Disaster planning and implementation

2. Presented by:
K. Sivasakthi,
M.Sc nursing II nd year,
Con- Pims.

3. Disaster is any occurrence that causes
damage, economic disruption, loss of human
life and deterioration of health and health
service on a scale sufficient to warrant an
extraordinary response from outside the
affected community or area.
-WHO

4. Disaster can be defined as an overwhelming ecological
disruption, which exceeds the capacity of a community to
adjust and consequently requires assistance from outside.
Pan American Health Organisation (PAHO)

5. Natural disaster
Man-made
disaster

6.  Metrological disaster: Storms (Cyclones, typhoons, hurricanes,
tornados, hailstorms, snowstorms), cold spells, heat waves and
droughts.
 Typological Disaster: landslides, avalanches, mudflows and floods.
 Telluric and Teutonic (Disaster originate underground):
Earthquake, volcanic eruptions and tsunamis (seismic sea waves).
 Biological Disaster: communicable disease, epidemics and insect
swarms (locusts).

8.  Warfare: conventional warfare (bombardment, blockade and siege) and
non-conventional warfare (nuclear, chemical and biological).
 Civil disasters: riots and demonstration.
 Accidents: transportation (planes, trucks, automobiles, trains and ships);
structural collapse (building, dams, bridges, mines and other structures);
explosions and fires.
 Technological failures: A mishap at a nuclear power station, leak at a
chemical plant causing pollution of atmosphere or the breakdown of a
public sanitation.

9.  Prevent the disaster
 Minimize the casualties
 Prevent further casualties
 Rescue the victims
 First aid
 Evacuate
 Medical care
 Reconstruction

10. 1. Resource for readiness.
2. Disaster pre planning.

11.  RED CROSS: Its primary concern in a disaster situation is to provide relief for human
suffering in the form of food, shelter, clothing, medical care, and occupational
rehabilitation of victims.
 COMMUNITY AND LOCAL GOVERNMENT: It shares the responsibility in clearing
rubble, maintaining law and order, determining the safety of a structure of habitation,
repairing bridges, resuming transportation, maintaining sanitation, providing safe food
and drinking water, etc.

12. CIVIL DEFENCE SERVICES: The civil defense and its medical
facility programmers provide for shelters, establishing
communication linkage, post disaster services, assistance to
affected community in the area of health, sanitation, maintaining
law and order, fire fighting, clearing debris, prevention and control
of epidemic of various diseases etc.

13. It is important to make the best possible use of the
resources. Some of the pre-planning aspects for disaster
related to medical care as follows

14. Depending upon the hospital‘s location and size, it mobilizes its resources to
manage any disaster. It should provide for immediate action in the event of:
i. An internal disaster in hospital itself eg. fire, explosion, etc.
ii.Some minor external disaster.
iii.Major external disaster.
iv.Threat of disaster.
v.Disaster in neighboring communities/country.

15. There is usually a system which on order of the medical
superintendent, is activated.eg.
i. Percentage of evacuation (discharge) of the patient from the
hospital.
ii.Addition of extra beds.
iii.Preparation of emergency ward.
iv.Such facilities should be near to X-ray, operation theatre,
central supply, medical store, etc.

16.  It is important to minimize confusion in receiving causalities. A team of well qualified
physician and nurses at the reception itself sorts out causalities and make quick decisions
of the treatment.
i. Additional nursing staff volunteers may be called and posted.
ii.Services of all departments of the hospital should be well integrated in the disaster
plan viz. dietary department, laundry, public works department (PWD),
engineering unit, etc.
iii.The planning should also take into consideration other aspects like traffic control,
types of medical records to be maintained, standardization of emergency medical
tags, public information centers, controlled dissemination of information without or
with minimum distortion, preparation of emergency supplies kept ready, all

17. Additional communication system should be planned. It is also
important to keep the hospital informed about the inflow of the
casualties from the scene

19. This refers to the ―REAL TIME event of the hazard occurring and
affecting elements of risk.

20. This refers to the first stage response to any calamity, which include
setting up control rooms, putting the contingency plan in action,
issue warnings, evacuating people to safe areas, rendering medical
aid to the needy, etc.

