SUDDEN ONSET OF DISASTER-REHABILITATION- HAZARD, Risk ,Vulnerable, Slow onset disaster Rapid onset disaster(Sudden, ) REHABILITATION AND RECONSTRUCTION, COMMON INJURY, ROLE OF REHABILITATION PROFESSIONALS, DISASTER MENTAL HEALTH NURSING, DISASTER RESPONSE TEAMS, Honeymoon period- Period of disillusionment , Period of disillusionment, Nodal Angencies for Disaster management and conclusion

1. SHANMUGA COLLEGE OF
NURSING
SALEM
WORKSHOP ON DISASTER
MANAGEMENT

2. SUDDEN ONSET OF DISASTER-
REHABILITATION
SELVARAJ.P
DEPARTMENT OF PSYCHIATRIC NURSING
SHANMUGA COLLEGE OF NURSING
SALEM-7

3. MEANING
• Etymologically, the term "Disaster" is derived from
the Greek world,
• Dis-meaning "bad" and "aster" meaning "star."
• The root of the word disaster (“bad star” in Greek)
• It stems from an astrological sense, blaming the
positions of the planets for bad omens and impacts.

4. DEFINITION
• “A disaster is an occurrence disrupting the normal
conditions of existence and causing a level of suffering
that exceeds the capacity of adjustment of the affected
community” (WHO-2017)
• “it is a sudden, calamitous event that seriously disrupts
the functioning of a community or society and causes
human, material, and economic or environmental
losses that exceed the community’s or society’s ability
to cope using its own resources.” (IFRC)

5. SOCIAL DEFINITION OF DISASTER
• It is that it’s a natural or anthropogenic occurrence
arising with little or no warning and causing serious
disruption in the functioning of the society or
community's lives, livelihoods, surrounding ecology,
and the environment with disruption in economic
activities.

6. When is an incident considered a
disaster?
• The outcome of the triggering event by its effects on
human and environment decides whether this is a
disaster or not. The factors affecting the disaster
outcome
1) Scope Of The Impact,
2) Speed Of The Impact,
3) Duration Of The Impact, And
4) Social Preparedness of the community.

7. HAZARD
• “A hazard is an agent which has the potential to
cause harm to a vulnerable target” .
• In disaster medicine, it is: “A Hazard is a potential
source of harm or adverse health effect on a person
or persons”
• For example, during a flood many people drown or
are injured, lose their animals and their property.

8. Risk
• “someone or something that creates or suggests a hazard”
• it is: “risk is the likelihood that a person may be harmed or
suffers adverse health effects if exposed to a hazard.
• Poor Construction Of Buildings,
• Inadequate Protection Of Assets,
• Lack Of Public Information,
• High Levels Of Poverty And Education,
• Lack Of Preparedness and measures,

9. Vulnerable
• “capable of or susceptible to being wounded or
hurt” .
• it as “the diminished capacity of an individual or
group to anticipate, cope with, resist and recover
from the impact of a natural or man-made hazard
• For example, a building with multiple floors may be
more vulnerable to shaking from an earthquake and
more likely to collapse than a one-story building.

11. CLASSIFICATION OF DISASTER
• On the basis of the speed of the onset
1. Slow onset disaster
2. Rapid onset disaster(Sudden)

12. Slow onset disaster
• One That Emerges Gradually Over Time. Slow-onset
disasters could be associated with, e.g., drought,
desertification, sea-level rise, epidemic disease .
• This leaves ample time and warning systems.
• Slow onset is frequently the result of a confluence
of events rather than a single event.
• It can take days, months, or even years to turn into
a disaster.

13. SUDDEN ONSET OF DISASTER
• A sudden-onset disaster is one triggered by a
hazardous event that emerges quickly or unexpectedly.
• Hazards that arise suddenly, or whose occurrence
cannot be predicted far in advance, trigger rapid-onset
disasters
• Earthquakes, tsunamis hurricanes, typhoons, wind
storms and associated storm surges floods volcanic
activity landslides.

14. • Have a limited warning—the warning time can be
seconds or, at best, a few minutes.
• Preparedness and mitigation potential are relatively
low, so causality and sudden casualties are usually
high compared to slow onset.

15. CHARACTERISTICS OF SUDDEN ONSET
• Lack of preparedness –This result in insufficient time to
prepare to reduce loss or causalities. Disaster management
may start only after the occurrence of events.
• Sudden and severe intensity- They produce immediate
and severe intensity on people and property.The intensity
would be high because they would occur unexpectedly
• A short period—Usually it may take a short period to
create a severe impact. EG: air crash, tidal waves.

