SEMINAR ON DISASTER NURSING

SUBMITTED TO: BY:

SUBMITTED

GENERAL OBJECTIVE At the end of the seminar the group will be able to understand about the Disaster Nursing and apply it in daily practice.

SPECIFIC OBJECTIVE At the end of seminar, the group will be able to;1. Meaning of disaster and hazard. 2. Explain the types of disaster. 3. Discuss the phases of disaster. 4. Explain the dimensions of disaster. 5. Describe the triage system of disaster management. 6. Explain stages of disaster and the role of nurse in disaster management. 7. Describe role of Community Health Nurse in Disaster Response. 8. Explain role of Community Health Nurse in Disaster Recovery.

hardship borne by population and the percentage of their GNP lost. in 2001 alone. if the consequences of the many smaller and unrecorded disasters that cause significant losses at the local community level were to be taken into account. the loss of lives and property due to disasters has not decreased. Natural disasters are not bound by political boundaries and have no social or economic considerations. Since 1991. as a result of which the impact of natural disasters is now felt to a larger extent. while just 2 percent were from highly developed nations. With the alarming rise in the natural disasters and vulnerability per se. . They are also merciless and as such the vulnerable tend to suffer more at the impact of natural disasters. natural disasters of medium to high range caused at least 25. increasing losses on account of urbanization and population growth. These figures would be much higher. They are borderless as they affect both developing and developed countries. more than double the previous year and economic losses of around US $36 billion.000 deaths around the world. there has been considerable concern over natural disasters. Those living in developing countries and especially those with limited resources tend to be more adversely affected. two-third of the victims of natural disasters was from developing countries. According to the United Nations. For example. In fact. the developing countries are much more seriously affected in terms of the loss of lives. Even as substantial scientific and material progress is made. There has been an increase in the number of natural disasters over the past years and with it. the human toll and economic losses have mounted. the world community is strengthening its efforts to cope with it.INTRODUCTION Presently at the global level.

DISASTER FACTORS • Agent • It is the physical item that actually causes the injury or destruction. dam failures. • Host: . heat. hurricanes. food. resource shortage (e. tsunamis. Natural disasters include droughts.g. TYPES Disaster is an occurrence. bombing and riots). • Primary and secondary agents will vary according to the type of disaster. ecological disruption. Primary agents include falling buildings. • Man-made disasters includes hazardous substance accidents (e.. blizzards. loss of human life or deterioration of health and health services on a scale sufficient to warrant and extraordinary response from outside the affected community or area (WHO. either natural or man-made that causes human suffering and creates human needs that victims cannot alleviate without assistance. radiologic accidents. tornadoes. • landslides and mudslides. terrorism. chemicals. wind. electricity and water). Disasters can be natural & man-made. forest fires.MEANING Disaster means that any occurrence that causes damage. floods and volcanic disruptions. toxic gases). earthquakes. Bioterrorism. structural fire and explosions and domestic disturbances (e. rising water and smoke..g. Secondary agents include bacteria and viruses that produce contamination or infection after the primary agent has caused injury or destruction.g. 1995)..

changes in roles. Psychological factors are closely related to agent. or lack of refrigeration owing to interrupted electrical services. . improper food storage. biological and social factors. Host factors include age. soil. degree of mobility and emotional stability. • Psychological factors contribute to the effect of the disaster on individuals. and the questioning of religious beliefs are social factors to be examined after a disaster. ground water or food supplies. chemical. immunization status. insect or rodent proliferation. Host factors are those characteristics of humans that influence the severity of the disaster's effect. weather conditions. • contaminated water. improper waste disposal.• The host is human kind. host and environmental conditions. The existence and length of a warning period and physical proximity to the actual site of the disaster influence the amount of psychological distress experienced by victims. The nature and severity of the disaster affect the psychological distress experienced by victims. • Chemical factors influencing disaster outcome include leakage of stored Biological factors are those that occur or increase as a result of chemicals into the air. The closer an individual is to the actual site of the disaster and the longer the individual is exposed to the immediate site of the disaster. pre-existing health status. • Physical factors include the time when the disaster occurs. the greater the psychological distress that individual will experience. • Environment: • Environmental factors that affect the outcome of a disaster include physical. • Social factors are those that contribute to the individual's social support systems. Loss of family members. the availability of food and water and the functioning of utilities such as electricity and telephone service.

