Disasters

any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources

disaster

describes a medical situation where the number of casualties exceeds the amount of emergency resources that are immediately available to treat patients

mass casualty incident

a single vehicle accident involving 4 severely individuals, with only two first responders available to help can be classified as

a multiple casualty incident

100 or more individuals involved

mass casualty event

2-100 involved

multiple casualty

someone who experiences the immediate, physical impact of an event, such as suffering injuries, losing their home, or being displaced

direct victim

someone not immediately present but who suffers subsequent emotional, financial, or secondary consequences, such as grieving relatives, responders, or laid-off employees

indirect victim

a group of people who have fled their homes or country as a result of famine, drought, natural disaster, war, or civil unrest

refugees

the ability to determine when and whether a disaster event will occur

predictability

speed

imminence

what are the characteristics of disasters

frequency

predictability

preventability

imminence

scope and number of casualties

intensity

actions taken to reduce loss of life and property

preventability/mitigation

what are the factors that contribute to disaster potential

host factors

agent factors

environmental factors

what are the host factors

age

general health

mobility

psychological factors

socioeconomic factors

natural or technologic element that causes the disaster

agent factors

those that could potentially contribute to or mitigate a disaster

enbironment factors

a core member of the emergency response team that has an affirmative, educated voice of reason

field epidemiologist

advocated for the early initiation of essential public health interventions and disease control programs on the basis of knowledge of the actual and potential distribution of diseases in the population

field epidemiologist

aims to reduce or avoid the potential losses from hazards, assure prompt and appropriate assistance to victims of disaster, and achieve rapid and effective recovery

disaster management

what are the 4 cycles of disaster management

1. prevention and mitigation

2. preparedness

3. response

4. recovery

ongoing process by which governments, businesses, and civil society plan for and reduce the impact of disasters, react during and immediately following a disaster, and take steps to recover after a disaster has occurred

disaster management cycle

Mitigation is made up of

prevention

emergency management

reducing risks before event occurs

personal checklis

emergency supplies kit

personal preparedness

nurse understands workplace and community disaster plans and participated in disaster drills and community mock disasters

professional preparedness

mock disasters

developing evacuation plans

warning systems

strategic reserves

community preparedness

has the capacity to provide large quantities of medicine and medical supplies to protect the american public in a public health emergency

strategic national stockpile

the response stage of disaster begins

immediately after the disaster

efforts to minimize the hazards created by a disaster

response

during the response stage of disaster there is an

onsite incident command

humanitarian organizations are often strongly present in this stage of the disaster management cycle

response

approves resource orders and demobilization

incident command

identifies operational resources that are, or will be, excess to the incident and prepares list for demobilization unit leader

operations section

develops and implements the demobilization plan

planning section

implements transportation inspection program and handles special transport needs

logistics section

processes claims, time records, and incident costs, and assists in release priorities

finance/admin section

identifies the patient and includes information about his or her condition and need for treatment

triage tag

identify and separate individuals quickly according to injury severity and needed treatment

disaster triage

in disaster triage, we focus on

sorting the greatest number as fast as possible

non life threatening injuries

receive care last

“walking wounded”

green tags : minor

condition is stable

no immediate danger of death

triage later may be necessary

requires observation and hospitalization

yellow tags: delayed

most urgent treatment needed

suffered life threatening injuries but has a change for survival if they can get immediate medical attention

red tags: immediate

deceased

injuries so extensive they wont be able to survive given the care that is available

black tags: deceased

acute illness burden and assessment of major and severe comorbidities

sequential organ failure assessment

transition of focus from individual principles of fairness, duty to care, duty to steward resources, transparency, and consistency.

crisis standards of care

Usual patient care space fully utilized

usual staff called in and utilized

cached and usual supplies used

usual care

conventional operating conditions

patient care areas repurposed

staff extension

conservation, adaptation, and substitution of supplies with occasional reuse of select supplies

functionally equivalent care

contingency operating conditions

potential for crisis standards is the indicator to prepare to shift into

contingency conditions

crisis standards of care is the trigger to shift into

crisis conditions

facility non patient care areas used for patient care, physical space is no longer available for clinical care

trained staff unavailable or unable to adequately care for volume of patients even with extension techniques

critical supplies lacking, possible reallocation of life sustaining resources

crisis standards of care

crisis operating conditions

a well coordinated casualty management effort

THREAT

What does THREAT stand for

Treat suppression

Hemorrhage control

Rapid Extrication to safety

Assessment by medical providers

Transport to definitive care

during an MCI, what is the key first step to avoiding additional casualties or injuries

suppressing the threat

occurs when a main artery is rapidly divided and can very quickly result in death id the situation is not handled quickly and efficiently

hemorrhage

in the event of trauma that causes severe bleeding among one or more victims, it is critical to

control bleeding asap

technique designed to quickly transport a patient from an unsafe environment while providing support for the head, neck, torso, and pelvis

rapid extrication

what is a crucial step in minimizing loss of life during an MCI

planning for casualty treatment

assessment can be started

immediately upon arrival of scene using simple triage

point where responders have a clear picture of which individuals need immediate transport to definitive care and which ones have less serious injuries

transport to definitive care

resilience is an example of

primary prevention

crisis intervention is an example of

secondary prevention

referral for treatment is an example of

tertiary prevention

many people want to help

first responders and personnel

heroic phase

feelings of despair if much time has elapsed or failure to receive promise aid

first responders may experience burnout

disillusionment phase

people tell stories of survival

gratitude

honeymoon phase

homes and services restored

sense of normality returning

reconstruction phase

begins when the danger from the disaster has passed and all agencies are present to help victims

cleanup begins

eval and revise disaster plans

recovery phase

what was a characteristic injury of the iraq and afghanistan wars

traumatic brain injury (TBI)

what are the most common causes of TBIs

blast

object hitting head

falls

TBIs are associated with

depression

PTSD

suicidal ideation

what should be assessed for in veterans

PTSD

TBI

unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives

terrorism

what are the different kinds of agents for terrorism

biologic

chemical

nuclear

anthrax, botulinum, bubonic plague, ebola, and smallpox are examples of

biological agents used in terrorism

explosives, nerve, blister, choking, and incapacitating/riot control agents

chemical agents used in terrorism

international terrorism is associated with

political factors

domestic terrorism is associated with

extremist views