Unique Needs Sekito

3:DISASTER MENTAL HEALTH AND HIGH-VULNERABILITY POPULATIONS NCM 120
Lecturer: Ms. Ma Concepcion Sekito, RN || March 30-31, 2023
 Disasters can be caused by a variety of You can see here in the examples, in the
event, it is not the magnitude of that bottom we have Physiological needs. We
event but it’s impact to human have food, sleep, shelter, clothing and
populations that makes the event a breathing. Next level we have Safety and
disaster. Security, after, love and belonging, self-
 Treatment options for adults may be esteem and self-actualization.
inappropriate or unavailable for children.
This will serve as your point of reference in
 Children with special health care needs
terms of determining the needs of this
also require refinement of their care.
vulnerable populations.
 Nurses and healthcare professionals
must be aware of the pediatric  Regardless of your child’s age, he or she
considerations during disaster may feel upset or have strong emotions
preparedness, mitigation, response, after an emergency.
recovery and evaluation efforts and  Some children react right away but
must be prepared to modify their others show signs of difficulty much
approaches accordingly. later. So, the effect takes place after a
 Infants, children and adolescents have period of time.
unique physiological as well as  How children react or common signs of
psychosocial needs during after distress can vary according to age.
disasters and public health emergencies. Knowing how to help children cope after
 The injury and illness pattern following an emergency can help them stay healthy
exposure to nuclear, biological, and in future emergencies.
chemical agents maybe different from  Nurses have an important role along with
those patterns assessed in the adults. this line. You have your role to helping
children cope because it has implications
in terms of future coping of this
individual.
 Emergency can happen anywhere and at
any time and it is important for parents
to know what steps they can take before,
during, and after an emergency to
protect their family.
 Parents ensure that family members are
ready and know what to do when
emergency happens.
BEFORE AN EMERGENCY
A little preparation can make a big

•
difference later.
It is important to prepare supplies of
As you can see here the hierarchy of needs. necessities of each person in the family. As
Who is the proponent? Abraham Maslow mentioned, we have your food, medicines,
TEZON, TIRONA, TIZON 1

water, flashlight and for children, diapers, place”) or they may recommend you to
clothes, lampin. You have to remember that go somewhere else (“evacuate”)
need to preparing special toys is important • If you have children in school in the
this will keep your children calm during exposed area, school authorities may
emergencies so that, the attention of the evacuate your children to a safer
children will be distracted during disaster. place or emergency shelter. In these
cases, do not go to your children
If children are old enough, they need to be
during the emergency or school
taught the contact emergency numbers as
authorities say it is safe for you to
well as memorize the important phone
pick up your children.
numbers aside from that, it is imperative to
• In terms of the emergency kit, they
create a plan. It is a part of family
have to be knowledgeable with the
communication plan to reunite with loved
content so they can help with the
ones, when it is safe to do so.
preparation.
Be informed, stay informed and get vital • During an emergency, actions are
information such as emergency warnings and essential. Different emergencies
alert from the reliable sources. require different actions
• Actions for earthquake for example
•Getting your children to help with
is different from that of flood.
preparing for an emergency can teach
• Each family members must know how
them basics of staying safe and will
to act during an emergency.
make emergencies less stressful
• Depending on an emergency,
because they will be prepared and
authorities may ask individuals to
empowered.
stay where they are, or
• Ask them what items they think
recommendations can be made to
should go in an emergency kit and
evacuate.
plan.
• If children are in schools, the
DURING AN EMERGENCY
authorities in that area may evacuate
• Different emergencies may require them to a safer place or an
different actions. Protect your emergency shelter and then parents
family by knowing what to do. can pick up the children the moment
• Each emergency is different and may it is safe to go out.
require different actions to keep you • You have to take note that infants,
and your family safe. Local children and adolescents have unique
authorities will share safety psychosocial/psychological needs
instructions and updates on during disasters, and emergency.
television, radio, the Internet, or • Moreover, you have to take note that
social media pages like Twitter and frequent options for pregnant women
Facebook. Depending on the and older adult may be appropriate
emergency authorities may ask you to but not with children.
stay where you are (“shelter in • Children with special health care
needs require refinement in their

care. Nurses should be aware about • As estimated 15,000 to 20,000

pediatric considerations. people died and many more suffered
o Example: Physiological aspects long-term health complications.
such as thinner skin, cells • With this chemical spill, what
divide faster, higher happened to the infants, pregnant
respiratory and heart rate, and elderlies? W
immature blood brain barrier, • What happened to the school
higher metabolic rate, weaker children population when chances are
immune system. classes are ongoing during a chemical
• In terms of these important spill?
considerations what will you do in
terms of disasters? 2. STRUCTURAL COLLAPSE
• Outside of the developing world,
MAN-MADE DISASTERS structural collapse disasters are
rare. However, they still do happen.
Man-made disasters can be divided into
• Hyatt Hotel 1991
3 categories:
• The recent collapse of the Surfside
1. Technological Disasters – Examples
Condominium in Florida shows that
include industrial accidents like chemical
these disasters can and do occur
spills, transportation accidents and
where 98 people dies when the 12-
mining accidents.
storey tower collapsed.
2. Social Disasters – Examples include
• World Trade Center Collapse
warfare, genocide, civil unrest,
3. DRINKING WATER CONTAMINATION
hyperinflation and terrorism.
• The most significant case of drinking
3. Environmental Disasters – Examples
water contamination occurred in
include deforestation and climate
Bangladesh.
change.
• The water sources were
contaminated with arsenic, poisoning
MAN-MADE DISASTERS BY TYPE upwards of 100 million people in the
region.
1. CHEMICAL SPILL
• The Flint Water Crisis which exposed
• The Bhopal disaster in 1984 is
over 100,000 people to the chemical
considered the worst chemical spill in
lead in the USA.
history.
• Many children experienced brain
• What happened is that 45 tons of the
damage as a result.
chemical methyl isocyanate leaked
4. TRANSPORT DISASTERS
from an insecticide plant owned by
• Transport disasters include air, rail,
Union Carbide.
road and water vehicle accidents.
• With that, thousands of people were
• These accidents are often too small
killed immediately from exposure to
to be considered disasters.
the gas and panic ensued as people
attempted to flee.