but with the aid of weather networks and satellites. A warning is given at the sign of the first possible danger to a community. The earliest possible warning is crucial in preventing loss of life and minimizing damage. members may not take future warnings very seriously. radio and television stations and any available method to alert the community and keep it informed. Emergency centers are opened by the local Civil Defense Authority. This is a time when individuals help neighbors and families at the scene. sleep disorders and muscular weakness. • Impact Phase: The impact phase occurs when the disaster actually happens. The community must be educated to recognize the threat as serious. disaster personnel will call on amateur radio operators. Communication is a very important factor during this phase. a time of "holding on" . Psychosomatic complaints and mental illness are also responses to disaster situations and are evidenced by loss of appetite. prior to the actual occurrence. This is the period when the emergency preparedness plan is put into effect. The role of the nurse during this warning phase is to assist in preparing shelters and emergency aid stations and establishing contact with other emergency service groups. Many times there is no warning.• Individuals may suffer impaired intellectual functioning. It is a time of enduring hardship or injury and of trying to survive. have difficulty concentrating. many metrological disasters can be predicted. or making decisions and experience impaired memory. When communities experience false alarms several times. PHASES OF A DISASTER • Pre-Impact Phase: The pre-impact phase is the initial phase of the disaster. fatigue. intestinal upset.

The victims of a disaster go through four stages of emotional response: 1. will understand the problem but may seem unaffected emotionally. 2. It serves as the center for communication with other government agencies.g. the type and number of needed disaster health services anticipated and the general health status and needs of the community must be evaluated. in a flood. victims of the atomic bombing of Hiroshima). Strong emotional response: In the second stage. Common reactions during this stage are trembling. Denial: During the first stage. heightened sensitivity. The victim may want to retell or relive the disaster experience over and over. this is the time when the Emergency Operation Center (EOC) is established and put in operation.. the person is aware of the problem but regards it as overwhelming and unbearable. weeping. sadness. tightening of the muscles. The impact phase continues until the threat of further destructions has passed and the emergency plan is in effect. The problems created by the disaster are being denied or have not fully "registered. . and passivity. restlessness. sweating. The number of persons requiring shelter. The impact phase may last for several minutes or for days or weeks (e. If there has been no warning. the center for recruitment of health care providers to staff shelters • Post impact Phase: Recovery beings during the emergency phase and end with the return of normal community order and functioning.g.. extend and geographical area of the disaster. The EOC is the operating center for the local chapter of the American Red Cross. famine or epidemic). This phase must provide for preliminary assessment of the nature.until outside help arrives. more likely. speaking with difficulty. the victim may deny the magnitude of the problem or. For persons in the impact area this phase may last a lifetime (e. anger." The victim may appear unusually unconcerned.

floods. Man-made disasters. weather-related disasters (e. they appear more often in certain geographical locations.3. time and scope or intensity... Recover: The fourth stage represents a recovery from the crisis reaction. while others. Predictability: Some events are more easily predicated then others. These dimensions influence the nature and possibility of preparation planning. have made it more feasible to accurately predict the probability of certain types of natural. tornadoes. authorities and emergency personnel have more time to prepare for situation than when an event is not foreseeable (i. the victim begins to accept the problems caused by the disaster and makes a concentrated effort to solve them. Residents of the coastal area live in what is commonly referred to as cyclone are at greater risk for experiencing later greater risk for earthquakes. frequency.e. are not as easily predicted. as well as response to the actual event. A sense of well-being is restored. are also less predictable. Advances in meteorology. It is especially important for victims to take specific actions to help themselves and their families. Frequency: Although natural disasters are relatively rare. for example. Acceptance: During the third stage. Victims develop a realistic memory of the experience. The ability to make decisions and carry out plans returns.g. spontaneous). such as earthquakes. and people who live near large river systems are at greater risk for . controllability. Whenever an event is predictable. and hurricanes). Routines become important again. Victims feels that they are back to normal. such as explosions or weeks. He or she feels more hopeful and confident. DIMENSIONS OF A DISASTER Disasters have a number of dimensions in which they may differ: predictability. 4.

