EDN Module I: Overview of Emergency and Disaster Nursing

Module I. Overview of Emergency and Disaster Nursing

EMERGENCY

Any sudden illness or injury that is perceived by the client or signicant other as requiring immediate intervention. It continues until the condition is stable and no longer threatens the client’s integrity or well-being

A perilous situation that arises suddenly and threatens the life or welfare of a person or group of people, as a natural disaster, medical crisis, or trauma situation

EMERGENCY RESCUE

A procedure for moving a victim from an unsafe place to a place of safety

EMERGENCY CARE

An episodic and crisis-oriented care provided by healthcare professionals to patients with serious or potentially life threatening injuries or illnesses

emergency nurse

establishes priorities

monitors and continuously assesses acutely ill and injured patients

supports and attends to families

supervises allied health personnel

teaches patients and family within a time-limited, high pressured care environment

nursing intervention

accomplished interdependently, in consultation with or under the direction of a licensed physician or nurse practitioner.

team

entire emergency health care staff members work as a _______ in performing the highly technical, hands-on skills required to care for patients in an emergency situation

Golden rules in giving emergency care

• Do obtain consent when possible

• Do think of the worst.

• Do remember to identify yourself to the victim

• Do provide comfort and emotional support

• Do respect the victim’s modesty and physical privacy

• Do be as calm and as direct as possible

• Do care for the most serious injuries first

• Do assist the victim with his or her prescription medication

• Do keep onlookers away from the injured person

• Do handle the victim to a minimum

• Do loosen tight clothing

• Do not let the victim see his/her own injury

• Do not leave the victim alone except to get help

• Do not assume that the victim’s obvious injuries are the only ones.

• Do not make unrealistic promises

• Do not trust the judgment of a confused victim and don’t require to make decision

Noah’s ark

firrst description of disaster and its management comes from

dus

Grk. bad

aster

Grk. star

dus and aster

calamity due to a bad position of a star or planet

disaster

An emergency with greater magnitude, longer duration, generally lower outcomes

A serious disruption of the functioning of a community or society involving widespread human, material, economic, or environmental losses and impacts, which exceed the ability of the affected community or society to cope using its own resources

American Red Cross

“An occurrence, either natural or manmade that causes human suffering and creates needs that victims cannot alleviate without assistance”

Disaster meaning by?

D - Destruction

I - Incidents

S - Sufferings

A - Administrative & Financial Failures

S - Sentiments

T - Tragedies

E - Eruption of Communicable Diseases

R - Research Programme and its Implementation

DISASTER acronym

natural disasters

An event caused by a natural hazard, which refers to a natural process or phenomenon that can result in loss of life, property damage, and environmental impact.

ex: Meteorological, Topographical, Environmental

natural

man-made

2 general types of disasters

Meteorological Disaster

Violent, sudden and destructive change to the environment related to, produced by, or affecting the earth's atmosphere, especially the weather-forming processes.

Examples: FLOODS, TYPHOON, TSUNAMI, HURRICANE, SNOW STORM, HAIL STORM, BLIZZARD

Topographical Disaster

The disasters that take place due to changes in the arrangement of natural and artificial physical features of a region.

Examples: EARTHQUAKES, VOLCANIC ERUPTIONS, LANDSLIDES, AVALANCHES, LIMNIC ERUPTIONS

Environmental Disaster

The realization of hazards to serious impacts, damages. and losses, initiating in some or the other environmental systems or resources. These hazards are related to various environmental processes and systems.

Examples: GLOBAL WARMING, DROUGHT, EL NINO, OZONE DEPLETION-UVB RADIATION, SOLAR FLARE

MAN-MADE DISASTERS

Those in which the principal direct causes are identiable human actions, deliberate or otherwise.

Ex: Technological, Industrial, Warfare and Violence

Technological Disasters

Large numbers of people, property, community infrastructure, and economic welfare are directly and adversely affected by major industrial accidents; unplanned release of nuclear energy; and fires or explosions from hazardous substances such as fuel, chemicals, or nuclear materials.

Ex. Transport Failure, Public Place, Cyberattacks. Fire

Industrial Disasters

Disasters caused by any chemical, mechanical, civil, electrical, or other processes.

The failure caused by an accident, negligence, or incompetence at an industrial plant can spread to areas inside or outside the plant, cause loss of life and property, and harm the environment.

Ex. chemical spills, radioactive spills, pollution

Warfare and Violence Disasters

Caused by sociopolitical conflicts that escalate into violence.

Ex. War, terrorism, civil unrest, mass shooting, CBRNE (Chemical, Biological, Radiological, Nuclear, and high-yield explosives)

Chemical, Biological, Radiological, Nuclear, and high-yield explosives

CBRNE in warfare and violence

Disaster Nursing

It is the care given to individual, families, groups, and communities affected by disaster to preserve health and prevent illness and other health complications brought about by the crisis.