• However, there have been many • The 2021 Texas grid outage is one of
situations where transport accidents the largest and most notorious grid
led to mass fatalities. failures in recent times.
• Often, these accidents are a 9. OIL SPILLS
byproduct of a natural disaster, such • Oil spills don’t usually cause direct
as foggy conditions. human death but can have massive
5. MINING ACCIDENTS environmental toll.
• Even if conditions are being improved • The largest accidental oil spill in
by mining companies, accidents are history is the 2010 BP Deepwater
still inevitable. Horizon oil spill. Approximately 134
• While mining has gotten safer, million gallons of oil were released
accidents still occur. and coated the Gulf Coas.
• Miners face the possibility of getting • However, the largest oil spill was not
trapped in collapsed mining tunnels, an accident.
poisonous gas leaks, dust explosions, • Recent in the Philippines is in Mindoro
and many other dangers. Oil Spill.
6. EXPLOSIONS AND FIRES • In 1990, during their retreat from
• The largest non-nuclear explosion Kuwait, Saddam Hussein ordered
disaster occurred recently. Iraqi to release oil into Kuwait’s Sea
• In 2020, improperly stored nitrate Island terminal.
exploded at the Port of Beirut. • It was estimated that 380 to 520
• More than 200 people died, and 6,000 million gallons of oil were intentionally
people were injured. spilled.
7. NUCLEAR AND RADIATION ACCIDENTS 10. GENOCIDE
• The Chernobyl accident is considered • The UN defines genocide as “acts
the worst nuclear disaster in history. committed with intent to destroy, in
• An explosion and fire occurred due to whole or in part, a national, ethnical,
poorly trained staff using unsafe racial or religious group”.
practices. • Some of the most recent genocide
• Massive amount of radioactive includes:
material was released into the air. o Rohingya genocide
• Approximately 350,000 people had to o Yazidis genocide by ISIS
be resettled, and the entire area o Darfur genocide
contained. o Effacer le tableau in the
8. GRID FAILURE Democratic Republic of the Congo
• When the grid fails, people can be 11. CIVIL UNREST
left without power for heating, • Civil unrest disasters can include
cooling, or lifesaving medical devices riots, strikes, and acts of mass
• Road accidents are also more likely on disobedience.
dark streets without working traffic • Throughout US history, there have
signals. been many incidences of civil unrest,

including many which resulted in • If climate change goals are not met,
massive property damage and death. researchers predict that there will
• The 1991 LA riots were one of the be widespread displacement of
worst in US History where 53 people people, famine, and warfare
were killed and thousands were resources.
injured. • Climate change also intensifies
12. HYPERINFLATION natural disasters, like drought,
• Hyperinflation occurs when people wildfires, and hurricanes.
lose faith in their currency, and it
loses value. 16. DEFORESTATION
• During the hyperinflation in • Deforestation is not always
Yugoslovia in the 1900s, the currency considered disaster in its own right.
lost value so quickly that people used • However, deforestation can cause
their worthless money as wallpaper. other disasters like landslides,
13. TERRORISM mudslides and flooding.
• Terrorism has many definitions but is • Deforestation also causes habitat
generally used to instill fear in the loss and increase global warming.
population. 17. POLLUTION
• There are many forms of terrorism. • Pollution usually isn’t thought of as a
These include: natural disaster, but it actually has a
o Mass shootings very high death toll.
o Bioterrorism • Some reports say pollution kills more
o Hostage-taking people each year than war, natural
o Hijacking disasters and hunger.
o Bomb attacks
o Cyberattacks GROUP A – CHEMICAL SPILL AND
o Biological weapons STRUCTURE COLLAPSE
14. PANIC, OVERCROWDING AND INFANT
STAMPEDES Need:
• The combination of panic and Chemical Spill Kits
overcrowding can lead to stampedes. Each Chemical Spill Kit contains one Toolbox/
• There have been numerous stampede PPE Spill Kit and two Universal Spill Absorbent
events that rose to the status of Kits.
manmade disaster. Part 1: Toolbox/ PPE Spill Kit
• For example, 100 people died in the Toolbox
Station nightclub in Rhode Island • 1 Pen, 1 Marker, 3 Twist Ties, and 4
when a fire broke out, and people Hazardous Waste Labels
rushed to leave the building. • 3 Waste Bags
15. GLOBAL WARMING AND GREENHOUSE • 1 Dustpan Set
EFFECT • Length of “Caution- Chemical Spill” Tape
• Climate change is considered the • 1 Spill Instructions
biggest threat” to modern humanity.

PPE o If the infant/toddler stopped

Hot Zone Bag breathing, start CPR and do not
• 4 Pairs L Disposable Nitrile Gloves and 2 stop until the child breathes on
Pairs of Tyvek Shoe Covers his/her own or until someone
• 1 XL Disposable Apron with Sleeves and takes over.
1 Pair of Chemical Splash Goggles o If skin is affected, remove the
Warm Zone Bag infant/toddler’s clothes and rinse
• 4 Pairs L Disposable Nitrile Gloves and 2 the skin with lukewarm water for
Pairs of Tyvek Shoe Covers at least 15 minutes.
• 1 XL Disposable Apron without Sleeves o If the eye is affected, wash the
and 1 Pair of Safety Glasses infant’s eye by holding the eyelid
open and pouring a steady stream
Part 2: Universal Spill Absorbent Kit of room temperature water into
• 1 3 in. x 10 ft. Absorbent Sock the inner corner for 15 minutes.
• 10 Universal Spill Pads o If a chemical was swallowed, take
• 7 lbs. Absorbent (absorbs 2 L of water) the infant away and have them
Before: spit out any remaining substance.
• Assess the community Do not make them vomit.
• Determine the actual and potential After:
threat of chemical spills • Assess and provide first aid to the
• Identify/Create a interdisciplinary injured/affected infant/toddler as soon
team as possible
• Set up of an emergency medical system • Evaluate public health needs of the
• Educate mothers with infants the affected population.
primary preventions during chemical • Coordinate with the local community in
spills case of medical assistance is needed at
• Identify and update record of the nearest hospital
vulnerable populations in the community CHILDREN
During: Before
• Evacuate the area immediately • Provide health education on areas that
• Evacuate to an area upwind and uphill are at risk for lethal methyl isocyanate
from the location of the spill if possible. poisoning.
• Do not turn any electrical switches ON • Provide health education to co-health
or OFF when exiting the room. Eliminate care members in rendering care to
all open flames. children who are exposed to lethal
• Contaminated clothing must be removed methyl isocyanate especially on exposure
immediately and the skin flushed with routes for the substance, and exposure
water for no less than fifteen minutes. control measures.
Clothing must be laundered before During
reuse. • Get the child away immediately from the
• Recognize and respond to symptoms of area.
toxic poisoning:

