LU 1.7 Disaster Management

What is disaster ?

• an incident that occurs in a sudden manner & complex in its nature

• resulting in loss of lives, damages to property & affecting daily activities of the local community

What is mass casualty incident (MCI) ?

• any incident in which emergency medical services resources are overwhelmed by the number & severity of casualties

What are the type of disaster & major incident ?

• natural

• human & technology related

• hybrid

What are the disaster management level ?

• Level 1 (District) : i) Localised, controlled by local authorities & no potential of spreading ii) using their own facilities & resources

• Level 2 (State) : i) More serious, covering wide area or more than two districts & has potential of spreading to other areas ii) state level assists in terms of financial, assets & human resources

• Level 3 (Central) : i) More complex, covering wide area or more than two states ii) central level assists in terms of financial, assets & human resources iii) assistance from foreign countries

What are the disaster phases ?

• Mitigation : activities that reduce or eliminate a hazard (eg: public education)

• Preparedness : activities taken to handle a disaster when it strikes (eg : emergency communication plan)

• Response : activities taken by hospitals immediately before, during, and after a disaster occurs

• Recovery : getting a community back to its pre-disaster status (eg : debris removal)

What are the vital information in hospital disaster activation phase ?

• ETHANE

• Exact location

• Type of event

• Hazards

• Access

• Number of casualties

• Emergency rescue services

What are the specific zones or centers establish during hospital activation phase ?

• Emergency operation center (operation room) : coordination of all activities

• Non-clinical areas (at ETD) : patient reception & triage area, treatment area, body holding area, emergency & trauma department control

What are the hospital disaster activation phases ?

• standby : warned of impending disaster , prepare for yellow alert

• full emergency (yellow alert) : requiring help from on call staff, stage of multiple casualties

• disaster (red alert) : function disruption of all department, further mobilization of staff & facilities

• all clear (stand down) : disaster relief effort ceased, back to normal function, debriefing

What are the role & responsibility of On-site medical commander (OMC) ?

• setting up a medical base station

• monitoring triage & treatment at scene

• ensure adequate documentation of injuries & treatment given

• update situation to hospital

• declared stand down

Who are the On-site medical team ?

• triage officer

• treat (red/yellow/green team leader & paramedics)

• transport officer

• forensic activities

What are the TRIAGE objective ?

• ensure unstable or potentially unstable patients are seen & treated urgently

• ensure those who are not likely to deteriorate could wait safely for care

What is START ?

What are the only 2 occasions that treatment is rendered ?

• obstructed airway, sucking chest wound, tension pneumothorax, flail chest, massive hemothorax

• major external & internal bleeding, burns > 20% BSA, pericardial tamponade

What is disaster nursing ?

• a specialized field focused on caring for individuals, families and communities affected by disasters

• it includes mitigation, preparedness, response, recovery activities

What are disaster nurses must be able to do ?

• assess and prioritize patient needs in emergencies

• manage triage and mass casualty situations

• prevent and control infections

• provide psychological support

What are the 10 essential roles of nurses in disaster management ?

1. preparedness : actively participate in drills to improve disaster response plans

2. mitigation : assess community hazards

3. response : lead triage to prioritize care for the most vulnerable

4. recovery : offer ongoing medical care for survivors

5. leadership and advocacy : conduct research and raise public awareness

6. documentation : maintain accurate records of patient care and disaster events'

7. community assessment : evaluate the needs of affected community

8. lead in public health campaign and disease prevention

9. capacity building and training : train fellow nurses in disaster response

10. ensure ongoing care for chronic and vulnerable patients

What are the unique skills and attributes of nurses in disasters ?

• clinical expertise for immediate assessment and care

• triage skills for prioritizing patients efficiently

• emotional support during trauma and crisis

• effective communication with patients, communities, teams

• ethical decision-making in challenging situations

• cultural sensitivity for respectful care delivery