It is the adaptation of professional nursing knowledge, skills, and attitude in recognizing and meeting the nursing, health and emotional needs of disaster victims.

Society for Advancement of Disaster Nursing (2021)

organization that said “Nurses are critical assets to disaster planning and response initiatives. Their unique skill sets are ideal for helping those affected by a disaster as are their abilities to organize, prepare families in advance, and communicate across discipline.”

provide acute patient care

helping treat the sick and injured

ensure access to basic health care services

role of nurses during disaster

Triage patients

Evacuate or transfer patients to another unit or facility.

Communicate with patients, volunteers, and healthcare workers.

Coordinate activities with outside agencies and volunteers.

Help set-up makeshift facilities with limited technologies and medical supplies.

Provide emotional support/psychological first aid.

other roles of nurses during a disaster

PRE-IMPACT PHASE, IMPACT PHASE, POST-IMPACT PHASE

phases of disaster

emergency setting

Do the best for each individual

disaster setting

Do the greatest good for the greatest number, MAXIMIZE SURVIVAL

PRE-IMPACT PHASE

It is the initial phase of disaster, prior to the occurrence a warning is given at the sign of the first possible danger.

objective of pre-impact phase

Prevent the loss of lives and minimize impact to health system

IMPACT PHASE

Disaster actually happens; it is the time of enduring impact phase hardships or injury and trying to survive. “holding on” until help arrives.

This phase may last for several minutes to several days or weeks

objective of impact phase

Save as much lives as possible

POST-IMPACT PHASE

Recovery begins during the emergency phase and ends with both the return of normal community order and functioning.

This phase can last a lifetime onto some survivors due to the gravity of results of the disaster

objective of post-impact phase

Prevent and control post disaster morbidities

DISASTER MANAGEMENT

It is defined as the organization and management of resources and responsibilities for dealing with all the humanitarian aspects of emergencies, in particular preparedness, response and recovery in order to lessen the impact of disaster. (International Federation of Red Cross and Red Crescent Societies, 2020).

An applied science which seeks, by systemic observation and analysis of disasters, to improve measures relating to prevention, emergency response, recovery and mitigation.

Encompasses all aspects of planning for, and responding to disasters, including both pre and post disaster activities

• Prevent the occurrence of disaster whenever possible.

• Provide first aid to the injured.

• Provide definitive medical care.

• Disaster management is the responsibility of all sphere of government.

• Rescue the victims and minimize the number of casualties if the disaster cannot be prevented.

• Evacuate the injured to medical facilities.

• Disaster management planning should focus on large scale events.

• Promote reconstruction of lives

Principles of Disaster Management (8)

Assess the Community

Diagnose Community Disaster Threats

Community Disaster Planning

Implementation of Disaster Plan

Evaluate Effectiveness of Disaster Plan

Roles of Nurses in Disaster Management (5)

ASSESS THE COMMUNITY

• Is the current community disaster plan in place?

• Previous disaster experience?

• How is the local terrain conductive to disaster formation? (typhoon, floods, eruptions)

• What are the local industry?

• What personnel and local agencies and organizations available for disaster interventions? (medical personnels, hospital, community volunteer rescuers, schools, Red Cross)

DIAGNOSE COMMUNITY DISASTER THREATS

• Determine actual and potential disaster threats (e.g. toxic waste, explosions, road accidents, oods, typhoon, earthquakes).

COMMUNITY DISASTER PLANNING

• Develop a disaster plan to prevent or deal with identified disaster threats.

• Identify local community communication system.

• Set up of an emergency medical system and chain of activation.

IMPLEMENT DISASTER PLAN

• Focus on primary intervention activities to prevent occurrence of man-made disaster.

• Practice using equipment, and obtaining and distributing supplies

EVALUATE EFFECTIVENESS OF DISASTER PLAN

• Critically evaluate all aspects of the disaster plan and practical drills for speed, effectiveness, gaps and revision.

• Evaluate the disaster impact on the community and surrounding regions.

• Evaluate response of personnel involved in disaster relief efforts.

MITIGATION, PREPAREDNESS, RESPONSE, RECOVERY

FOUR PHASES OF DISASTER MANAGEMENT

MITIGATION

• Improved reconstruction

• Legislative planning

• Regularly scheduled vulnerability & risk assessments

PREPAREDNESS

• Threat assessment

• Resource assessment acquisition

• Inter- and intra-jurisdictional cooperation

• Drills & exercises

• Writing a plan

RESPONSE

• Activation of emergency protocol

• Medical assistance and rst aid

• Shelter & evacuation

• Search & Rescue

• Secondary damage reduction

RECOVERY

• Damage assessment Cleanup

• Restoration of critical systems & facilities

• Providing temporary basic needs

• Basic reconstruction