• Discard clothing that may have been 1. Create an interdisciplinary team

contaminated. 2. Establishing lines of communication with
• Call the nearest emergency care facility. others as needed inside and outside the
• As a nurse it is important to assess the workplace to prevent and prepare for
child for poisoning such as: early possible exposure scenarios.
symptoms may include eye irritation, 3. Educating the worker about chemicals of
coughing, and shortness of breath. In concern, providing information on the
cases of severe exposure, later substance(s) possible routes of
symptoms may include vomiting and exposure, and emphasizing exposure
diarrhea. Acute exposure to high vapor prevention measures.
concentrations may cause relatively 4. Make sure there is a well-stocked first
rapid and severe pulmonary edema, aid kit containing some of the supplies
alveolar wall injury, and corneal damage. needed for treating chemical exposure
Initial signs of irritation may progress to available. This include the following
vomiting, diarrhea, and death. Survivors items:
of acute exposures may exhibit long- • Eyewash bottle
term respiratory and ocular effects. • Plenty of clean water
• Remove contaminated clothing and • Syrup of ipecac
personal belongings and place them in • Activated charcoal powder
double plastic bags. • Soap
• Wash the exposed skin thoroughly with • Disposable towels
soap and water. Use caution to avoid • Clean change of clothes
hypothermia when decontaminating 5. Prepare an Emergency Supply Kit that
victims, particularly children or the includes duct tape, scissors and plastic to cover
elderly. Use blankets or warmers after doors, windows and vents
decontamination as needed 6. Make a Family Emergency plan
After 7. Know how to operate your home’s
• Follow-up evaluation of respiratory ventilation system
function should be arranged for severely DURING
exposed patients. Patients who have skin 1. Listen to local radio or television
or corneal lesions should be reexamined citations for detailed information and
within 24 hours. follow instructions carefully
• Instruct the parent of the child for 2. If asked to evacuate, do so immediately
follow up check up to monitor possible 3. Quickly try to figure out which areas are
long term effects. affected or where the chemical is coming
• Counseling and recommendations for from, and get away immediately
psychological trauma are provided. 4. If the chemical is inside the building, get
• Information on prohibited areas and out of the building without passing
precaution measures are rendered to the through the contaminated area, if
community. possible
PREGNANT WOMAN 5. If you can’t get out of the building or
BEFORE find clean air without passing through

the affected area, move as far away as amounts of water, occasionally lifting the
possible and shelter-in place lower and upper lids.
If told to stay indoors: • Chemical contacts the skin: dust it off
6. Seek shelter in an internal room. Close immediately and then flush the
and lock all exterior doors and windows. Close contaminated skin with water. If this
vents, fireplace dampers and as many interior chemical or liquids containing this
doors as possible. Sea the room with duct tape chemical penetrate the clothing,
and plastic sheeting promptly remove the clothing and flush
7. Turn off air conditioners and ventilation the skin with water.
systems so that no outside air is drawn into your • If a person breathes large amounts of
house or in the building this chemical: move the exposed person
8. Seal gaps under and around the following to fresh air at once. If breathing has
areas with wet towels, plastic sheeting, duct stopped, perform artificial respiration
tape, wax paper or aluminum foil:
• Doorways and windows AFTER
• Air conditioning units 1. Do not leave the safety of a shelter to
• Bathroom and kitchen exhaust fans go outdoors, including to help others,
• Stove and dryer vents with duct tape and until authorities say it is safe to do so.
plastic sheeting If you have evacuated, return home only
9. Take shallow breaths through a cloth or when authorities say it is safe
towel if gas or vapors could have entered your 2. If you are affected by a chemical agent
house or building and medical help is not immediately
10. Avoid eating or drinking any food or available, the best action is to
water that may be contaminated DECONTAMINATE yourself and help
If outside when an incident occurs: others to do so, if possible.
11. Quickly decide what is the fastest way 3. Intervene to support rehabilitative or
to find clean air. Move away immediately, in a protective activities. Provide counseling
direction upwind of the source and referral for psychological trauma.
12. If in a car, keep car windows and vents 4. Provide information on health effects,
closed and shut off the air conditioner and control measures, and contraindications.
heater 5. Provide information on off limit areas
13. Find the closest building to shelter - in and public health guidelines, especially if
place clean up efforts are long term.
14. Conduct a history assessment of a STRUCTURAL COLLAPSE
chemical exposure situation. Which includes: INFANT
• Determine the specific location of the Before
chemical exposure • For the safety of the infant and the
• Identifying specific chemical involved whole family, be aware of the structure
• Determine the route of exposure into and integrity of the building eg. cracks in
the body (inhalation, ingestion, dermal). walls, bulging walls, displaced columns,
• Eye exposure to chemicals: immediately sagging floors
wash (irrigate) the eyes with large

• Prepare a family emergency kit which • Transport children who need immediate
include infant necessities eg. formula medical care to the nearest hospital.
milk, vitamins, clothing, diaper, toys • Give specific task to children to let them
During know they can help.
• Given the opportunity to exit, move the • Help children to make them feel safe and
infant together with the whole family to secure by talking with them or read them
a safe location a book to relax.
• Protect the baby against debris and • Provide them opportunities to talk about
falling objects and cover nose to avoid what they went through.
inhalants such as dust. PREGNANT WOMEN
• While safely carrying the infant, move BEFORE
around as little as possible ro avoid • Industrial building should be specially
kicking up dust, which may be harmful to designed. Construction materials should
inhale. be tested properly in labs. Opt for a
• If possible, use a flashlight so you can collapse-resistant infrastructure.
see the surroundings and to signal your • Conduct regular inspection for possible
location to the rescuers. hazard such as cracked walls, damaged
After power wires, etc. and check for
• Do not re enter the building and follow structural instabilities
the instructions of the responders. • Establish an exit map for every
• Distract and calm the infant by giving infrastructure.
handheld toys, and singing lullabies. • Conduct drills regarding where to
• Refer the infant to the nearest medical evacuate assuring that optimal safety
facility to check for vital signs and and injury prevention id practiced.
overall health condition. DURING
CHILDREN • Instruct individuals to leave the
BEFORE infrastructure/building immediately in a
• Conduct a drill and provide information calm manner, priorotizinng pregnat
to children on the level of their women. Move to an open space away from
understanding. falling debris.
• Involve children during planning. • When evacuating, advise individuals not
• Review safety plans together with the to use elevators which can trap them.
family . Allow them to use the stairs and use
DURING escape/ exit routes.
• As a nurse, stay calm to focus on one • Insruct individuals especially pregnant
goal. women to stay away from mirrors, glass
• Tell the children what is happening in a doors or windows and heavy objects that
way that they can understand. may cause them harm.
• Vacate the children with strict guidance. • When escaping is impossible, instruct
AFTER individuals to hide under the table or a
• Provide first aid heavy doorframe, sit still and cover and
protect the head and neck using hands.

