UNIVERSITY OF CEBU LAPU-LAPU AND MANDAUE COLLEGE OF NURSING TOPIC: Emergency and Disaster Nursing (Dengue Prevention and

Control) General Objectives: After 30 minutes of lecture-discussion, the Level IV students will be able to acquire advance knowledge, apply basic procedures and appreciate intervention rendered to the community affected with vector borne disease (dengue haemorrhagic fever). SPECIFIC OBJECTIVES Specifically, the students will be able to: 1. list and describe the Five basic phases of disaster nursing five phases of disaster 1. Preparedness or risk assessment phase management. -evaluate the facilities vulnerabilities or propensity for disasters. Issues to consider includes: weather patterns, geographic location, expectation related to public events and gatherings; age, condition, and location of the facility; and industries inclose proximity to the hospital. Lecturediscussion 10 minutes B.Human Resources -students -Clinical Instructor C.Books Tener Goodwin Veenema. Disaster Nursing and Emergency Preparedness for Chemical, Biological, and Radiological Terrorism and CONTENT METHOD OLOGY TIME ALLOTMENT RESOURCES EVALU ATION

A.Materials -laptop -paper -ballpen Quiz

2.

Mitigation

-this are steps that are taken to lessen the impact of a disaster should one occur and can be considered as prevention measures. Examples of mitigation activities include: installing and maintaining back up generator power to mitigate the effects of a power

failure or cross trainnig staff to perform other tasks to maintain services during a staffing crisis that is due to a weather emergency.

Other Hazards.

3. response -this phase is the actual implementation the disaster plan. The best response plans to use an incident command system, are relatively simple, are routinely practice, and are modified when improvement are needed. Response activities need to be continually monitored and adjusted to the changing situation.

4. recovery -once the incidence is over the organization and staff need to recover. In variably, services have been disrupted and it takes time to return to routines. Recovery is usually easier, during the response, some of the staff have been assigned to maintain essential services while others will assigned to the disaster response.

5. evaluation -often this phase of disaster palnning and response receives the least attention. After a disaster, employees and the community are anxious to return to the usual operations. It is essential that a form evaluation be done to determine what went well and what problems were identified. A specific individual should be charge with the evaluation and follow through activities.

2. formulate strategies that can help the community prevent and control dengue haemorrhagic fever utilizing the five phases of disaster management.

1. y

Preparedness or risk assessment phase Absences of piped water, people collect water in large containers varying from 44-gallon drums to open 10,000-gallon concrete tanks. These containers provide the perfect breeding habitat for Aedes mosquitoes. Absence of electricity. Absence of program specific for dengue. Cases was already existing since 1971 Over 3,300 cases affecting 2% of the population. Dengue hemorrhagic fever (DHF) developed in 54 of these cases resulting in 12 deaths. There was minimal partnership between the Public Health Department, the corporate sector, nongovernmental organizations and urban communities. Rainfall patterns are often very local and may vary on small distance. Lack of laboratory surveillance. Minimal health education or community participation. Mitigation Recommendation plan to install piped water in the area. Formulation of dengue awareness health teaching programme. Formulation of dengue prevention and control programme. Develop a health care team to facilitate the dengue prevention and control programme for maintenance. Develop representatives from each of provincial and island groupings to form a joint committee. Recognition of the disease by proper dissemination of information through leaflets. Isolation of affected patients. Epidemiological investigation. Case finding and reporting.

Lecturediscussion

10 minutes

Quiz

y y y y y y y y 2. y y y y y y y y y

3. y y y

Response Coordinated to the government agency/organization regarding the installation of piped water. Developed health care team and visited the community for a health teaching programme. Formulated a dengue prevention and control programme. Public health nursing responsibilities under dengue prevention and control programme: i. Report immediately to the Municipal Health Office any known case outbreak. ii. Refer immediately to the nearest hospital, cases that exhibit symptoms of hemorrhage from any part of the body no matter how slight. iii. Conduct a strong health education program directed towards environmental sanitation the 4-S: S- Search and Destroy. - changing water and scrubbing sides of flower vases once a week. - Destroying breeding places of mosquitoes by cleaning surrounding and properly disposing rubber tires, empty bottles, and cans. - keep water containers covered. - Larvae eating fish - avoid too many hanging clothes inside the house. S- Self-protective measures. - apply mosquito repellent - use mosquito nets. -wear light-colored clothing S- Say no to indiscriminate fogging. S- Seek early consultation. iv. Assist in the diagnosis of suspect based on the signs and symptoms.

