Ch #17: Disasters

Disasters - Definition

• Any natural or human-made event that causes a level of destruction or emotional trauma exceeding the abilities of those affected to recover from without community assistance

Disasters - Natural Examples

Disasters - Human Made Examples

How can disasters effect community health?

• Premature death, illness, injuries

• Destroy local healthcare

• Psychological, emotional, and social well-being

• Food shortages

• Large population movements

• Frameworks for response

Disaster Characteristics - Casualty Definition

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

Disaster Characteristics - Multiple Casualty Definition

• 2+ but less than 100 casualties as a result of a disaster

• Resources are sufficient to manage

Disaster Characteristics - Mass Casualty Definition

• Incident where now resources and healthcare system is OVERWHELMED

• Need for resources exceeds availability of resources

Disaster Characteristics - Scope Definition

• Range of its effect

• Geographically or in terms of the number of people effected

Disaster Characteristics - Intensity Definition

• Level of destruction and devastation it causes

Directly Impacted - Definition

• Experience the event firsthand

• Dead or the survivors of the event

Directly Impacted - Displaced vs. Refugee Definitions

• Displaced Person = Forced to leave their home to escape effects of disaster

  • Usually temporary

• Refugee = People forced to leave their homeland because of war or persecution

Indirectly Impacted - Definition

• Relatives and friends of persons directly impacted by disaster

• May experience anguish trying to locate loved ones or accommodate their emergency needs

Factors Contributing to Disasters

1. Host → Human being that experiences the disaster

2. Agent Factors → Natural or technologic element that causes the disaster

3. Environmental Factors → Could contribute to or mitigate disaster

Agencies for Disaster Relief

Agencies for Disaster Relief - Red Cross

• Disaster relief free of charge across country

Agencies for Disaster Relief - FEMA

• Oversees the following:

  • National Incident Management System (NIMS) = Allows responders from different jurisdictions and disciplines to act cohesively and proactively

  • Incident Command System (ICS) = Unified approach to incident management that emphasizes preparedness, mutual aid, and resource management

Why is communication so important in a disaster?

• Point of breakdown for communities coping with disaster

• Risk of misinformation and misinterpretation that can result in delayed treatment and increased loss of life

• Clarity and flexibility

In the planning phase of a disaster, what are two major things to be addressed regarding communication during a disaster?

• HOW will information be shared

• WHAT information will be shared

Agencies for Disaster Relief - DHHS

• Federal agency for public and medical services during a public health or medical disaster

• Provide services to state, local, and territorial governments

Phases of Disaster Management

Disaster Management → Phase #1

• Mitigation

Disaster Management: Phase #1 - Mitigation Definition

• PREVENTION

• Prevent future emergencies or minimize their effects

Disaster Management: Phase #1 - Mitigation Actions

• Public policy development

• Development of infrastructures

All actions in the Mitigation phase of a disaster should happen …?

• Before and after a disaster emergency

Disaster Management → Phase #2

• Preparedness

Disaster Management: Phase #2 - Preparedness Definition

• Improving community and individual reaction and responses

• Minimize the effects of a disaster

Disaster Management: Phase #2 - Preparedness Actions

• Plans for communication

• Evacuation and rescue plans

• Victim care plan

• Recovery plans

Disaster Management → Phase #3

• Response

Disaster Management: Phase #3 - Response Definition

• Begins immediately after onset of disaster event and during emergency

• Putting preparedness plans into action

• Goals = Save lives and prevent further injury or damage

Disaster Management: Phase #3 - Response Actions

Disaster Management → Phase #4

• Recovery

Disaster Management: Phase #4 - Recovery Definition

• Repair, rebuild, or relocate after disaster event

• Restore health and social economic

How long could the Recovery phase of a disaster take?

• Months to years

Strategic National Stockpile

• Items acquired in order to be prepared for and to be used in a disaster

When do you stop rescuing during a diasater?

• Increasing danger to rescue workers

• Diminishing number of survivors

• Diminishing possibilities for survival

Disaster Triage - Definition

• RAPID assessment done in 30 to 60 seconds

When is a disaster triage used?

• MCI when the number of casualties is greater than the treatment reources

Disaster Triage Categories - Green

• Walking wounded

Disaster Triage Categories - Yellow

• Delayed care

Disaster Triage Categories - Red

• Immediate care

Disaster Triage Categories - Black

• Deceased

Disaster Triage Categories - Determining Factors

• Ambulation ability → Alone? With help?

• Respirations → Even? Agonal?

• Perfusion → Pulse?

• Mental status

Disaster Triage - Breakdown

Disaster Treatment - Nurses Role

• Give Rx on site, at mobile field hospital, in shelters, or within hospital

• Distribute supplies, food, and beverages

• Adequate, accessible, and safe sanitation

• Psychological and spiritual care to support survivors

Disaster Treatment - In Hospital

• Each hospital will have own emergency plan in place for various scenarios

  • Will run drills to practice

During a disaster, patients will be … again at the hospital?

• Triaged → Split into normal vs. disaster

Disaster treatment includes caring for the … which consists of …?

• Dead

• Identification and safe transport to dead to the morgue or hold facility

• Notification of family members

Six Phases of a Disaster

Disaster Prevention - Primary

• Keeping the disaster from ever happening or minimizing damage

  • Psychologically → Build resilience

Disaster Prevention - Secondary

• Earliest possible detection and treatment

  • Psychologically → Crisis Intervention (CISD session)

Disaster Prevention - Tertiary

• Reducing the amount and degree of disability or damage result from a disaster

  • Psychologically → Referral for treatment or therapy

Terrorism - Definition

• 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 - Agents

• Biologic

• Chemical

• Nuclear

Terrorism Agents - Biological

• Only a small amount is needed to effect thousands of people

Veterans are at risk for TBI that are commonly caused by … and associated with …?

• Blasts, object hitting head, and falls

• Depression, PTSD, and suicidal ideation

Future of RN during a Disaster