• Instruct to use flashlight instead of Secure vaccine for infants and

•
match to avoid explosion in case of gas children for possible bioterrorism
leaks. Instruct to cover nose and mouth attack
to minimize dust inhalation. INTERVENTION DURING TERRORISM:
GENERAL
AFTER
• Follow evacuation protocol or plan for
• Activate search and rescue operations
respective institution and city.
for possible missing individuals.
• Once the recue teams has loacted the • Follow the advice of local emergency
victims, an immmediate assessment of officials.
the victim shall be done. • Ensure a head count of everyone in
• Assess the welfare of survivors. Provide the population.
psychological first aid and stress • Use of therapeutic speech to calm
debriefing. during the incident.
• Do not try to re-enter a building or enter • Check if the event occurs near you,
a debris field.
check for injuries, give first aid and
• Pay attention for possible disconnected
get help if seriously injured.
electricity wires and gas leaks
• Close and lock all windows and
exterior doors.
GROUP B- TERRORISM
• When evacuating make sure to let all
INTERVENTION BEFORE TERRORISM:
wear long-sleeved thickened clothes
• Establish an emergency plan including
to prevent injuries.
the evacuation plan
• Coordinate to local officials for
• List important contacts such as the
adequate supplies during evacuation.
police department and emergency
• Take your pets with you.
department
• Listen to radios and televisions for
• In high-risk areas for terrorism,
news and instructions.
Advise the hospital administrators to
INFANT
strengthen securities in
• Securely wrap the infant to protect
particular circumstances and immediately
from falling debris and extreme
report any unusual and suspicious activities
environmental noise.
to the
• Distract them with toys.
authorities
• Carry the infant and stay away from
• Have emergency kits ready at all
the war zone as far as you can.
times
• Always carry with you the essentials
• In high risk areas for terrorism,
needed by the infant. CHILDREN
encourage women and children to
• Make sure children don't view
participate in drills of
explicit/violent content found on the
terrorist attacks, moreover, perform such
television during terrorist attacks to
drills regularly as necessary
prevent panic.

• Distract them with toys. • Educate family members to attend

• If available, let the children listen to seminars for another possible
music through headphones. terrorist attack.
• Supervise and never leave behind GROUP C- EXPLOSION AND FIRE
during the evacuation process.
PREGNANT
• Keep the pregnant woman as far away
from the site of the attack to
prevent stress to the mother and
child.
• Pregnant mothers do not relay the
information to them but instead
direct it to the head of family.
• If available, provide wheelchairs for
every transport.
INTERVENTIONS AFTER TERRORISM:
GENERAL
• Ensure that the environment is safe
and secure
• Coordinate with agencies such as
police for further management of
security
• Locate family members
• Triage
• Assess overall condition
• Apply first aid/ basic life support as
needed (masks, oxygen, wound care,
medications, etc) GROUP D: NUCLEAR DISASTER
• Stay informed with the latest new
updates in local sites NUCLEAR AND RADIOLOGIC CONSIDERATION:
• Therapy: PREGNANT WOMEN
o Play therapy (special toys for infant and  The exposure of a fetus to radiation is
children) o Arttherapy(children) referred to as prenatal radiation exposure.
This can occur when the mother's abdomen
o Music therapy (applicable to all)
is exposed to radiation from outside her
• Evaluation on the applied body. Also, a pregnant woman who
interventions (what went wrong, what accidentally swallows or breathes in
were effective and what needs radioactive materials may absorb that
substance into her bloodstream. From the
improvement)
mother's blood, radioactive materials may
pass through the umbilical cord to the baby

or concentrate in areas of the mother's Abraham H. Maslow, (born April 1,

body near the womb (such as the urinary 1908, New York, New York, U.S.-died June 8,
bladder) and expose the fetus to radiation. 1970, Menlo Park, California), American
 The possibility of severe health effects psychologist and philosopher best known for
depends on the gestational age of the fetus his self-actualization theory of psychology,
at the time of exposure and the amount of
which argued that the primary goal of
radiation it is exposed to. Unborn babies
psychotherapy should be the integration
are less sensitive during some stages of
Maslow felt that Freud's psychoanalytic
pregnancy than others. However, fetuses
theory and Skinner's behavioural theory
are particularly sensitive to radiation during
their early development, between weeks 2 were too focused on the negative or
and 18 of pregnancy. The health pathological aspects of existence and
consequences can be severe, even at neglected all of the potential and creativity
radiation doses too low to make the mother that human beings possess.
sick. Such consequences can include stunted
growth, deformities, abnormal brain Introduction of the theory:
function, or cancer that may develop
sometime later in life. However, since the Maslow's Hierarchy of Needs (often
baby is shielded by the mother's abdomen, represented as a pyramid with five levels of
it is partially protected in the womb from needs) is a motivational theory in psychology
radioactive sources outside the mother's that argues that while people aim to meet
body. Consequently, the radiation dose to basic needs, they seek to meet successively
the fetus is lower than the dose to the higher needs in the form of a pyramid.
mother for most radiation exposure events. Abraham H Maslow felt as though
conditioning theories did not adequately
 Most radiation exposure during medical capture the complexity of human behaviour
testing is unlikely to harm a developing In a 1943 paper called A Theory of Human
baby. But sometimes, depending on the
Motivation, Maslow presented the idea that
radiation dose and the developmental stage
human actions are directed toward goal
of the fetus, the effects can be serious and
attainment Any given behaviour could satisfy
may result in:
several functions at the same time, for
instance, going to a bar could satisfy one's
o failure of the embryo to implant
needs for self-esteem and for social
o miscarriage
interaction.
o abnormalities of the central nervous
system o congenital malformations o
slower than normal growth
o malformation o cataracts
 Just like the hierarchy of needs for
o childhood cancer
adults that was identified by Maslow,
our baby’s needs can be looked at on
table here, check on the last page nalang!
a continuum, where basic needs must
be met first before more complex
INFANTS needs can be addressed.
 All babies have three basic levels of
need: physical, emotional and
MASLOW'S HIERARCHY OF NEEDS cognitive. All of the things that
babies need to thrive can be lumped
Introduction of the theorist: into one of these three categories.

