Chapter 19 ppt

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 19: Community
Preparedness: Disaster
and Terrorism

Chapter Highlights
• History of public health nurses and disaster response
• Types of disasters
• Disaster management
• Public health response
• Role and responsibility of nurses in disasters
• Classification of agents
• Field response
• Skill building for field activity

Nursing Roles
• Nurses play an important role in all phases of disaster
response.
• All practicing nurses should become familiar with disaster
phases and their role during an event.
• Public health nurses practice principles of disaster
response on a daily basis.

Question
Is the following statement True or False?
Disasters are considered events that require a swift,
intense response on the part of existing community
resources.

Answer
False
Rationale: Emergencies are considered events that
require a swift, intense response on the part of existing
community resources. Disasters are often unforeseen,
serious, and unique events that disrupt essential
community services and cause human morbidity and
mortality that cannot be alleviated unless assistance is
received from others outside the community.

Emergencies
• Emergencies are considered events that require a swift,
intense response on the part of existing community
resources.

Disasters
• Disasters are often unforeseen, serious, and unique
events that disrupt essential community services and
cause human morbidity and mortality that cannot be
alleviated unless assistance is received from others
outside the community.
• Disasters vary by the following points:
– The type of onset
– The duration of the immediate crisis
– The magnitude or scope of the incident
– The extent that the event affects the community

Three Types of Disasters
• Natural
• Accidental
• Terrorist attacks

Disaster Management
• Preimpact
• Impact
• Postimpact

Preparedness
• Although disasters do not occur with frequency, planning
with vulnerability assessment can reduce the impact on
the community.
• Identification of hazards
• Analysis of vulnerability
• Assessment of risk

Identification of Hazards
• The identification of all existing and potentially dangerous
situations before disasters occur is the first step in
planning for an effective response.
• The types and combination of hazards are unique to a
community.

Analysis of Vulnerability
• Vulnerability analysis predicts who will be affected the
most and identifies community resources that are
available for a response.

Assessment of Risk
• Using the comprehensive data gathered from hazard
identification and vulnerability analysis, the probability of
adverse health effects due to a specific disaster can be
calculated.
• This is often represented as a low, medium, or high risk.

National Response Framework
• Framework that guides how the nation conducts all-
hazards incident response

Mitigation
• Mitigation is an effort to prevent identified risks from
causing a disaster.
• Mitigation involves efforts to lessen the impact of a
disaster by initiating measures to limit damage, disease,
disability, and loss of life among the members of a
community.

Question
All response begins at the state level, where the disaster
management plan is implemented and responders are
deployed.

Answer
False
Rationale: All response begins at the local level, where
the disaster management plan is implemented and
responders are deployed.

Response
• Incident command system
– Common organizational structure implemented to
improve emergency response
• National Incident Management System
– Structured, flexible framework that guides the
response to disasters at all levels of governments,
private companies, and nongovernmental
organizations

Recovery
• Recovery is the stabilization of the community and the
return of the disaster area to its previous status.

Adverse Health Effects After Any Kind of
Disaster
• Continuing death, chronic illness, and/or disability
• Population shift if recovery is prolonged
• Contamination of food and water supplies, with an
increased risk of infectious diseases
• Collapse of local and regional health care access
• Increased need to provide mental health services—
“psychological first aid” for disaster victims and
responders

Evaluation
• Foundation for evidence-based disaster response
• Following a thorough review of the responses, a final
report is prepared with recommendations for improving
emergency response in the future.

Roles of Nurses in Disaster Management
• Public health nurses as first responders
• Just in time training
• Field triage
• Point of distribution plans
• Personal protective equipment
• Documentation in a disaster
• Skill building for disaster response

Bioterrorism
• History
• Categories of bioterrorism agents
– Can be easily disseminated or transmitted from
person to person
– Result in high mortality rates
– Have the potential for major public health impact
– Might cause public panic and social disruption, and
require special action for public health preparedness

Detection of a Bioterrorism Event
• Anthrax
• Botulism
• Plague
• Smallpox
• Tularemia
• Viral hemorrhagic fevers

Chemical Disasters
• Unlike biological agents, which require an incubation
period before symptoms appear, a chemical agent, when
released, makes its presence known immediately through
observation (explosion), self-admission (accidental), or
the occurrence of rapidly emerging symptoms, such as
burns, difficulty breathing, or convulsions.

Role of Nurses in a Chemical Disaster
• Stay or go, the evaluating factors include the following:
– The hazardous material involved
– The population threatened
– The time span involved
– The current and predicted weather conditions
– The ability to communicate emergency information

Shelter-in-Place
• Shelter-in-place is used for short duration incidents,
when moving would result in a greater hazard, or it is
impractical to evacuate.

Question
Evacuation, where people in a hospital or residential
facility may be moved to another floor or area within the
facility, may occur.

Answer
False
Rationale: Evacuation occurs when there is potential for
massive explosions and fire as well as for long–duration
events. Invacuation, where people in a hospital or
residential facility may be moved to another floor or area
within the facility, may occur.

Evacuation
• Evacuation occurs when there is potential for massive
explosions and fire as well as for long–duration events.
• Invacuation, where people in a hospital or residential
facility may be moved to another floor or area within the
facility, may occur.

Radiological Disasters
• The health outcome depends on the following:
– The amount or dose of radiation absorbed
– The type of radiation
– The route of exposure
– The length of time exposed to the dose
• Dirty bombs

Public Health Disaster Response
• Scope and magnitude of response
• Communication during a disaster
• Recovery and after action evaluation

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