DISASTER PREPAREDNESS & MANAGEMENT

DISASTERS

“Any natural or human-made event that causes a level of destruction or emotional trauma exceeding the ability of those affected to recover withoutcommunity assistance.”

• May be human-made or natural

Often there is interplay between the two, making it difficult to capture in data

• Vast variation in the geographic distribution and types of disasters globally

Influenced by environmental, sociopolitical, and topographic factors

NATURAL DISASTERS

“Environmental phenomena that have the potential to impact societies and the human environment.”

• Includes droughts, floods, earthquakes, storms, extreme temperatures, volcanoes, wildfires, tornados, glacial lake outbursts, mass movements (dry or wet)

• Global distribution & impact vary substantially from year to year due to many complicated and interwoven sociopolitical, environmental, and topographical factors

HUMAN-MADE DISASTERS

Caused by human activity

• Includes mass shootings, bombing, riots, nuclear reactor meltdowns, industrial accidents, oil spills, construction accidents, air, train, and bus crashes

• Also includes terrorism and warfare—-Dangerous acts that are injurous to human life, informed by extreme political positions, Coercion or intimidation that affects government

TERRORISM & WARFARE

• Typically involves biological or chemical agents, explosives, or incendiary devices

• Bioterrorism: intentional use of biologic agents or microorganisms to bring about death by contaminating water or air——anthrax, botulinum, bubonic plague, Ebola, smallpox

• Chemical Warfare: using chemicals to cause confusion, debilitation, death, or destruction—-explosive, nerve agents (sarin), blister agents (mustard gas), choking agents (ammonia/chlorine), or riot-control agents (tear gas, pepper spray)

• Nuclear attack: use of nuclear weapons or destruction of a nuclear plant

Casualty

someone who has been injured or killed by or as a direct result of an accident or natural disaster

Multiple casualty incidents

more than two but fewer than 100

Host

the individual impacted by the disaster

• Individual-level factors that may either be protective from or make someone more susceptible to injury, death, or displacement

Environment

the greater ecological and social context in which the disaster occurs

• Community-level factors that can exacerbate or mitigate the impact of disaster

Agent

the natural or human-made cause of disaster

Four Phases of Disaster Management

• Mitigate

• Prepare

• Respond

• Recover

• Mitigate

MITIGATE

• Prevent future emergencies or minimize their effects—-reduce or eliminate risk from hazards, primarily happen before disasters

• Focus both on built environment and behavior/knowledge of the community

• Public and instuitional policies that modify the causes of disasters or minimize their effects on people, property, and infrastructure——building codes, zoning requirements, business continuity plans for essential services, immunization education/mandates

MITIGATATION:NURSING ACTIONS

• Primary prevention strategies

• Conducting community needs assessments in partnership with community

• Policy advocacy for health protective policies

• Providiing education and resources to individuals that promote safety health—Vaccine education, Violence prevention

PREPARE

• Improve individual and community reactions and responses to disaster so that effects are minimized

• Happens before disaster

• Focus both on training and public education—-Disaster exercises, all hazards education campaigns

• Resource reserves & allocation

PREPARATION:NURSING ACTIONS

• Primary prevention strategies—Community education (where to go/what to do in event of disaster—disaster assembly & dissemination)

• Participate in and lead disaster exercises

• Registration with disaster agencies

Respond

React to a catastrophic event or emergency

• Happens during disasters, as soon as they begin

Focus on resource coordination and management

• Often provided via an Incident Command System

RESPONSE:NURSING ACTIONS

• Primarily secondary prevention strategies

• Earliest possible detection and treatment

• Scene Survey

• Prompt Treatment of those impacted—-rescue, triage, stabilization, transportation, treatment at local hospitals, supportive care for relief workers, ensuring safety of the extended community from hazards

RESPONSE PHASENURSING ACTIONS: TRIAGE

• Black—Deceased/Non-Salvagable

• Red—Immediate

• Yellow—Delayed

• Green—Walking wounded/minor

Are they walking?
Are they breathing?
Are they tachypneic?
Are they perfusing?
Are they mentating?
⟶ evaluated in 30-60 seconds

RECOVER

• Repair and rebuild following disaster

• Happens after disasters and lasts until community’s economic and civil life are restored

• Focus on restoring infrastructure, addressing trauma, and rehabilitating injuries within the community

RECOVERY:NURSING ACTIONS

• Primarily tertiary prevention strategies

• Treat/care for those injuries and support their recovery

• Treat/care for those with psychological trauma—-seeking therapy, support groups, addressing post-traumatic stress

RECOVERY PHASE
PHASES OF PSYCHOLOGICAL REACTION TO DISASTER

Developed by SAMHSA (Substance Abuse and Mental Health Services Administration)

• Heroic: Intense excitement and concern for survival—often a rush of assistance from outside the area

• Honeymoon: Affected individuals begin to bond and relive their experiences

• Disillusionment: Responders and affected individuals can experience depression and exhaustion

• Reconstruction: Involves adjusting to a new reality and continued rebuilding of the area

Local-Level Agencies

• First to respond

• In Philadelphia: Office of Emergency Management (local governmental agency)

Federal Emergency Management Agency (FEMA)

• Federal-level governmental agency, part of Department of Homeland Security (DHS)

• Provides resources, funds, and technical assistance to those experiencing disasters or those preventing/preparing for disasters

• Oversees National Incident Management System (NIMS)

Guides governmental agencies, non-governmental organizations, and private sector agencies in working together during disaster response

American Red Cross

• Non-governmental agency that provides nationwide disaster assistance

• Extensive training programs for both medical professionals and concerned citizens

Department of Homeland Security

Coordinates national security efforts, responds to terrorism