 Teething tablets or gel

 Physiological needs
PHYSIOLOGICAL NEEDS
 Bulb syringe
- Physiological needs during this period
 Toddler snacks
are as important as ever. As a baby
 Extra clothes
grows into a toddler their nutrient
intake needs to keep up with that  Extra emergency blankets (at
growth. Poor nutrients can actually slow least two)
the physical development of a young  Receiving blankets (at least
child. With infants, there is a lot of
two)
evidence that breast feeding is the best
 Thermos (to keep formula cool
option if available.
- When we think about our babies’ physical or warm longer)
needs, we need to consider their  Small camp stove for boiling
nutrition, sleep and comfort. It is also water for sanitizing
imperative that they are living in a clean
environment and that they have access
to quality medical care. SAFETY NEEDS
- Nutrition. It is important to figure out
- Infants and toddlers need a lot of help
what form of feeding works best for
with fulfilling this need. Their general
your baby and to provide an adequate
curiosity can get them into unsafe
amount of nutritious food, be it breast
situations. One way they get this need
milk or formula.
met is by parents "Baby Proofing" their
- Comfort. Be sure to keep your baby’s homes.
diapers and clothes clean and dry.
- Instruct to stay inside, close and lock all
Remember that babies have difficulty
windows and doors. Go to the basement
regulating their body temperatures, so
or the middle of the building.
be sure to dress your baby for weather,
- Instruct to stay inside at least 24 hours
keeping him cool enough in hot weather
unless told otherwise by authorities
and warm enough on cool days.
- Carefully remove the outer layer of the
- Clean environments. Babies’ immune
clothing before entering the build
systems are much weaker than those of
adults, so be sure to sterilize bottles and
BELONGING AND LOVE NEEDS
sanitize toys on a regular basis.
- Emotional needs refer to our babies’
- Shelter
needs for security and love. Once our
 Clean Air
babies’ physical needs have been met,
 Keeping the baby warm bonding with caregivers can flourish. The
 A well-stock diaper bag ways that caregivers interact with
- Ready- to - feed infant babies will help to create security and
will allow for emotional bonds to grow.
formula in single serving cans or
Babies who have their physical needs
bottles met, who are secure and who have good
 Disposable cups bonds with their caregivers tend to be
 Medications happy babies. Caregivers can foster
 Burp rags or smaller blanket their babies’ emotional needs by creating
a structured environment with routines,
 Pacifiers (at least two)

by responding to their babies when they - stunted growth

cry and by being affectionate and loving. - abnormal brain functioning
- Respond to their cries. There is a time - deformities
and place when letting your baby cry it - increase risk for cancer
out makes sense, but it is also important
- chromosomal anomalies in peripheral
to make sure you are responding to the
blood leukocytes - death
needs of your baby. When your baby is
crying, try to figure out why. After all, NURSING INTERVENTION
she can’t talk to tell you what she needs
right now. Crying is how she - Family preparedness plan
communicates. - Prepare an Emergency Kit
- Be affectionate and loving. When you - Take Prophylactic medication (Potassium
hug, kiss and cuddle your baby, it helps Iodide)
her to feel loved and secure, which in
- Instruct to stay inside, close and lock all
turn gives her the confidence to explore
windows and doors. Go to the basement
and try new things.
or the middle of the building.
- It is crucial to maintain the psychological
- Instruct to stay inside at least 24 hours
bond between the infant and the mother
unless told otherwise by authorities -
after birth, especially during distress
Carefully remove the outer layer of
like a disaster.
the clothing before entering the build
- Apart from physical contact, they need
- Stay inside for at least 24 hours
face to face interaction and prolonged
- When possible, take a shower with lots
eye contact to develop their self-
of soap and water to help remove
regulatory system. Inconsistencies in
radioactive contamination.
socialization weaken the neonate's
- For the parents, remain informed, if
selfregulatory systems.
possible, by checking in with local news
- Skin to skin contact is not only soothing
sources.
for the neonate but also essential for
- Monitor the physical health needs of the
brain development.
infant.
SELF-ACTUALIZATION
NUCLEAR AND RADIOLOGIC CONSIDERATION:
- Infants and toddlers most likely do not
CHILDREN
fulfill this need as described by Maslow.
At 12 months a child is just beginning to  Radiation, sometimes known as
electromagnetic waves, is energy that
become self aware. This means they are
comes from a source and travels through
just beginning to understand that they
space at the speed of light. Each of us is
are an individual person. For them to
exposed daily to radiation from natural
have a sense of what they are capable of
sources, including the sun and the earth.
is asking a lot. However, experiments
Nuclear radiation accidents/emergencies
show that they are able to recognize
include nuclear power plant accidents and
simple physical characteristics of their
nuclear blast. During a radiation emergency,
appearance and notice when it changes.
radioactive material may be released into
the air and breathed into the lungs, or it
may get into the body through open wounds.
EFFECTS:

● Children can be exposed to ● Explain what is happening. Assess

environmental radiation as a result level of anxiety
of nuclear power, fuels reprocessing, ● Ask child’s cooperation throughout
and weapons production plant the calamity
(hereafter designated “nuclear ● Minimize time child is exposed to
plant”) events; from an improvised radiation source
nuclear device or radiologic dispersal
● Maximize child’s distance from the
device; or from abandoned medical
radiation source
radiation equipment that could
● Maximize the shielding between the
potentially result in substantial
source of radiation and the child
levels of radiation exposure and
associated health effects. ● Instruct the child to stay with adults
at all times
● Children are likely to experience
● Instruct the child to stay inside.
higher external and internal
Close and lock all the windows and
radiation exposure levels than adults doors. Go to the basement or the
because children are shorter and middle of the building.
have smaller body diameters and
organ sizes. Children have a longer
time to live, and, thus, more time in After:
which to develop adverse outcomes.
● Decontaminate immediately if
CARE FOR CHILDREN DURING
exposed (help the child to get as
NUCLEAR AND RADIATION
clean as he could) ● Remove outer
ACCIDENTS laying of clothes ● Stay indoors
unless told otherwise.
NEEDS:
● Assess child’s overall condition
● Shelter in place instead of ● Stay tuned in
evacuating
● Special toys (teddy bear, art REDUCING RADIATION RISK
materials)
 Detailed and continuous education on the
● Extra clothes
risks of radiation must be provided to
● Protective equipment (such as mask susceptible populations to increase radiation
and goggles) awareness and reduce exposure risk. A large
fraction of the Japanese general population,
INTERVENTIONS:
including students, has not been properly
educated on the mechanisms and risks of
Before:
radiation, with most individuals gathering
information from biased news outlets.
● Build an emergency supply kit
Therefore, schools play an important role in
● Make a family disaster plan the spreading of unbiased radiation
● Have several ways to receive information and accurate risk awareness.
emergency alerts
 In addition, an individual’s understanding of
During:
radiation has been shown to be related to
personal perceptions and environmental
● Assess the child’s level of thinking
factors. While healthcare providers often