21. It has three overlapping phases of emergency relief rehabilitation and
reconstructing.

22. Evolving economy and long-term prevention/disaster reduction
measures like construction of houses capable of withstanding the on
slought of heavy rains, wind speeds and shocks of earthquakes.

23. Protective or preventive actions that lessons the scale of impact.
Minimizing the effects of disaster. Eg. building codes and zoning,
vulnerability analyses, public education.

24. Includes the formulation and development of viable emergency
plans, of the warning system, the maintenance of inventories and the
training of personnel.

25. The word triage is derived from French word ―trie which means
sorting or choosing.

26. An effective triage system should be able to achieve the following:
 Ensure immediate medical intervention in life threatening situations.
 Expedite the care of patents through a systematic initial assessment.
 Ensure that patients are prioritised for treatment in accordance with the severity of their medical
condition.
 Reduce morbidity through early medical intervention.
 Improve public relations by communicating appropriate information to friends and relatives who
accompany patients.
 Improve patients flow within emergency departments and/or disaster management situation.
 Provide supervised learning for appropriate personnel.

27. The main principles of triage are as follows:
 Every patient should be received and triaged by appropriate skilled
health-care professionals.
 Triage is a clinic-managerial decision and must involve
collaborative planning.
 The triage process should not cause a delay in the delivery of
effective clinical care.

28. Triage consists of rapidly classifying the injured on the bases of
severity of their injuries and the likelihood of their survival with
prompt medical intervention.

29. A seriously injured patient has one hour in which they need to
receive Advanced Trauma Life Support. This is referred to as the
golden hour

30.  Higher priority is granted to victims who‘s immediate or long term
prognosis can be dramatically affected by simple intensive care.
 Immediate patients are at risk for early death
 They usually fall into one of two categories. They are in shock from
severe blood loss or they have severe head injury
 These patients should be transported as soon as possible

31.  Delayed patients may have injuries that span a wide range
 They may have severe internal injuries, but are still compensating
Delayed patients have:
i. Respirations under 30/minutes
ii. Capillary refill under 2 seconds
iii.Can do-follow simple commands

32. Patients with minor lacerations, contusions, sprains, superficial burns
are identified as - minor/minimal.

33. Morbid patients who require a great deal of attention with
questionable benefit have the lowest priority.
Patients with whom there are signs of impending death or massive
injuries with poor likelihood of survival are labeled as expectant

34.  Red indicate high priority treatment or transfer
 Yellow signals medium priority
 Green indicate ambulatory patients
 Black indicates dead or moribund patients

35. The hospital is an integral part of the society and it has great role to play in
the disaster management.
Internal Hospital disasters like fire, building collapse, terrorism, etc
External disasters like earthquakes, floods, etc

36.  Preparedness of staff, optimising of resources and mobilisation of the
logistics and supplies within short notice
 To make community aware about the hospital disaster plan and benefits of
plan
 Training and motivation of the staff
 To carry out mock drills
 Documentation of the plan and making hospital staff aware about the
various steps of the plan

38. 1. Director of the hospital
2. HOD of accidents and emergency services
3. All heads of the departments
4. Nursing superintendent
5. Hospital administrator
6. Representatives of the staff

39. To prepare a hospital disaster plan for the hospital
To prepare departmental plan in support of the hospital plan
Assign duties to the staff
Establishment of criteria for emergency care
To conduct, supervise and evaluate the training programmes
To supervise the mock drills
Updating of plans as need arises
Organize community awareness programmes, through mass media
Assist in information, education, communication (IEC) programmes in respect of the
disaster preparedness, prevention and management.

40. A. Disaster co-ordinator: Organising, Communicating, Assigning duties,
Deployment of staff, Taking key decisions
B. Administrator: The responsibilities of the administrator is to execute the
authority through the departmental heads
C. Departmental heads: Development of departmental plans
D. Nursing superintendent : Deployment of nursing staff
E. Medical staff: Specific role of rendering medical care both pre-hospital and
hospital care
F. Nursing staff: Nursing care and support critical care

41. Accident and emergency department
Operating department
Critical care units
Radiology departments
Laboratory
Blood bank

42. a) Laundry
b) CSSD
c) Dietary department
d) Housekeeping services
e) Medical records
f) Public relations
g) Communications
h) Transportation
i) Mortuary
j) Medic-social worker
k) Engineering department
l) Security and safety services
m) Media relations

43. DISASTER DRILL
Definition
A disaster drill is an exercise in which people simulate the
circumstances of a disaster so that they have an opportunity to
practice their responses.