or less intense. and by deliberately blasting dikes and dams to divert flood waters to less populated areas. A disaster can be very intense and highly destructive. Nurses . the speed of onset of the disaster. Time: There are several characteristics of time as it relates to the impact of a disaster. THE NURSING ROLE IN DISASTERS • Disaster nurses play key leadership and service provision roles in planning and implementing disaster relief efforts. Scope and Intensity: A disaster may be concentrated in a very small area or involve a very large geographical region. • During a disaster many environmental health problems emerge. the time available for warning the population. causing many injuries. preventing technologic disasters. and the actual length of time of the impact phase. with relatively little damage done to property or individuals. others do not. usually affecting many more people. The immediate impact on people was reduced by the ability of emergency personnel to organize evacuations and reduce the risk of injury and death. The scope and magnitude of these problems determines the nursing role. and property damage. such as the physical and emotional stress of disaster victims. deaths. and addressing problems that occur during a disaster. Emergency planners were able to control some of the effects of the flooding by sandbagging levees and river or sea banks to reduce the effects of water damage.flooding than people who live elsewhere Controllability: Some situations allow for pre warning and control measures that can reduce the impact of the disaster.

g.g. industrial or agricultural pollutants. nationally? • How is the local climate conducive to disaster formation (e. nurses make numerous referrals to community agencies for a variety of needs including psychologic care. tornadoes. statewide.collaborate with community agencies and officials to recognize and reduce disaster risks and maximize the health and safety of individuals involved in disaster crises. emergency medical teams)? • What are the locally available disaster resources (e. mudslides)? • What are the local industries? • Are there any community hazards (e. churches.g. mass transportation problems)? • What personnel are available for disaster interventions (e. volunteers. formula.g. dentists. schools. forest fires.g. income. Red Cross)? • What is immediately available for infant care (e. food. clothing.. blizzards)? • How is the local terrain conducive to disaster formation (e.g. emergency medical. flooding. clergy.. The communicable disease implications of disasters are also immense: Assess the Community • Is there a current community disaster plan in place? • What previous disaster experiences has the community been involved with locally. • Following a disaster. hospitals.. earthquakes. doctors.. hurricanes. diapers) and care .. toxic waste and chemical spills. pharmaceutical)? • What are the local agencies and organizations (e. pharmacists.. shelter. and home.. emotional support services. avalanches. Recovery encompassed dealing with many disaster effects such as loss of life. nurses. and treatment for victims and their families.g.

• Set up an emergency medical system and chain for activation. emergency triage. • Identify a local community communication system. • Evaluate Effectiveness of Disaster Plan . earthquakes).. crises and grief counselling). diabetes. Check proper functioning emergency equipment. • Identify disaster personnel. providing supplies such as food. • Practice using equipment. Implement Disaster Plan • Focus on primary prevention activities to prevent occurrence of man-made disasters. including private and professional volunteers. Community Disaster Planning • Develop a disaster plan to prevent or deal with identified disaster threats. explosions. Identify outdated supplies and replenish for appropriate readiness.g. and resources. agencies. water. • Identify specific responsibilities for various personnel involved in disaster coping and establish a disaster chain of command. • Identify regional backup agencies. cardiovascular)? • Diagnose Community Disaster Threats • Determine actual and potential disaster threats (e. Identify location and accessibility of equipment and supplies. personnel. obtaining and distributing supplies. blizzards. local emergency personnel. toxic waste spills. medicine.of the elderly and disabled? • What are the most salient chronic illnesses in the community that will need immediate attention (e. tornadoes.. floods.g. arthritis.g. hurricanes. mass transit accidents.. • Practice community disaster plans with all personnel carrying out their previously identified responsibilities (e.

Effective mitigation includes recognizing and preventing potential technologic disasters and being adequately prepared should such events occur.g. Disasters such as floods.. reduce the chance of a disaster happening. . and local industry. nurses. and Early warning systems alert the public to the probability of immediate danger and help to reduce the impact of predictable disaster such as hurricanes or tornadoes. To plan effectively for disaster prevention the nurse needs to have community assessment information. They may also provide information on an evacuation plan or other immediate actions that improve the chance of survival and reduce the probability of injures. preparedness. • Evaluate response of personnel involved in disaster relief efforts. The primary goals of disaster management are to prevent or minimize death. or reduce the damaging effects of unavoidable disasters.g. PHASES OF DISASTER MANAGEMENT It has been identified that there are four phases of disaster management which include:.. response. doctors. including knowledge of community resources (e. Mitigation Mitigation includes my activities that prevent a disaster. and revisions.• Critically evaluate all aspects of disaster plans and practice drills for speed. and volunteers). and recovery. gaps. hurricanes. tornadoes. Nurses have a key role in disaster mitigation by working with local. emergency medical teams. which serve as a model for community disaster preparations and nursing interventions. emergency services.mitigation. and clinics). dentists. • Evaluate the disaster impact on community and surrounding regions. effectiveness. pharmacists. hospitals. state and federal agencies in identifying disaster risks and developing disaster prevention strategies through extensive public education in disaster prevention and readiness. community health personnel (e. community government officials.