have basic knowledge of radiation, teachers • 1 XL Disposable Apron without Sleeves

tend to not educate students about radiation and 1 Pair of Safety Glasses
because the topic is deemed unimportant or
inapplicable. In the Fukushima disaster, the
lack of radiation knowledge and awareness
Part 2: Universal Spill Absorbent Kit
led to a lack of fear for entering potentially
harmful areas. Yet, proper radiation • 1 3 in. x 10 ft. Absorbent Sock
knowledge and awareness has also • 10 Universal Spill Pads
contributed to higher levels of anxiety • 7 lbs. Absorbent (absorbs 2 L of water)
among individuals living within a post-
disaster setting. If schools Before:
GROUP E: CHEMICAL SPILLS • Assess the community
• Determine the actual and potential
threat of chemical spills
Situation:
• Identify/Create a interdisciplinary
40 tons of lethal methyl isocyanate leaked out
team
of the Union Carbide plant
• Set up of an emergency medical system
• Educate mothers with infants the
INFANT
primary preventions during chemical
spills
Need:
• Identify and update record of
Chemical Spill Kits
vulnerable populations in the community
Each Chemical Spill Kit contains one Toolbox/
PPE Spill Kit and two Universal Spill Absorbent
During:
Kits.
• Evacuate the area immediately
Part 1: Toolbox/ PPE Spill Kit
• Evacuate to an area upwind and uphill
Toolbox
from the location of the spill if possible.
• Do not turn any electrical switches ON
• 1 Pen, 1 Marker, 3 Twist Ties, and 4
or OFF when exiting the room. Eliminate
Hazardous Waste Labels
all open flames.
• 3 Waste Bags
• Contaminated clothing must be removed
• 1 Dustpan Set
immediately and the skin flushed with
• Length of “Caution- Chemical Spill” Tape
water for no less than fifteen minutes.
• 1 Spill Instructions
Clothing must be laundered before
reuse.
PPE
• Recognize and respond to symptoms of
Hot Zone Bag
toxic poisoning:
o If the infant/toddler stopped
• 4 Pairs L Disposable Nitrile Gloves and 2
breathing, start CPR and do not
Pairs of Tyvek Shoe Covers
stop until the child breathes on
• 1 XL Disposable Apron with Sleeves and
his/her own or until someone
1 Pair of Chemical Splash Goggles
takes over.
o If skin is affected, remove the
Warm Zone Bag
infant/toddler’s clothes and
rinse the skin with lukewarm
• 4 Pairs L Disposable Nitrile Gloves and 2
water for at least 15 minutes.
Pairs of Tyvek Shoe Covers

o If the eye is affected, wash the cases of severe exposure, later

infant’s eye by holding the eyelid symptoms may include vomiting and
open and pouring a steady stream diarrhea. Acute exposure to high vapor
of room temperature water into concentrations may cause relatively
the inner corner for 15 minutes. rapid and severe pulmonary edema,
o If a chemical was swallowed, alveolar wall injury, and corneal damage.
take the infant away and have Initial signs of irritation may progress to
them spit out any remaining vomiting, diarrhea, and death. Survivors
substance. Do not make them of acute exposures may exhibit long-
vomit. term respiratory and ocular effects.
• Remove contaminated clothing and
After: personal belongings and place them in
• Assess and provide first aid to the double plastic bags.
injured/affected infant/toddler as soon • Wash the exposed skin thoroughly with
as possible soap and water. Use caution to avoid
• Evaluate public health needs of the hypothermia when decontaminating
affected population. victims, particularly children or the
• Coordinate with the local community in elderly. Use blankets or warmers after
case of medical assistance is needed at decontamination as needed.
the nearest hospital
After
• Follow-up evaluation of respiratory
CHILDREN function should be arranged for severely
exposed patients. Patients who have skin
Before or corneal lesions should be reexamined
• Provide health education on areas that within 24 hours.
are at risk for lethal methyl isocyanate • Instruct the parent of the child for
poisoning. follow up check up to monitor possible
• Provide health education to co-health long term effects.
care members in rendering care to • Counseling and recommendations for
children who are exposed to lethal psychological trauma are provided.
methyl isocyanate especially on exposure • Information on prohibited areas and
routes for the substance, and exposure precaution measures are rendered to the
control measures. community.
During
• Get the child away immediately from PREGNANT WOMAN
the area.
• Discard clothing that may have been BEFORE
contaminated. 1. Create an interdisciplinary team
• Call the nearest emergency care 2. Establishing lines of communication with
facility. others as needed inside and outside the
• As a nurse it is important to assess the workplace to prevent and prepare for
child for poisoning such as: early possible exposure scenarios.
symptoms may include eye irritation, 3. Educating the worker about chemicals of
coughing, and shortness of breath. In concern, providing information on the