y y 4. y y y y y

Conduct epidemiologic investigations as a means of contacting families, case finding and individual as well as community health education. Treatment of the affected people which includes the following: i. For hemorrhage- keep the patient at rest during bleeding episodes. For nose bleeding, maintain as elevated position of trunk and promote vasoconstriction in nasal mucosa membrane through an ice bag over the forehead. For melena, ice bag over the abdomen. Avoid unnecessary movement. If transfusion is given, support the patient during therapy. Observe signs of deterioration such as low pulse, cold clammy perspiration, prostration. ii. For shock- prevention is the best treatment. Dorsal recumbent position facilitates circulation. 1. Adequate preparation of the patient, mentally and physically prevents occurrence of shock. 2. Provision of warmth-through lightweight covers (overheating causes vasodilation which aggravates bleeding). iii. Diet- low fat, low fiber, non-irritating, non-carbonated. Noodle soup may be given. Information dissemination through leaflets and health teachings. Develop representatives from each of provincial and island groupings to form a joint committee. Recovery Continual larval surveys measuring household Continual monitoring for dengue prevention, control and treatment program. Continual updates of information regarding dengue. Continual health teaching programme. Piped water maintenance

v.

5. Evaluation y Presence of evaluating officers for the overall evaluation of programmes. y Evaluation on piped water for leakage. (can be a source of Aedes mosquitoes) y Evaluation on the people of the community for continuing the 4-S

y y

Evaluation on the health care team for efficiency of care rendered to the community. Evaluation on the facilities. Lecturediscussion 10 minutes Public Health Nursing in the Philippines Quiz

3. develop a Dengue Prevention and Control Program community based teaching What is dengue fever? program for the y Dengue is an acute, febrile disease caused by dengue virus. prevention and control on Mode of transmission: dengue. y bite of an Aedes aegypti mosquito. Aedes aegypti mosquito: y A Day biting mosquito y It Breeds on stagnant water (pundo nga tubig) y Limited-flying and low- flying mosquito y Have fine white dots at the base of its wings, with white bands on the legs. Signs and symptoms: 1. Febrile stage(first 4 days) y High fever y Abdominal pain y Headache y Flushing of face y Vomiting y Epistaxis 2. Hemorrhagic stage(4th-7th days) y Lowering of temperature y Severe abdominal pain y Vomiting, hematemesis and melena y Unstable BP y Narrow pulse pressure and shock

3. Recovery stage(7th to 10th days) Generalized flushing with intervening areas of blanching appetite regained and blood pressure already stable. Classification: y Severe, frank type- with flushing, sudden high fever, severe hemorrhage, followed by sudden drop of temperature, and terminating in recovery or death y Moderate- with high fever, but less hemorrhage, no shock y Mild- with slight fever, with or without petechial hemorrhage . Source of infection: y Aedes aegypti or the common household mosquito y The infected person Incubation period: y Probably 6 days to 1 week. Period of Communicability: y Unknown. Presumed to be on the first week of illness when virus is still present in the blood. Susceptibility, Resistance, Occurrence y All persons are susceptible. y But sexes are equally affected. y Age groups predominantly affected are the preschool age and school age. y Adults and infants are not exempted. y Dengue fever usually occurs during the rainy season June-November. y Peak months are September and October

4-S: S- Search and Destroy. - changing water and scrubbing sides of flower vases once a week. - Destroying breeding places of mosquitoes by cleaning surrounding and properly disposing rubber tires, empty bottles, and cans. - keep water containers covered. - Larvae eating fish - avoid too many hanging clothes inside the house. S- Self-protective measures. - apply mosquito repellent - use mosquito nets. -wear light-colored clothing S- Say no to indiscriminate fogging. S- Seek early consultation.

Bibliography Books: y Taleo G, Capuano C and Burkot TR. Dengue control in Vanuatu: towards an integrated vertical and horizontal control programme. Dengue Bulletin, 2000, 24: 11- 17. y y y Muto R. Summary of dengue situation in WHO Western Pacific Region. Dengue Bulletin, 1998, 22: 12-19. Public Health Nursing in the Philippines Tener Goodwin Veenema. Disaster Nursing and Emergency Preparedness for Chemical, Biological, and Radiological Terrorism and Other Hazards.