Disasters can be natural, man-made, or hybrid. They cause disruption and harm to communities. Disaster management involves preparing for, responding to, and recovering from disasters. Key aspects include defining disaster levels; triaging casualties into red, yellow, green, and black categories; and having disaster plans, committees, and rapid response teams in place at the community level. The nurse's role includes assessing disaster risks and threats, planning and practicing disaster response, and evaluating effectiveness. International agencies provide humanitarian assistance during disasters.

1. DISASTER MANAGEMENT

2. Disaster is an occurrence arising
with little or no warning, which causes
serious disruption of life and perhaps death
or injury to large number of people.

3. DEFINITION
A disaster can be 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 extra
ordinary response from outside the
affected community or area.”
(WHO , 1995)

4. TYPES OF DISASTER:-
The disasters are of 3 types. They are.
 Natural disasters
 Manmade disasters
 Hybrid disasters

5. NATURAL DISASTERS:-
Natural disaster is the effect of a natural
hazard (eg: flood, tornado, hurricane,
volcanic eruption, earthquake, heat wave,
and landslide). It leads to financial
environmental or human losses.

6. MANMADE DISASTERS:-
Man-made disasters are disasters are
disasters resulting from manmade hazards
as opposed to natural disasters resulting
from natural hazards.
Manmade disasters are sometimes referred
to as anthropogenic.
 Eg: Railway accidents
Road traffic accidents

7. HYBRID DISASTERS:-
A Hybrid Disaster is one which occur when a
natural or manmade hazard causes great
damages.
A hybrid disaster is a man made one, when
forces of nature are unleashed as a result
of technical failure or sabotage.

8. LEVELS OF DISASTER:-
 Disasters are categorized under 3 levels
based on the extent of damage.
 Level 3 disaster:-
This level is considered a
minor disaster. These are involves minimal
level of damages.

9.  Level 2 disaster:-
This level is considered a
moderate disaster. The local and community
resources has to be mobilized to manage
this situation.

10.  Level 1 disaster:-
This level is considered as a
massive disaster. This involves a massive
level of damage with severe impact.

11. PHASES OF A DISASTER
There are three phases to any disaster.
The actions of emergency personnel and
other health professional depend on which
phase of the disaster is at hand.
 Pre impact phase
 Impact phase
 Post impact phase

12. PRE IMPACT PHASE
Pre impact phase is the initial phase of the
disaster, prior to the actual occurrence. A
warning is given at the sign of the first
possible danger to a community.
Many times there is no warning but with the
aid of weather net work and satellites many
meteorological disasters can be predicted.

13. IMPACT PHASE
The impact phase occurs when the disaster
actually happens. It is a time of enduring
hardship or injury and of trying to survive.
 This is a time when individuals help
neighbors and families at the scene a time
of ‘holding on’ until outside help arrives.

14. POST IMPACT PHASE
Recovery being during the emergency phase
and ends with the return of normal
community order and functioning. For a
person in the impact area this phase may
last a life time

15. IMPACTS OF DISASTER
Physical impacts :-
 Injury
 Disabilities
 Infectious diseases
Social impacts:-
 Robbery
 Insecurity
 Loss of shelter leads to wandering
 Rape
 Lack of food and, water leads to death due to
starvation.
 Poverty

16. Environmental impacts:-
Due to geographical hazards there
were more changes in the environment;
destruction of agriculture, pollution results
from the dead bodies of animals,
communicable diseases results from fecal
contamination of drinking water and food.

17. Economical impacts:-
 Financial crisis and poverty results from the
disaster
Psychological impacts:-
 Anxiety
 Crisis, grief
 Depression
 Phobic disorder
 Post traumatic stress disorder
 Inter personal conflicts
 Impaired performance

19. PRINCIPLES OF DISASTER MANAGEMENT
The eight basic principles are as follows
 Prevent the occurrence of disaster whenever
possible
 Minimize the number of casualties if the
disaster cannot be prevented
 Prevent further causalities from occurring
after the initial impact of the disaster

20.  Rescue the victims
 Provide first aid to the injured
 Evaluate the injured to medical facilities
 Provide definitive medical care
 Promote reconstruction of lives

21. GOALS OF DISASTER MANAGEMENT
 To prevent or minimize death
 Prevent disability
 Prevent or minimize the loss or suffering

22. PHASES OF DISASTER MANAGEMENT
Preparedness
Response
phase
Recovery
phase
Rehabilitation
phase
Prevention
phase

23. PREVENTION (MITIGATION) PHASE:-
 Mitigation includes the activities that
prevent a disaster, reduce the chance of a
disaster happening, or reduce the
damaging effect of unavoidable disasters.

24. PREPAREDNESS PHASE:-
Emergency preparedness is a program of
long term development activities whose
goals are to strengthen the overall capacity
and capability of a country to manage
efficiently all types of emergency.

25. RESPONSE PHASE:-
 The level of disaster varies and the
management plans mainly based on the
severity or extend of the disaster. It
include,
 Identifying patients and documenting patient
information
 Triage of Disaster victims
 Managing internal problems
 Communicating with the media and family

26. RECOVERY PHASE:-
This phase begins when assistance from
outside starts to reach the disaster area.
During this phase actions are taken to
repair, rebuilt or reallocate damaged homes
and businesses and restore health and
economic vitality to the community.

27. REHABILITATION PHASE:-
 The final phase in a disaster should lead to
restoration of the pre disaster conditions.
Rehabilitation starts from the very first
moment of a disaster. Too often measures
decide in a hurry, tend to obstruct re-
establishment of normal conditions of life.

28. TRIAGING
 Triage is the sorting of causalities to
determine priority of health care needs
and the proper site for treatment.
 In non disaster situations, health care
workers assign a high priority and allocate
the most resources to those who are the
most critically ill. But in disaster the
health care provider faced with a large
number of casualities.ie. mass causality.

29. TRIAGE CATEGORIES
 Triage categories separate patients
according to severity of injury and use a
color-coded tagging system so that the
triage category is immediately oblivious.
 There are several triage systems in use
across the country, and every nurse should
be aware of the system used by his or her
facility and community.

30.  The North Atlantic Treaty Organization
(NATO) triage system is one that is widely
used and is presented here.
 It consists of four colours red, yellow,
green and black. Each colour signifies a
different level of priority.

31. TRIAGE CATEGORY TYPICAL CONDITIONS COLOUR
Immediate:-
Injuries are life threatening
but survival with minimal
intervention.
Individuals in this group survive
with minimal intervention.
Individuals in this group can
progress rapidly to expectant if
treatment is delayed
Sucking chest wound, airway
obstruction secondary to
mechanical cause, shock,
hemothorax, tension
pneumothorax, asphyxia, unstable
chest and abdominal wounds, in
complete amputations, open
fractures of long bones and 2nd or
3rd degree burns of 15-400C total
body surface area.
RED

32. TRIAGE CATEGORY TYPICAL CONDITIONS COLOUR
Delayed:-
Injuries are significant and
require medical care, but can
weight hours without threat to life
or limb. Individuals in this group
receive treatment only after
immediate causalities are treated
Stable abdominal wounds
without evidence of significant
hemorrhage soft tissue
injuries, maxillofacial wounds
without airway compromise
vascular injuries with adequate
collateral circulation,
genitourinary tract disruption
fractures requiring open
reduction, debridement and
external fixation most eye and
CNS injuries
YELLOW

33. TRIAGE CATEGORY TYPICAL CONDITIONS COLOUR
Minimal:-
Injuries are minor and
treatment can be delayed hours to
days. Individuals in this group
should be moved away from the
main triage area.
Upper extremity fractures
minor burns, sprains, small
lacerations without significant
bleeding, behavioral
disorders or psychological
disturbances.
GREEN

34. TRIAGE CATEGORY TYPICAL CONDITIONS COLOUR
Expectant:-
Injuries are extensive and
chances of survival are unlikely
even with definitive care. Persons
in this group should be separated
from other causalities but not
abandoned. Comfort measures
should be provided when possible.
Unresponsive patients with
penetrating wounds, high
spinal code injuries, wound
involving multiple anatomical
sites and organs, 2nd and 3rd
degree burns in excess of
60% of body surface area,
seizures or vomiting within 24
hours.
BLACK

35. DISASTER MANAGEMENT – NURSE’S ROLE IN
COMMUNITY
Assess the community
Assess the local climate conductive for
disaster occurrence, past history of disaster in
the community, available community disaster
plans and resources, personnel available in the
community for the disaster plans and
management, local agencies and organizations
involved in the disaster management activities
availability of health care facilities in the
community.

36. Diagnose community disaster threats
Determine the actual and potential
disaster threats eg: explosions, mass
accidents, tornados, floods, earthquakes
etc.

37. Community disaster planning
 Develop disaster plan to prevent or deal
with identified disaster threats.
 Identify local community communication
system
 Identify disaster personnel including
private and professional volunteers, local
emergency personnel, agencies and
resources

38.  Identify regional back agencies and personnel
 Identify specific responsibilities for various
personnel involved in the disaster plans
 Set up an emergency medical system and
chain for activation
 Identify location and accessibility of
equipment and supplies
 Check proper functioning of emergency
equipments
 Identify out dated supplies for appropriate
use.

39. Implement disaster plans
 Focus on primary prevention activities to
prevent occurrence of manmade disasters
 Practice community disaster plans with all
personnel carrying out their previously
identified responsibilities (eg: emergency
triage, providing supplies such as food, water,
medicines, crises and grief counseling)
 Practice using equipment obtaining and
distributing supplies.

40. Evaluate effectiveness of Disaster plan
 Critically evaluate all aspects of disaster
plans and practice drills for speed,
effectiveness gaps and revisions
 Evaluate the disaster impact on community
and surrounding regions
 Evaluate the response of personnel
involved in disaster relief efforts.

41. DISASTER MANAGEMENT COMMITTEE:-
The following members would comprise the disaster
management committee, under the chairmanship of
medical superintendent / director.
 Medical superintendent / director
 Additional medical superintendent
 Nursing superintendent / chief nursing officer
 Chief medical officer (causality)
 Head of departments – surgery, medicine,
orthopedics, radiology, anesthesiology, neurosurgery.
 Blood bank in charge
 Security officers
 Transport officer
 Sanitary personnel

42. RAPID RESPONSE TEAM :-
 The medical superintendent will identify
various specialists, nurses and
pharmacological staff to respond within a
short notice depending up on the time and
type of disaster.
 The list of members and their telephone
numbers should be displayed in the disaster
control room(ie. existing causality may be
referred as the disaster control room)

43. INTERNATIONAL AGENCIES PROVIDING
HEALTH HUMANITARIAN ASSISTANCE.
 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.

44.  Several international or regional agencies
have established special funds, procedures
and offices to provide humanitarian
affairs (OCHA), World Health
Organization (WHO), UNICEF, World
Food Programme (WFP), FAO.

45.  Inter governmental organizations are
European Community Humanitarian office
(ECHO), Organization of American States
(OAS), centre of co-ordination for
prevention of natural disasters in central
America, Caribbean Disaster Emergency
Response Agency. Some Non Governmental
Organizations are CARE, International
committee of REDCROSS, International
Council of Voluntary Agencies (ICVA).