substance(s) possible routes of 8. Seal gaps under and around the following
exposure, and emphasizing exposure areas with wet towels, plastic sheeting,
prevention measures. duct tape, wax paper or aluminum foil:
4. Make sure there is a well-stocked first 9. Doorways and windows
aid kit containing some of the supplies 10. Air conditioning units
needed for treating chemical exposure 11. Bathroom and kitchen exhaust fans
available. This include the following 12. Stove and dryer vents with duct tape and
items: plastic sheeting
• Eyewash bottle 13. Take shallow breaths through a cloth or
• Plenty of clean water towel if gas or vapors could have entered
• Syrup of ipecac your house or building
• Activated charcoal powder 14. Avoid eating or drinking any food or
• Soap water that may be contaminated
• Disposable towels 15. If outside when an incident occurs:
• Clean change of clothes 16. Quickly decide what is the fastest way
5. Prepare an Emergency Supply Kit that to find clean air. Move away immediately,
includes duct tape, scissors and plastic to cover in a direction upwind of the source
doors, windows and vents 17. If in a car, keep car windows and vents
6. Make a Family Emergency plan closed and shut off the air conditioner
7. Know how to operate your home’s and heater
ventilation system 18. Find the closest building to shelter - in
DURING place
1. Listen to local radio or television 19. Conduct a history assessment of a
citations for detailed information and chemical exposure situation. Which
follow instructions carefully includes:
2. If asked to evacuate, do so immediately • Determine the specific location
3. Quickly try to figure out which areas are of the chemical exposure
affected or where the chemical is coming • Identifying specific chemical
from, and get away immediately involved
4. If the chemical is inside the building, get • Determine the route of expo-
out of the building without passing sure into the body (inhalation,
through the contaminated area, if ingestion, dermal).
possible • Eye exposure to chemicals:
5. If you can’t get out of the building or immediately wash (irrigate) the
find clean air without passing through eyes with large amounts of water,
the affected area, move as far away as occasionally lifting the lower and
possible and shelter-in place upper lids.
If told to stay indoors: • Chemical contacts the skin: dust
6. Seek shelter in an internal room. Close it off immediately and then flush
and lock all exterior doors and windows. the contaminated skin with water.
Close vents, fireplace dampers and as If this chemical or liquids
many interior doors as possible. Sea the containing this chemical
room with duct tape and plastic sheeting penetrate the clothing, promptly
7. Turn off air conditioners and ventilation remove the clothing and flush the
systems so that no outside air is drawn skin with water.
into your house or in the building

• If a person breathes large • While safely carrying the infant, move

amounts of this chemical: move around as little as possible ro avoid
the exposed person to fresh air kicking up dust, which may be harmful
at once. If breathing has stopped, to inhale.
perform artificial respiration • If possible, use a flashlight so you can
see the surroundings and to signal your
AFTER location to the rescuers.
1. Do not leave the safety of a shelter to After
go outdoors, including to help others, • Do not re enter the building and follow
until authorities say it is safe to do so. the instructions of the responders.
If you have evacuated, return home only • Distract and calm the infant by giving
when authorities say it is safe handheld toys, and singing lullabies.
2. If you are affected by a chemical agent • Refer the infant to the nearest medical
and medical help is not immediately facility to check for vital signs and
available, the best action is to overall health condition.
DECONTAMINATE yourself and help
others to do so, if possible. CHILDREN
3. Intervene to support rehabilitative or BEFORE
protective activities. Provide counseling • Conduct a drill and provide information
and referral for psychological trauma. to children on the level of their
4. Provide information on health effects, understanding.
control measures, and contraindications. • Involve children during planning.
5. Provide information on off limit areas • Review safety plans together with the
and public health guidelines, especially if family .
clean up efforts are long term.
GROUP E: STRUCTURAL COLLAPSE DURING
INFANT
Before • As a nurse, stay calm to focus on one
• For the safety of the infant and the goal.
whole family, be aware of the structure • Tell the children what is happening in a
and integrity of the building eg. cracks way that they can understand.
in walls, bulging walls, displaced columns, • Vacate the children with strict
sagging floors guidance.
• Prepare a family emergency kit which
include infant necessities eg. formula AFTER
milk, vitamins, clothing, diaper, toys • Provide first aid
During • Transport children who need immediate
• Given the opportunity to exit, move the medical care to the nearest hospital.
infant together with the whole family to • Give specific task to children to let
a safe location them know they can help.
• Protect the baby against debris and • Help children to make them feel safe
falling objects and cover nose to avoid and secure by talking with them or read
inhalants such as dust. them a book to relax.

• Provide them opportunities to talk about • Once the recue teams has loacted the
what they went through. victims, an immmediate assessment of
the victim shall be done.
PREGNANT WOMEN • Assess the welfare of survivors. Provide
psychological first aid and stress
BEFORE debriefing.
• Industrial building should be specially • Do not try to re-enter a building or enter
designed. Construction materials should a debris field.
be tested properly in labs. Opt for a • Pay attention for possible disconnected
collapse-resistant infrastructure. electricity wires and gas leaks
• Conduct regular inspection for possible GROUP F: GLOBAL WARMING &
hazard such as cracked walls, damaged GREENHOUSE EFFECT
power wires, etc. and check for
INFANTS & CHILDREN
structural instabilities
• Establish an exit map for every Needs:
infrastructure.
• Conduct drills regarding where to • Food for nourishment (Breastfeeding
evacuate assuring that optimal safety per demand)
and injury prevention id practiced. • Clothes to keep their bodies warm
• Water to quench thirst
DURING • Shelter for protection
• Instruct individuals to leave the • Love & Care from significant people
infrastructure/building immediately in a around them
calm manner, priorotizinng pregnat
• Adequate Rest & Sleep for growth &
women. Move to an open space away from
development
falling debris.
• Social Play to sustain their curious
• When evacuating, advise individuals not
to use elevators which can trap them. minds
Allow them to use the stairs and use • Emotional & Character Development
escape/ exit routes. training
• Insruct individuals especially pregnant
women to stay away from mirrors, glass
Interventions:
doors or windows and heavy objects that
may cause them harm.  Assess first the weather condition of
• When escaping is impossible, instruct the day before decision making.
individuals to hide under the table or a o Choose weather-appropriate
heavy doorframe, sit still and cover and
clothes for the infant & child’s
protect the head and neck using hands.
comfort.
• Instruct to use flashlight instead of
match to avoid explosion in case of gas
o Avoid staying in areas of the
leaks. Instruct to cover nose and mouth house where high temperature is
to minimize dust inhalation. mostly felt.
 Assess the infant’s/child’s skin for
AFTER rashes, redness & dryness.
• Activate search and rescue operations
for possible missing individuals.