45.  Used to identify weak points in a disaster response plan
 To get people familiar with the steps they need to take so that their
response in a disaster will be automatic.

46.  In disaster preparedness
 In disaster response
 In disaster recovery

47.  To facilitate preparation with community
 To provide updated record of vulnerable populations within community
 The nurse should be involved in educating these populations about what
impact the disaster can have on them.
 Nurse leads a preparedness effort
 Nurse can help recruit others within the organization that will help when a
response is required.

48. Contd.,
 Nurse play multi roles in community
 Nurse should have understanding of community resources
 Nurse who sects greater involvement or a more in-depth
understanding of disaster management can be involved in any
number of community organizations such as the American Red Cross,
Ambulance Corps etc.

49.  Nurse must involve in community assessment, case finding and
referring, prevention, health education and surveillance
 Once rescue workers begin to arrive at the scene, immediate plans for
triage should begin.
(a)Higher priority
(b)Second Priority
(c)Last priority

50.  Nurse work as a member of assessment team
 Nurse working as members of an assessment team have the
responsibility of give accurate feed back to relief managers to facilitate
rapid rescue and recovery.
 To be involved in ongoing surveillance

51. 1. Successful Recovery Preparation
2. Health teaching
3. Psychological support
4. Referrals to hospital as needed
5. Remain alert for environmental health

52. Assessment of disaster preparedness by conducting a mock drill in a tertiary care
teaching, research and referral medical institute in South India.
- K. Vamsi Krishna Reddy, Jonnala Sindhu, N. Lakshmi Bhaskar
ABSTRACT
Background: Disaster management occupies an important place in this country's policy
framework as it is the poor and the under-privileged who are worst affected on account
of calamities /disasters. Disasters and mass casualties can cause great confusion and
inefficiency in the hospitals. Hospital disaster drills provides the opportunity to plan,
prepare and when needed enables a rational response in case of disasters/ mass casualty
incidents.

53. Contd.,
Method: A mock drill was conducted to assess disaster preparedness of
the hospital on 15th Sep 2019. Mock drill was done under the supervision
of Department of Hospital Administration. The drill assessed the
functioning of Emergency and other areas in the hospital during disaster
situations. The assessment was done on the basis of a
checklist/questionnaire developed from the “Tool for Evaluating Core
Elements of Hospital Disaster Drills” prepared by The Johns Hopkins
University Evidence based Practice Centre, Baltimore.

54. Contd.,
Results: Thus assessment of drills showed that the Incident Command System
(ICS) and Treatment zone worked effciently but the Restriction Zone and Triage
Zones need to be strengthened and managed more effciently.
Recommendations: There is need to conduct regular drills and their proper
assessment with standardized tools should be done by appropriate authorities
who are well trained beforehand. A table top exercise can help to motivate
hospital staff to learn more about disaster preparedness and can help to teach
staff about aspects of disaster-related patient care in a way that simulates the
practice setting.

57. Book reference:
 Jogindra Vati" Principles and Practice of Nursing Management and Administration ,Jaypee
Brothers Medical Publishers (P)Ltd,2013,NewDelhi,Pg.No:508-515.
 Deepak.K."A Comprehensive Textbook on Nursing Management ", EMMESS
publications, 2nd edition, Pg no:451-461.
Net reference:
 https://www.worldwidejournals.com/indian-journal-of-applied-research-
(IJAR)/fileview/assessment-of-disaster-preparedness-by-conducting-a-mock-drill-in-a-tertiary-
care-teaching-research-and-referral-medical-institute-in-south-
india_January_2020_1577785238_3104528.pdf
 https://www.slideshare.net/PIRATERHINO/disaster-management-ppt