saving the greatest number of lives is the most important goal. Triage is a French word meaning "sorting" or "categorizing.disability. or they will be ineffective and possibly detrimental a disaster victims. Evacuate the injured to medical facilities. Minimize the number of casualties if the disaster cannot be prevented. the goal is to maximize the number of survivors by sorting the treatable from the untreatable victims. Provide first aid to the injured. Promote reconstruction of lives. In a disaster. Rescue the victims. It is critical that rescue workers use these principles in proper sequence. . Provide definitive medical care. Prevent further casualties from occurring after the initial impact of the disaster. TRIAGE There are several times during the emergency response in which triage may be necessary to best determine the needs of injured victims. the potential for survival and the availability of resources are the primary criteria used to determine which patients receive immediate treatment. In a disaster situation. Preparedness PRINCIPLES OF DISASTER MANAGEMENT There are eight fundamental principles that should be followed by all who have a responsibility for helping the victims of a disaster. suffering and loss on the part of disaster victims. Triage may take place during the rescue operation at the scene of the disaster." The term first came into use during World War 1 when casualties were sorted during battle. The eight basic principles are as follows (Grab and Eng 1969): Prevent the occurrence of the disaster whenever possible. During a disaster.

Conflicts arise between family and work-related responsibilities. Probably the best and most easily understood four-category system is the first-priority. Prioritising of victims for treatment can be done in many ways. A disaster worker who is not well is of little service to his or her family. and other disaster victims. Nurses who take disaster preparation seriously will take the time to read and understand workplace and community disaster plans and will participate in disaster drills and community . second-priority. Personal preparedness can help case some of the conflicts that will arise and allows nurses to attend to client needs sooner that one may anticipate. third-priority. clients. second priority Green . the community health nurse who will be assisting in disaster relief efforts must be as healthy as possible.most urgent.urgent. first priority Yellow . Professional Preparedness • Professional preparedness requires that nurses become aware of and understand the disaster plans at their workplace and community. both physically and mentally. some communities use color coding. Preparedness Personal Preparedness Great stress is placed on the nurse with client responsibilities who also becomes a disaster victim. In addition.dying/dead STAGES OF DISASTER AND THE ROLE OF NURSES 1.third priority Black . and dying-or-dead system: Red .and again at each stage of transport for the disaster victims.

The more adequately prepared nurses are.mock disasters. One certain factor about disaster is that change is a constant. Some communities remain vigilant as to the possibility of a disaster hitting their community and stay prepared by having a solid disaster plan on paper and by participating in yearly mock disaster drills ROLE OF THE COMMUNITY HEALTH NURSE IN DISASTER RESPONSE • The role of the community health nurse during disaster depends greatly on the nurse's past experience. • Although valued for their expertise in community assessment. is flexibility. Personal items that are recommended for any nurse preparing to help in a disaster include the following • A copy of their professional license • Personal equipment. such as a stethoscope • A flashlight and extra batteries • Cash • Warm clothing and a heavy jacket (or weather-appropriate clothing) • Record-keeping materials • Pocket-sized reference books Community Preparedness The level of community preparedness for a disaster is only as good as the people and organisations in the community make it. case finding and . the more they will be able to function in a leadership capacity and assist others toward a smoother recovery phase. and special interest. role in the institutions and community's preparedness. however. The most important attribute for anyone working in a disaster. specialized training.

at times the community health nurse is the first to arrive on the scene and must respond accordingly. Community health nurses . • Community health nurses working as members of an assessment team have the responsibility of feeding back accurate information to relief managers to facilitate rapid rescue and recovery. . Many times nurses are required to make home visits to gather needed information. and working with aggregates. and even death from heart attacks. In addition. prevention. surveillance. ROLE OF THE COMMUNITY HEALTH NURSE IN DISASTER RECOVERY • The role of the community health nurse in the recovery phase is as varied as in the preparedness and response phases of a disaster. Types of information included in initial assessment reports include the following: • Geographical extent of disaster's impact • Population at risk or affected • Presence of continuing hazards • Injuries and deaths • Availability of shelter • Current level of sanitation • Status of health care infrastructure. For example. Community cleanup efforts can incur a host of physical and psychological problems.referring. a task that comes quite naturally to the community health nurse. the continuing threat of communicable disease will continue as long as the water supply remains threatened and the living conditions remain crowded. severe fatigue. the physical stress of moving heavy objects can cause back injury. health education. Flexibility remains an important component of a successful recovery operation.