o Watch out for signs of o Let the child express the

dehydration & overheating such as experience in a way he/she is
poor skin turgor, sunken eyeball, comfortable with.
irritability, flushed, warm-to- o Let the child do it on his/her own
touch skin & diaphoresis. pace, gradually and ensuring that
o Offer sips of water often & find his/her feelings are valid.
places to cool off.
o Have children play when it is
PREGNANT
cooler outside.
o Wear hypoallergenic sunscreen Needs:
for protection.
 Water (Clean)
 Food
 Keep kids safe during & after an
 Vitamin Supplements
extreme weather event.
 Clothes
o The family should have an
 Mosquito repellants and nets
evaluation plan especially if they
live in an area prone to severe
weather changes. Interventions:
o Access to potable water should be Educate the mother about :
readily available & children should
not be allowed to play in dirty 1. Water - related illness
bodies of water. a) Water condition: boiling of tap
o Avoid exposing the child to toxic water for 15 mins.
materials found in the aftermath b) Secure clean sources of water.
of the disaster. c) Avoid unsafe and unsure sources
 Explain what Global Warming & of water
Greenhouse Effect to the child in a
manner at par with his/her cognitive 2. Food-related Illness
understanding. a) Nutrient supplementation such as
o Teach the child what to do in case calcium, ferrous sulfate etc.
of an emergency and he is b) Alternative food sources
currently away from home (eg. c) Secure healthy food options
school) d) Food sanitation practices
o Let the child wear an
identification card with contact 3. Heat-related Illness
information in case he gets lost. a) Maintain hydration
b) Provide good ventilation
 Give your child opportunities to talk c) Wear loose clothing
about what he/she went through or d) Avoid prolonged exposure under
what he/she thinks about it. the sun

4. Insect-related Illness c) Energy Sources

a) Use mosquito repellant always  Encourage usage of renewable and
b) Use mosquito nets when sleeping environmentally friendly energy
c) Proper waste disposal sources such as solar panels and wind
d) Implement the 4s of dengue turbines
prevention in the community  Encourage the 3R’s (Reuse, reduce
• Search and destroy and recycle)
• Seek early consultation
• Secure self-protection d)Health Awareness
• Support fogging  Maintain adequate fluid intake
 Monitor fluid loss and weight loss
 Health teaching on global warming
5. Mental Health Illness
and greenhouse effects on health
 Identify and establish good support
 Provide well ventilated room
system
e) Clothes
ADOLESCENCE  Encourage to wear loose clothes
Needs:
 Encourage the adolescence to
protect themselves from extreme
 Foods weather conditions such as intense
 Water heat or rainfall.
 Energy Sources
 Health awareness GROUP G – DEFORESTATION
 Clothes DEFORESTATION
• refers to the clearing of
Interventions: forests/woodlands, usually for human
activities such as agriculture, mining,
a) Foods or urbanization. The effects of
 Reduce cut food waste deforestation can be significant and
 Reducing the amount of nitrogen far- reaching.
fertilizers applied to crops CAUSES:
 Patronize food that are plant based • Illegal Mining
than commercialized • Agricultural
 Encourage to take vitamins or • Livestock
supplements • Logging
• Activities
• Ranching
b) Water
• Urbanization
 Conserve water
• Desertification
 Check toilet for leaks
• Forest Fires
 Install water-saving shower heads • Overpopulation
 Take shorter showers INTERVENTIONS
1. PRE-IMPACT

• Tree planting • Join environmental organization such

• Education about raising awareness as Greenpeace Philippines for
• Use recycled products reforestation
• Recycle paper and cardboard • Coordinate with DENR (to obtain free
• Support organization campaigning tree/plant seeds and farming tools
deforestation for the benefit of deforestation-
• Don’t play with fire especially in affected population)
forest or near trees NEEDS OF A CHILD
2. IMPACT 1. PHYSIOLOGIC
• Activation of Emergency Protocol or • Proper nutrition
Early Emergency Warning System • Emergent Comfort
o When the early warning IMPLICATIONS:
system indicates warnings, • Nutritional Deficiences
immediately activate the • Leptospirosis
warning system and send alerts • Injuries
to residents in the affected • Hypothermia
area through multiple channels, • Infection
such as sirens, loudspeakers, 2. SAFETY AND SECURITY
text messages, and social • Safe place to stay temporarily
media. • stress debriefing
• Secure safety of pregnant women, • Counselling children
infant, and child IMPLICATIONS:
• Evacuation (according to emergency • Trauma
protocol) • Separation Anxiety
o Quickly evacuate people from 3. LOVE AND BELONGING
landslide and flood prone • Emotional support
areas to a safe location, which • Reunited with family and friends
should be located on higher • Support system
ground or outside of the IMPLICATIONS:
danger zone. Provide • Ineffective Coping
transportation if needed and 4. ESTEEM NEEDS
assist those with mobility • Talk to children about event in a way
issues. they can under
• Address physiological needs such as food • Give opportunity to talk about
and injuries
experience
• Reassure children and comfort victims
• Listen to child express their feelings
3. POST-IMPACT
5. SELF-ACTUALIZATION
• Relocation (landslide and wildfire
• Children most likely der not fulfil this
prone areas)
need yet because they do not have
• Raise awareness on rights of the
enough life experiences and
indigenous people of their land
perception of reality yet.

NEEDS OF AN INFANT conducted. In the event your child’s

1. PHYSIOLOGIC NEEDS condition requires hospitalization.
• Include the necessities of the infant Physical Assessment
in the emergency kit such as formula • After a neonatal/pediatric transport.
milk, feeding bottles, clean The thing that you should do is to
water, lampeins or diapers, toys that check on the infant. Try not to move
infant can play with & use of free- him or her if seriously injured, until
tree products. EMT arrives.
• Encourage the parents about • It may be possible for you to calm the
practicing the 3R's (Reuse, Reduce, infant or do basic assessment such as
Recycle), especially in purchasing checking up for vital signs while
products for the infant waiting for the EMT’s to arrive:
• Introduce to the parents about the • You look into your infant’s eyes with a
companies and organizations that are special torch to check how their eyes
committed to reducing deforestation look and move.
where they can buy products for • Listen to infant’s heart to check their
their infant. heart sounds.
2. SAFE SECURITY • Examine their hips to check the
• Instructed the parents to establish joints.
emergency escape plan • Check for respiratory rate of an
• Educate the parents about tree infant.
planting. • Once the EMT arrives, they will
• Educate the parents to make sure quickly assess his or her condition.
they cover the infant during Allow them to take the child out of
deforestation. the car seat and perform an
3. LOVE & BELONGING examination and determine the
• Inform the parents to make time with extent of the injury.
the infant despite of the disaster. Immediate Medical Treatment
Infantile/Pediatric Transport • After your child has been treated by
• This service provides safe emergency room doctors, it is
transportation of the pediatric important that you follow up with his
victims with transporting team or her primary care physician to
members that are knowledgeable and ensure proper treatment.
skilled in the needs of the critically • