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Disaster Nursing
WORLDS
GREATEST
DISASTERS
Gujarat Earthquake
DISASTERS
Disasters are events that inflict significant damage
to life or property and that substantially
overwhelm the local community’s resources.
DISASTER NURSING
• THE GOAL OF DISASTER NURSING is ensuring
that the highest achievable level of care is
delivered through identifying, advocating, and
caring for all impacted populations
throughout all phases of a disaster
event, including active participation in all
levels of disaster planning and preparedness.
Concept and Meaning of Disaster Nursing
D- Detection
I- Incident command
S- Safety and security
A- Assess
S- Support
T- Triage and treatment
E- Evaluation
R- Recovery
Principles of disaster Nursing
• Prevent the disaster
– Primary prevention
– Secondary prevention
– Tertiary prevention

•
•
•
•
•
•
•

Minimize casualties
Prevent further casualties
Rescue the victims
First aid
Evacuate
Medical care
Reconstruction
Classification of Disaster
• Natural disasters
– Ex: Hurricanes, flood, cyclones, earthquakes, land
slides, wind storm, epidemics and draught

• Man made disasters
– Fire explosion, Accidents of passenger
vehicles, bomb blast, terrorism, riots and violence
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
4. Trauma team and trauma code
5. Management of cardiopulmonary arrest
6. Emergency medicine records
7. Chain of command in the team and system
8. Alternative chains and flexibility standards
9. Procedures involving medico-legal issues
10. Disaster preparedness
11. Disaster drills
12. Infection control measures
13. Quality management of disaster services
Disaster Management cycle/Phases
Preparedness

Prevention
Response

Recovery
Disaster Preparedness
• Personal preparedness
• Professional preparedness
• Community preparedness
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
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
Guidelines/Elements of disaster plans
•
•
•
•
•
•
•
•
•
•
•
•

Chain of authority
Lines of communication
Routes & modes of transport
Mobilization
Warning
Evacuation
Rescue & recovery
Triage
Treatment
Support of victims and families
Care of dead bodies
Disaster worker rehabilitation
Triage Protocol/System
Red: High priority for treatment & transfer
Yellow: Medium Priority
Green: Ambulatory patients

Black: Dead or Moribund patients
Resources for disaster management
•
•
•
•
•
•
•
•

Administrative system
Policies, procedures and protocols
Physical facilities
Components & equipments
Emergency/Disaster medical systems
Staffing and training
Resources for disaster drills
Effective evaluation system
Coordination & involvement of various
Govt. and Non-Govt. organization
• India
– National disaster management authority of India
– Emergency Management and research Institute

• Worldwide
–
–
–
–
–
–

International association of emergency managers
Red cross/red crescent
United Nations
World bank
European union
International recovery platform
Role of Nurse
•
•
•
•
•
•

Assess the community
Diagnose community disaster threats
Community disaster planning
Implement disaster plans
Shelter management plans
Evaluate the effectiveness of disaster plans
Legal aspects of disaster nursing
•
•
•
•
•
•

Licensure
Good Samaritan law
Good rapport
Standard care
Standing order
Written consent for
operation and
procedures

• Correct identity
• Drug maintenance
• Self discharge of the
patient
• Documentation
• Protection of patient
property
• Reporting
Impact on health and after effects
• Social reaction
• Communicable
diseases
• Population
displacements
• Climatic exposure

• Food & Nutrition
• Water supply &
sanitation
• Mental health
• Damage to the
health
infrastructure
Post Traumatic Stress Disorder (PTSD)
• PTSD is a severe anxiety disorder that can
develop after exposure to any event that
results in psychological trauma.

• Symptoms: Flashbacks and nightmares
Diagnosis of PTSD
•
•
•
•

History of exposure to a traumatic event
Persistent re-experiencing
Persistence avoidance and emotional numbing
Persistent symptoms of increased arousal not
present before
• Duration of symptoms for more than 1 month
• Significant impairement
Management of PTSD
•
•
•
•
•

Provide sense of safety
Calm the patient
Improve self efficacy of the patient
Make social connectedness
Give hope
Rehabilitation after Disaster
•
•
•
•
•
•
•
•

Water supply
Food supply
Basic sanitation
Personal hygiene
Physical rehabilitation
Psychosocial rehabilitation
Financial rehabilitation
Relocation
Thank you.

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Disaster nursing / Disaster Management

  • 3.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25. DISASTERS Disasters are events that inflict significant damage to life or property and that substantially overwhelm the local community’s resources.
  • 26. DISASTER NURSING • THE GOAL OF DISASTER NURSING is ensuring that the highest achievable level of care is delivered through identifying, advocating, and caring for all impacted populations throughout all phases of a disaster event, including active participation in all levels of disaster planning and preparedness.
  • 27. Concept and Meaning of Disaster Nursing D- Detection I- Incident command S- Safety and security A- Assess S- Support T- Triage and treatment E- Evaluation R- Recovery
  • 28. Principles of disaster Nursing • Prevent the disaster – Primary prevention – Secondary prevention – Tertiary prevention • • • • • • • Minimize casualties Prevent further casualties Rescue the victims First aid Evacuate Medical care Reconstruction
  • 29. Classification of Disaster • Natural disasters – Ex: Hurricanes, flood, cyclones, earthquakes, land slides, wind storm, epidemics and draught • Man made disasters – Fire explosion, Accidents of passenger vehicles, bomb blast, terrorism, riots and violence
  • 30. 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
  • 31. 4. Trauma team and trauma code 5. Management of cardiopulmonary arrest 6. Emergency medicine records 7. Chain of command in the team and system 8. Alternative chains and flexibility standards 9. Procedures involving medico-legal issues 10. Disaster preparedness 11. Disaster drills 12. Infection control measures 13. Quality management of disaster services
  • 33. Disaster Preparedness • Personal preparedness • Professional preparedness • Community preparedness
  • 34. 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
  • 35. 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
  • 36. Guidelines/Elements of disaster plans • • • • • • • • • • • • Chain of authority Lines of communication Routes & modes of transport Mobilization Warning Evacuation Rescue & recovery Triage Treatment Support of victims and families Care of dead bodies Disaster worker rehabilitation
  • 37. Triage Protocol/System Red: High priority for treatment & transfer Yellow: Medium Priority Green: Ambulatory patients Black: Dead or Moribund patients
  • 38. Resources for disaster management • • • • • • • • Administrative system Policies, procedures and protocols Physical facilities Components & equipments Emergency/Disaster medical systems Staffing and training Resources for disaster drills Effective evaluation system
  • 39. Coordination & involvement of various Govt. and Non-Govt. organization • India – National disaster management authority of India – Emergency Management and research Institute • Worldwide – – – – – – International association of emergency managers Red cross/red crescent United Nations World bank European union International recovery platform
  • 40. Role of Nurse • • • • • • Assess the community Diagnose community disaster threats Community disaster planning Implement disaster plans Shelter management plans Evaluate the effectiveness of disaster plans
  • 41. Legal aspects of disaster nursing • • • • • • Licensure Good Samaritan law Good rapport Standard care Standing order Written consent for operation and procedures • Correct identity • Drug maintenance • Self discharge of the patient • Documentation • Protection of patient property • Reporting
  • 42. Impact on health and after effects • Social reaction • Communicable diseases • Population displacements • Climatic exposure • Food & Nutrition • Water supply & sanitation • Mental health • Damage to the health infrastructure
  • 43. Post Traumatic Stress Disorder (PTSD) • PTSD is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. • Symptoms: Flashbacks and nightmares
  • 44. Diagnosis of PTSD • • • • History of exposure to a traumatic event Persistent re-experiencing Persistence avoidance and emotional numbing Persistent symptoms of increased arousal not present before • Duration of symptoms for more than 1 month • Significant impairement
  • 45. Management of PTSD • • • • • Provide sense of safety Calm the patient Improve self efficacy of the patient Make social connectedness Give hope
  • 46. Rehabilitation after Disaster • • • • • • • • Water supply Food supply Basic sanitation Personal hygiene Physical rehabilitation Psychosocial rehabilitation Financial rehabilitation Relocation