Disaster Nursing

Disaster Nursing

Types of Disasters

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  • Mass casualty incidents

  • Terrorism

  • Natural disasters

  • Outbreaks

  • Epidemics

  • Pandemics

  • Biologic, chemical, and nuclear or radiation incidents

Question and Answer Set

Question #1

  • Is the following statement true or false?

    • Nurses don’t typically work with patients involved in natural disasters.

Answer to Question #1

  • False

  • Rationale:

    • Disaster nurses’ responsibilities include:

    • Preparing for the management of patients affected by various disasters.

    • This encompasses natural disasters, outbreaks, epidemics, and pandemics.

Regulatory Agencies and Preparedness

  • Federal agencies

    • Incident Command System

  • State and local response agencies

    • American Red Cross

    • Metropolitan Medical Response Team

    • Office of Emergency Management

Emergency Operations Plan (EOP)

Essential Components of the Plan

  • First Set of Essential Components:

    • An activation response

    • An internal and external communication plan

    • A coordinated patient care plan

    • Security plans

    • Identification of external resources

    • Management plan for people and traffic flow

  • Second Set of Essential Components:

    • Data management strategy

    • Demobilization response

    • After-action report or corrective plan

    • Plan for practice drills

    • Anticipated resources

    • Mass casualty incident (MCI) planning

    • Education plan

Initiating the Emergency Operations Plan

  • Key Actions:

    • Identifying patients and proper documentation

    • Triage processes

    • Management of internal problems

    • Communicating with media and families

    • Managing media requests for information

    • Caring for affected families

    • The nurse’s role in emergency response

    • Stress management strategies in crises

The Nurse’s Role in Disaster Response

  • Variability of the Nurse’s Role:

    • Nurses may be required to perform duties beyond their typical expertise, including:

    • Intubation

    • Insertion of chest tubes

    • Suturing

    • May assume responsibilities as a triage officer.

    • Nurses must strive to maximize patient safety.

    • Awareness of state regulations is critical.

Ethical Conflicts in Disaster Response

  • Critical ethical considerations include:

    • Assisted suicide

    • Confidentiality

    • Informed consent

    • Medical duty of care

    • Futile therapy situations

    • Rationing of medical care

    • Resuscitation decisions

Managing Behavioral Issues in Disaster Response

  • Common Behavioral Issues:

    • Anxiety

    • Compassion fatigue

    • Depression

    • Impaired work performance

    • Interpersonal conflicts among staff

    • Posttraumatic stress disorder (PTSD)

    • Somatization symptoms (e.g., fatigue, general malaise, headaches, gastrointestinal disturbances, skin rashes)

    • Substance use disorder among staff and patients

Personal Protective Equipment (PPE)

  • Purpose of PPE:

    • To protect healthcare providers from various hazards (chemical, physical, biologic, and radiologic) when caring for contaminated patients.

Categories of Protective Equipment

  • Level A:

    • Self-contained breathing apparatus (SCBA)

    • Vapor-tight chemical-resistant suit, gloves, and boots

  • Level B:

    • High level of respiratory protection (SCBA)

    • Lesser skin and eye protection; chemical-resistant suit

  • Level C:

    • Air-purifying respirator

    • Coverall with splash hood

    • Chemical-resistant gloves and boots

  • Level D:

    • Typical work uniform

Question #2

  • What is level A protective equipment?

    • Options include descriptions for various levels of protective equipment.

Answer to Question #2

  • Correct Answer:

    • Self-contained breathing apparatus (SCBA) and vapor-tight chemical-resistant suit, gloves, and boots

  • Rationale:

    • Level A protection is required when there is a need for the highest level of respiratory, skin, eye, and mucous membrane protection.

    • This includes wearing an SCBA and a fully encapsulating vapor-tight suit with appropriate gloves and boots.

Triage

  • Definition:

    • The process of sorting patients to assess priority health care needs and determine proper treatment site.

  • Differentiation in Situations:

    • In normal circumstances, healthcare workers assign highest priority and resources to the most critically ill.

    • During disasters, triage decisions factor in the likelihood of patient survival and resource allocation.

Color-Coded Triage Categories

  • Categories:

    • Red: Immediate care needed

    • Yellow: Delayed injuries

    • Green: Minimal care needed

    • Black: Expectant or deceased patient

  • SALT Triage System:

    • A specific method used for disaster triage management.

Question #3

  • What is the name for the triage category in which injuries are significant but can wait hours for treatment?

    • Options: Delayed, Expectant, Immediate, Minimal

Answer to Question #3

  • Correct Answer:

    • Delayed

  • Rationale:

    • Delayed injuries (identified by triage color yellow) are serious but can wait for hours without immediate threat to life or limb.

Natural Disasters

  • Patient Arrival Patterns:

    • Patients typically arrive in three waves:

    • Minimally injured individuals

    • Severely injured individuals

    • Rescued individuals

    • Characteristics of walking wounded:

    • Require shelter and water.

    • Need for veterinary assistance for animals affected.

Outbreaks, Epidemics, and Pandemics

  • Definition of Terms:

    • Outbreak:

    • An occurrence of a disease within a population that exceeds what is normally expected.

    • Can relate to communicable diseases or exposure to various toxins.

    • Epidemic:

    • A widespread outbreak of a specific infectious disease from a single source, exceeding anticipated impact levels.

    • Pandemic:

    • An epidemic that spans multiple countries or continents.

  • Key Actions:

    • Identify the source of illness.

    • Recognize that manifestations of the disease may vary depending on the source.

Weapons of Terror

  • Terrorism Definition:

    • Systematic use of violence designed to create fear.

  • Blast Injuries:

    • Factors influencing blast injuries include distance from the blast and the type of debris.

    • Four Effects of Blast Injuries: [Details omitted for brevity]

  • Types of Weapons:

    • Biological weapons: e.g., smallpox, anthrax

    • Chemical weapons

    • Nuclear radiation exposure

Question #4

  • Is the following statement true or false?

    • Category A biologic weapons are associated with high mortality.

Answer to Question #4

  • True

  • Rationale:

    • Category A biologic weapons correspond with high mortality and include:

    • Anthrax

    • Botulism

    • Tularemia

    • Dengue

    • Ebola

    • Smallpox

    • Plague

End of Notes