2. Nurses are at the forefront of disasters and
take an active role in the management of
the event. Training and disaster drills are
two ways to help prepare nurses to meet
the patients' and families' needs. The
process for disaster management combines:
Preparation, Response, Recovery and
Mitigation.
3. Emergency and casualty services
Emergency and casualty services of both private and public
hospitals cater to medi- cal, surgical, orthopaedic and all
other types of emergencies round the clock. This
department caters to patients who
1. come on their own.
2. are brought by relatives,
3. are brought by the police,
4. are brought as a result of vehicular accident and
5. are brought due to any other emergency such as
poisoning and falls.
4. Functions of emergency care/casualty
1. To attend to all patients brought to the department and
decide appropriate management, which includes
a. immediate resuscitation,
b. first aid,
c. emergency investigations,
d. hospitalization (Fig. 11.1),
e. referral to specific specialty,
5. f. observation of patient to decide whether he or she
needs admission or whether he or she can go home and
attend appropriate outpatient department and
g. reassurance and short counselling.
2. To carry out medicolegal formalities.
3. To maintain up-to-date list of critically ill patients for
the purpose of
a. issuing one visit pass to relatives,
b. replying to telephone calls,
6. C. deciding on acceptance or rejection of transfer of patient
from other hospitals and
d. assisting in intrahospital transfer.
4. To carry out services of nonemergency nature as per the
policy of the
organization, e.g. evening dispensary, antirabies clinic, etc.
5. To maintain list of doctors on emergency duty, their
availability and alternative arrangements, if they are busy.
6. To be prepared for mass casualties in the event of a
disaster situation.
7.
8. Site, area and design of emergency/casualty
Important areas essential for effective functioning
of casualty services are as follows:
1. Reception or enquiry counter
2. Waiting area for the relatives
3. Space for trolleys and wheelchairs
4. Space for trolley/stretcher boys and ambulance
driver
5. Space for security staff, police constable
6. Space for administrative medical officer or
administrator and night supervisor
7. Space for patient brought dead
9.
10. Definitions of hazard/disaster
1. Hazard is a rare or extreme event in the natural or
human-made environment that adversely affects human
life or activity to the extent of causing a disaster.
2. Any occurrence that causes damage, economic
disruption, loss of human life and deterioration of health
and health services on a scale sufficient to warrant an
extraordinary response from the outside of the affected
community or area is a disaster.
11. Types of hazards/disasters
1. Sudden-onset hazard (geological and climatic hazards):
Earthquakes, tsunamis, foods, tropical storms, volcanic
eruptions, landslides, etc.
2. Slow-onset hazards (environmental hazards): Droughts,
famine, environmental degradation, desertification,
deforestation, pest infestation, etc.
3. Industrial/technological disasters: System
failure/accidents, spillages, explosions, fires, etc.
12. 4. Wars and civil strifes: Armed aggression, insurgency,
terrorism and other actions leading to displaced persons
and refugees.
5. Epidemics: Water and food-borne diseases, AIDS,
vector-borne diseases, etc.
13. Natural disasters
1. Earthquake
2. Floods
3. Drought
4. Volcanic eruption
5. Tropical cyclones
Human made Disasters
1. Nuclear warfare ( When a nuclear
bomb is exploded in the air, it causes
blast heat and radiation)
2. Biological warfare
14. 3. Chemical warfare
4. Conventional warfare: Conventional arms have been
used for a long time and include explosives and fire bombs.
They produce the following effects:
a. Wounds and fractures caused by flying splinters of the
explosives.
b. Rupture of ear drums, lungs and small intestines.
c. Falling buildings may cause multiple injuries and
fractures.
d. Fire caused by the destroyed buildings may cause severe
burns