16. • The damages -The lack of preparation increased
vulnerability, and the location or time, location of
accident increased damage to people and property.
• Risks on mitigation-Do not give much time. As a
pre-disaster measure, it is very effective in
managing any disaster, but in a rapid occurrence,
the mitigation has less scope, and therefore it
affects the mitigation of disasters and increases the
vulnerability.

17. • More localised but intense-These are more local
but have intense impacts on people and their
suffering.
• Disaster severity and political unrest-
failure to strictly apply the law, lack of public and
workforce education on disaster risks, poor urban
planning; unstable security situations; citizen
intervention; the endowment of equipment, tools,
and infrastructure; and lack of funding.

18. • 100ல் இருந்து 10ஐ எத்தனை
முனை கழிக்க முடியும்?
• How many times can you subtract 10
from 100?

20. DISASTER MANAGEMENT
• It is a discipline that involves preparing, supporting, and
rebuilding society when natural or human-made
disasters occur
• Planning,
• Organizing,
• Coordinating, And
• Implementing For Prevention, Preparedness,
Mitigation, Response,
• Rehabilitation, Reconstruction, and Capacity Building.

22. REHABILITATION AND RECONSTRUCTION
• Resumption of services for returning to normalcy while
implementing preventive measures in order to
minimize the impact in the event of a disaster event
occurs, takes months to years depending on the
response processes.
• In this stage, save the undamaged issues, restore the
restorable, and try to go back to pre-disaster condition.
• Work to fix and rebuild the health-care facility is done
in this stage.

23. COMMON INJURY
• The type of hazard and a range of other factors, such as
time of day, building quality, local preparedness and
level of health infrastructure
• Fractures
• Limb amputations
• Spinal Cord Injury
• Traumatic Brain Injuries*
• Soft tissue injuries (including burns)
• Peripheral nerve injuries

24. • Fractures -simple pelvic, lumbar, rib, and ankle
manipulation Fractures . Generally, fractures are
more likely to be managed conservatively or
fixed with external fixation.
• Amputations: Selection of level may be influenced
by locally available prosthetic provision.. Some
techniques such as myoplasty . Transport and Early
Stabilisation

25. • Spinal cord injury- immobilize the spine as gently and
quickly as possible using a rigid neck collar and a rigid
carrying board, which they use during transport to the
hospital.
• Brain injuries-Minor head injuries will be treated and
observed by its symptoms that may include pain
medication of headache and medications for nausea
and vomiting.
• If the person's breathing and heart rate are normal, but
the person is unconscious,. Stabilize the head and neck.

26. • Burns and soft tissue injuries-Cool the burn with
cool or lukewarm running water for 20 minutes as
soon as possible after the injury.
• Never use ice, iced water, or any creams or greasy
substances like butter. Keep the person warm. Use a
blanket or layers of clothing, but avoid putting them
on the injured area.

27. • Rehabilitation of Peripheral Nerve Injuries in Disasters
and Conflicts
• Oedema Management.
• Pain Management.
• Range of Motion.
• Positioning and Splinting.
• Graded Progressive Exercise.
• Weight-Bearing.
• Psychological Considerations.
• Patient and Family Education.

28. ROLE OF REHABILITATION PROFESSIONALS
• The assessment of need for rehabilitation
• The mapping of available rehabilitation and other
specialist services for those with injuries and/or
disabilities.
• The provision of acute rehabilitation, including
orthopaedic, neurological, respiratory and burns
rehabilitation, either in local hospitals, the
community, or as part of foreign medical teams.

29. • The provision of holistic education of patients,
carers and other health personnel
• Triage and referral
• The coordination of discharge and follow up
• The provision of psycho-social support or referral to
appropriate services.
• The provision or replacement of assistive devices

30. • Assessment of environments (such as camps) and
environmental adaptation to ensure accessibility for
those with injuries and disabilities.
• Preventative care for the elderly, people with
chronic health conditions and those with disability,
affected by the disaster.
• The identification or assessment of people at
increased risk, such as the elderly or those with
disability.

31. • The provision of musculoskeletal rehabilitation or
manual handling training and support to other
professionals involved in the response
• A holistic approach is important in areas where
resources are stretched or access to care is limited.
• Therapists may find themselves needing broad
rehabilitation skills, but also need to be aware of
wider clinical and social issues patients may face,
including psychosocial concerns.

