streptococcus pyogenes or Staphylococcus aureus
It is a medical emergency requiring prompt care
Management of oral problem in Palliative care setting jenishaadhikari
Oral complications from radiation to the head and neck or chemotherapy for any malignancy can compromise patients’ health and quality of life, and affect their ability to complete planned cancer treatment.
For some patients, the complications can be so debilitating that they may tolerate only lower doses of therapy, postpone scheduled treatments, or discontinue treatment entirely.
Oral complications can also lead to serious systemic infections
community heath nursing
Gender inequality refers to unequal treatment or perceptions of individuals based on their gender. It arises from differences in socially constructed gender roles.
Gender equality, also known as sex equality, sexual equality, or equality of the genders, is the view that everyone should receive equal treatment and not be discriminated against based on their gender.
baby born before 37 weeks of gestation calculating from the first day of last menstural period is defined as preterm baby/ premature baby.
These babies are known as preemies
Clinical teaching is an individualized
or group teaching to the nursing
student in the clinical area by the
nurse educators, staff and
clinical nurse manager
Placental abruption is premature separation of placenta from the uterus/ in other words separates before childbirth.
It occurs most commonly around 25 weeks of pregnancy characterized by vaginal bleeding, lower abdominal pain, and dangerously low blood pressure
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. Content
• Trauma team
• Triage nurse and their responsibilities
• Hospital response
• Emergency preparedness
• Use of triage in hospital
• Disaster management
• Post disaster action
5. Triage nurse
Registered nurse positioned in an emergency
room (ER); responsible for assessing patients,
initiating emergency treatment and
determining their level of need
medical assistance.
6. Responsibilities of a Triage Nurse
• Responsibilities of a Triage Nurse include :
• Perform patient assessment
• Reassess patients who are waiting
• Initiate emergency treatment if necessary
• Manage and communicate with patients
in waiting room
7. Contd..
• Provide education to patients and families
when necessary
• Sort patients into priority groups according
to guidelines
• Transport patients to appropriate treatment
areas
10. Notification
• The hospital is informed about the
disastrous event, type of disaster,
number of casualties and severity
• All the department are notified
12. Preparation
• Empty and expand the emergency room
– Immediate disposition decisions and movement
– Triage order - red and yellow for emergency room
and green to outpatient
13. Contd..
• Empty and expand hospital
– Early discharge
– Transferring patient
– Postponing elective surgery
14. • Additional staff
– Staff as per duty and manage volunteers
• Stock all necessary medical supplies
• Inform the blood bank
15. Receival of casualties
• Quick and through assessment of victims
• Triage
• Rapid turnover of of patient
• Life and limb threat take priority
18. Emergency preparedness
• Formulate hospital policy and action plan for
Emergency preparedness for disaster
management (EPDM)
• Strength the capabilities of health worker in
the disaster management team
• Establish triage protocol
19. Contd.
• Specify protocol for response to disaster
who would all report to and
has what responsibilities
• Have a back up plan for
persistent flow of electricity,
water and fuel supplies
20. Contd.
• Keep stock of medical supplies for use of
emergency
• Carry out regular drills (Mock drill)
to be well prepared for genuine
response to disaster
21. Use of triage in hospital
• Usually four category system in used
to sort out the case on
the basis of need for immediate,
therapeutic intervention
22. • Usual color are
– Red
– Green
– Yellow
– Black
• Nevertheless individual hospital can have their
own protocol
23. Contd ..
• Red
All life threatening patient who needs
immediate intervention
24. Eg –
Acute cardio pulmonary insufficiency
Severe hemorrhage
Chest injuries
Spleen/ liver injuries
State of shock
Skull injury with coma
Burn over 20 %, etc
26. Contd..
Eg –
Close fracture and dislocation
Closed abdominal trauma
Skull injury without coma
Less severe burn, etc
These patient require close monitoring and
immediate intravenous infusion
27. Contd ..
• Green
In this category those patient whose
treatment can be delayed for 4 – 6 hours
who needs minor treatment and who
need no treatment are included
29. • Black
No need for medical care
Eg –
dead on scene
Absence of brain activity
30. Disaster management
Respond to disaster
Before the arrival of victims
oCollect information from the authorized
person
in the disaster site about type of disaster,
number of casualties and severity
oApoint commander and vice commander
for disaster management
31. Contd.
oActivate the disaster protocol
oSpecify the receiving area or casualty collection
point the triage area based number of injury
oAlert all department to remain stand by;
operation theater, all indoor unit,
laboratory, radiology, etc
32. Contd.
oAssign definite task to people in disaster plan
oSuspend all other regular hospital activities
except for the critical one
oPrepare standardized tag in advance
oEvacuation of minor cases
33. Contd.
After the arrival of the victim
oTriage nurse or volunteer receive in the reception
area
oTriage nurse keep the crowd away with the
help of volunteer of team
oThe nurse in charge mobilizes nurses and mobilizes
to their duties
34. Contd.
o Triage nurse screen the case before
moving the victim to triage area
and carryout rapid concise and focused
subjective and objectives assessment of case
and categories patient as the
severity of illness
35. Contd.
oPatient are tagged before moving from
reception area and tag must include such
information on patient as their
name, age, sex, triage category, diagnosis
and initial treatment
36. Contd..
oTriage nurse coordinates with different diagnostic
facilities X- ray, laboratory, etc for investigation
required
oTriage nurse constantly assess the progress
of patient and report to physician if patient
need change in his/her triage category
37. Contd.
oThe triage physician decide appropriate place
for the treatment of each treatment of
each patient which could be operation theater,
ICU,CCU, other ward or the emergency room
or triage area
38. Contd.
oOne among the triage nurse, who is identified
as the spokesperson communicate with family
in waiting room through phone or intercom
oCompletes all legal procedure before sending
the dead bodies to morgue or handing them
over to families
39. Contd…
Crowd controlling
– Managed in collaboration with security and other
volunteer
– The main hospital gate should be closed
and only vehicle and individual carrying
casualty should be permitted
40. Contd..
• People from media should be allowed entrance only
as far as the information center or reception area
41. Contd..
• Record and reporting
– Document all cases with full detail and as medico
legal cases
– Inform the police if case are discharged, referred
or expired
43. Post disaster action
• Routine tasks that were suspended in the
emergency management of disaster
are resumed.
• After the disaster management the reports are
analyzed to assess the effectiveness of the disaster
preparedness and response activities is carried out
44. Reference
• Singh Indira, leading and managing in Health,
5th edition, Hisi offset printer Pvt. Ltd page no
410-416
• Metha R S, Pokharel Tara, leadership and
mangement (nursing management ) 1st
edition, Heidal press Pvt Ltd, page no 382-394
• https://www.slideshare.net/NcDas/disaster-
management-11960149