INTRODUCTION

Disaster is a serious disruption of life and perhaps death or injury to large number of people.

It is may be a man made or natural event that causes destruction and devastation which
cannot be relieved without assistance.

TYPES OF DISASTER

Natural. Eg : earthquake, floods, hurricane, tsunami.

Manmade.Eg: nuclear accidents, industrial accidents

Hybrid Eg: spread of disease in community, global warming.

LEVELS OF DISASTER

Level iii disaster – considered a minor disaster. These are involves minimal level of damage

Level ii disaster- considered a moderate disaster. The local and community resources has to
be mobilized to manage this situation

Level i disaster- considered a massive disaster- this involves a massive level of damage with
severe impact.

DISASTER MITIGATION

Disaster mitigation refers to actions or measures that can either prevent the occurrence of a
disaster or reduce the severity of its effects. (American Red Cross).

Mitigation activities include awareness and education and disaster prevention measures.

PHASES OF DISASTER MANAGEMENT

Prevention phase

Preparedness phase

Response phase

Recovery phase

Prevention phase

Identify community risk factors and to develop and implement programs to prevent
disasters from occurring.

Preparedness phase

Personal preparedness
PROFESSIONAL PREPAREDNESS

Key organizations and professionals in disaster management

Health care community

Hospitals

Health professionals

Pharmacies

Public health departments

Rescue personnel

Non-health care community

Fire fighters

Municipal or government officials

Media

Medical examiners

Medical supply manufactures

Police

Community preparedness

The level of community preparedness for a disaster is only as high as the people and
organization in the community make it.

Community must have adequate warning system and a back up evaluation plan to remove
people from the area of danger

Response phase

The level of disaster varies and the management plans mainly based on the severity or
extent of the disaster.

Recovery phase

During this phase actions are taken to repair, rebuilt, or reallocate damaged homes and
businesses and restore health and economic vitality to the community.

Psychological recovery must be addressed.Both victims and relief workers should be offered
mental health activities and services.
DISASTER MANAGEMENT CYCLE

Prevention                     ------>        preparedness

         I                                                         v

                                                
Recovery                <---------            response                           

DISASTER MANAGEMENT PLANS

Aims of disaster plans

to provide prompt and effective medical care to the maximum possible in order to minimize
morbidity and mortality

Objectives

To optimally prepare the staff and institutional  resources for effective performance in
disaster situation

To make the community aware of the sequential steps that could be taken at individual and
organizational levels

Disaster management committee

The following members would comprise the disaster management committee under the
chairmanship of medical superintendent/ director

Medical superintendent/ director

Additional medical superintendent

Nursing superintendent/ chief nursing officer

Chief medical officer (casualty)

Head of departments- surgery, medicine, orthopedics, radiology, anesthesiology,

neurosurgery

Blood bank in charge

Security officers

Transport officer

Sanitary personnel

Disaster control room

the existing casualty may be referred as the disaster control room.

Rapid response team

The medical superintendent will identify various specialists, nurses and pharmacological
staff to respond within a short notice depending up on the time and type of disaster.

The list of members and their telephone numbers should be displayed in the disaster
control room.

Information and communication

the disaster control team would be responsible for collecting, coordinating and
disseminating the information about the disaster situation to the all concerned.

Disaster beds

Requirement of beds depends up on the magnitude of the disaster.

Utilization of vacant beds, day care beds, and pre-operative beds

Convalescing patients, elective surgical cases and patients who can have domiciliary care or
opd management should be discharged

Utility areas to be converted in to temporary wards such as wards with side rooms,
corridors, seminar rooms etc.

Creating additional bed capacity by using trolleys, folding beds and floor beds

Logistic support system

Resuscitation equipments

Iv sets, iv fluids,

Disposable needles, syringes and gloves

Dressing and suturing materials and splints

Oxygen masks, nasal catheters, suction machine and suction catheters

Ecg monitors, defibrillators, ventilators

Cut down sets, tracheostomy sets and lumbar puncture sets

Linen and blankets

Keys of these cupboards should be readily available at the time of disaster

Training and drills

Mock exercise and drills at regular intervals are conducted to ensure that all the staff in the
general and those associated with management of causalities are fully prepared and aware
of their responsibilities. 

ELEMENTS OF DISASTER PLAN

A disaster plan should have the following elements

1. Chain of authority
2. Lines of communication
3. Routes and modes of transport
4. Mobilization
5. Warning
6. Evacuation
7. Rescue and recovery
8. Triage
9. Treatment
10. Support of victims and families
11. Care of dead bodies
12. Disaster worker rehabilitation
13. Activation of disaster management plans
14. Standard operating procedures (SOPs)
15. Reception area
16. Triage

Priority one- needing immediate resuscitation, after emergency treatment shifted to

intensive care unit

Priority two- immediate surgery, transferred immediately to operation theatre.

Priority three- needing first aid and possible surgery- give first aid and admit if bed is
available or shift to hospital

Priority four- needing only first aid-discharge after first aid.

1. Documentation
2. Public relations.
3. Essential services.
4. Crowd management/ security arrangement.
5. Disaster management- nurse’s role in community
6. Assess the community
7. Assessment - the local climate conducive for disaster occurrence, past history of
disasters in the community, available community disaster plans and resources,
personnel available in the community for the disaster plans and management, local
 agencies and organizations involved in the disaster management activities,
availability of health care facilities in the community etc.
8. Diagnose community disaster threats
9. Determine the actual and potential disaster threats (eg; explosions, mass accidents,
tornados, floods, earthquakes etc).
10. Community disaster planning
11. Develop a disaster plan to prevent or deal with identified disaster threats
12. Identify local community communication system
13. Identify disaster personnel, including private and professional volunteers, local
emergency personnel, agencies and resources
14. Identify regional back up agencies and personnel
15. Identify specific responsibilities for various personnel involved in the disaster plans
16. Set up an emergency medical system and chain for activation
17. Identify location and accessibility of equipment and supplies
18. Check proper functioning of emergency equipments
19. Identify outdated supplies and replenish for appropriate use.
20. Implement disaster plans
21. Focus on primary prevention activities to prevent occurrence of manmade disasters
22. Practice community disaster plans with all personnel carrying out their previously
identified responsibilities (eg: emergency triage , providing supplies such as food,
water, medicine, crises and grief counseling)
23. Practice using equipment; obtaining and distributing supplies
24. Evaluate effectiveness of disaster plan
25. Critically evaluate all aspects of disaster plans and practice drills for speed,
effectiveness, gaps and revisions.
26. Evaluate the disaster impact on community and surrounding regions
27. Evaluate the response of personnel involved in disaster relief efforts.

Conclusion

Disaster is an emergency situation, therefore coordination of actions and various

departments is an essential requisite for efficient management of mass casualties. 

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