32. DISASTER MENTAL HEALTH NURSING
• To meet the bio psychosocial needs of victims and
communities as they experience different periods of
the recovery process.
• Heroic period- immediately after the disaster,.
Victims may require medical care as well as crisis
intervention to meet their immediate bio
psychosocial needs

33. • Honeymoon period- 4 weeks to 6 months after the
disaster,
• when victims develop a strong sense of unity
through shared experiences of a catastrophic
disaster.
• Clients may require interventions for clinical
symptoms of psychiatric disorders such as anxiety,
posttraumatic stress disorder (PTSD), or unresolved
grief

34. • Period of disillusionment -- may last up to 2 years
after the disaster.
• Clients may require psychosocial interventions if
patience is exhausted; dissatisfaction, frustration,
anger, or violence occurs; or clinical symptoms of
disorders such as depression or alcoholism evolve

35. • Period of reconstruction -- may last for several
years.
• Nurses may utilize interventions such as
empowerment techniques to help victims regain
self-confidence and courage toward restoring their
lives

36. DISASTER RESPONSE TEAMS
• Mental health specialists,
• Victim advocates,
• Public safety individuals,
• Members of the clergy,
• Volunteer their services
• The most essential element of psychiatric–mental
health intervention during a crisis or disaster is the
ability of the nurse to provide emotional support

37. INTERVENTION
STEP-1 PSYCHOSOCIAL AND LETHALITY ASSESSMENT
• A detailed head-to-toe assessment of the victim
including the availability of the support system, medical
needs, current stressors, current use of alcohol and
drugs, and coping resources.
• A rapid triage assessment is necessary for cognitive,
emotional, and behavioural aspects.
• A lethality assessment is required to determine suicidal
thoughts or potential harm to oneself or others

38. • STEP 2: ESTABLISHING RAPPORT AND A
RELATIONSHIP WITH THE SURVIVOR:
• A worker should try to establish rapport with the
survivor by communicating with genuineness,
respect, and acceptance.
• Furthermore, nonverbal techniques such as eye-to-
eye contact, a nonjudgmental attitude, and positive
mental attributes aid in the development of
interpersonal relationships with survivors.

39. • STEP 3: IDENTIFYING THE MAJOR ISSUES AND
CRISIS PRECIPITANTS
• Intervention should focus on current health
problems that precipitated the crisis situation.
• Workers should explore to find an answer to why
and how.
• It is equally important to prioritize the problems. In
terms of seriousness and the need for action
required.

40. • STEP 4 DEALS WITH FEELINGS AND EMOTIONS.
• Workers should allow the survivor to vent his or her
feelings.
• The survivor should be asked to narrate the incident
in his or her own words.
• The use of therapeutic communication techniques
such as active listening, exploration, paraphrasing,
probing, and reflecting will help crisis workers
obtain detailed information on the situation.

41. • STEP 5 GENERATES AND EXPLORE ALTERNATIVE
• The client probably achieved the feeling of emotional
balance.
• Now the healthcare workers and clients mutually work
on searching for the alternatives, such as temporary
housing, establishing a no-suicide contract, and brief
hospitalization to ensure safety, etc.
• They also discuss the pros and cons of these
alternatives before making them final.

42. • STEP 6 IMPLEMENT THE ACTION PLAN
• Ensure safety: remove all harmful objects, and make no
suicide contract while the client agrees to maintain his
or her safety.
• Future communication: schedule follow-ups, make
phone calls and subsequent visits, and make a
connection.
• Manage anxiety and sleep: Use medication to treat
panic attacks, anxiety, and sleep disturbances.

43. • Reduce isolation: encourage family members,
friends, and neighbors to be with the survivor to
provide social support.
• Hospitalization: Temporary hospitalization may be
initiated to deal with severely ill victims and to
ensure safety.

44. • STEP7 A POST CRISIS FOLLOW UPS
• Physical condition: nutrition, sleep, and hygiene.
• Psychological Needs: emotional status, thoughts, level
of anxiety, satisfaction with services and treatment, and
counseling.
• Identification of current stressors and ways to manage
them
• Further needs: legal, medical, and housing.
• Booster sessions, along with a follow-up schedule, help
to discuss potential problems and treatment gains.

48. • India is the 7th largest country by area in the world and
the 2nd most populous country, with over 1.39 billion
people. In terms of disasters, India is one of the ten
most disaster-prone countries in the world.
• The country is vulnerable to a large number of natural
and man-made disasters on account of its unique geo-
climatic and socio-economic conditions. It is highly
vulnerable to floods, droughts, cyclones, earthquakes,
landslides, and forest fires.

49. • There are 28 states and 8 union territories in the
country. Of those, 27 of them are more disaster-
prone. This clearly contributes to a situation where
disaster seriously threatens India's economy, its
population, and sustainable development

50. CONCLUSION
• Disaster is a special situation requiring different
management styles and techniques.
• It is mainly the difference in number which exceeds the
resources, and for its proper management there is a
desperate need for planning to recall staff and surge
space and stuff. There are situations which require the
utilization of the entire country’s resources, while
others may even necessitate international aid.