.must remain vigilant in teaching proper hygiene and making sure immunization records are up to date. mental distress may persist in these valuable populations who continue to live in chronic adversity. In addition. and grief. depression. The psychological stress of cleanup and moving can bring about feelings of severe hopelessness. Recovery can be impeded by short-term psychological effects eventually merging with the longterm results of living in adverse circumstances. Lack of water supply. In some cases. • Acute and chronic illnesses can be exacerbated by the prolonged effects of disaster. or lack of electricity. Referrals to mental health professional should continue as long as the need exists. stress can lead to suicide and domestic abuse. although most people eventually recover from disasters. • The community health nurse must also remain alert for environmental health hazards during the recovery phase of a disaster. Home visits may lead the nurse to uncover situations such as a faulty housing structure.

4. Banarasidas Publishers Jabalpur Pp 600. Jaypee Brothers. Park K Preventive And Social Medicine. Jaypee brothers New Delhi. . 19 th edition. Gulani K Community Health Nursing. Disaster Nursing. 7 th edition. New Delhi pp 953-961. Basvantappa B. kumar publishing services New Delhi 3. 1 st edition. 5. Venera.BIBLIOGRAPHY:- 1. textbook of Community Health Nursing. Spring Publication Company New York.T. Essentials of Community Health Nursing. 2. Tener Goodwin. 1 st edition. Kamalan.

Namita SUBMITTED . loss of human life or deterioration of health and health services on a scale sufficient to warrant and extraordinary response from outside the affected community or area (WHO. 1995). ecological disruption. TYPES 1) Man-made disasters 2) Natural disasters DISASTER AGENT • Agent • Host: • Primary and secondary agents will vary according to the type of disaster • Environment: Ms.HANDOUT SUBMITTED TO BY Mrs. Priya D Jadhao TOPIC: .DISASTER NURSING INTRODUCTION MEANING Disaster means that any occurrence that causes damage.

and treatment for victims and their families.Physical factors • Chemical factors • Biological factors • Social factors • Psychological factors PHASES OF A DISASTER • • Pre-Impact Phase • Impact Phase • Post impact Phase . The scope and magnitude of these problems determines the nursing role. Strong emotional response . such as the physical and emotional stress of disaster victims. emotional support services. Denial . Nurses collaborate with community agencies and officials to recognize and reduce disaster risks and maximize the health and safety of individuals involved in disaster crises. • During a disaster many environmental health problems emerge. preventing technologic disasters. and addressing problems that occur during a disaster. Recovery . • Following a disaster. nurses make numerous referrals to community agencies for a variety of needs including psychologic care. Acceptance • Recover DIMENSIONS OF A DISASTER Predictability: Frequency: Controllability: Scope and Intensity Time: THE NURSING ROLE IN DISASTERS • Disaster nurses play key leadership and service provision roles in planning and implementing disaster relief efforts.

third priority Black . income. Basvantappa B. textbook of Community Health Nursing.T. Preparedness Personal Preparedness Professional Preparedness Community Preparedness ROLE OF THE COMMUNITY HEALTH NURSE IN DISASTER RECOVERY ROLE OF THE COMMUNITY HEALTH NURSE IN DISASTER RESPONSE BIBLIOGRAPHY:1. and home. The communicable disease implications of disasters are also immense: THE NURSING ROLE IN DISASTERS ASSESS THE COMMUNITY Community Disaster Planning THE NURSING ROLE IN DISASTERS THE NURSING ROLE IN DISASTERS Mitigation PRINCIPLES OF DISASTER MANAGEMENT PRINCIPLES OF DISASTER MANAGEMENT TRIAGE Red . second priority Green .encompassed dealing with many disaster effects such as loss of life.urgent.dying/dead STAGES OF DISASTER AND THE ROLE OF NURSES 1. 7 th edition.most urgent. first priority Yellow . .

Disaster Nursing. 4. kumar publishing services New Delhi 3. Tener Goodwin. 19 th edition. Park K Preventive And Social Medicine. Gulani K Community Health Nursing. 1 st edition. 2.Jaypee Brothers. Venera. 5. Essentials of Community Health Nursing. Banarasidas Publishers Jabalpur Pp 600. 1 st edition. Spring Publication Company New York . Kamalan. New Delhi pp 953-961. Jaypee brothers New Delhi.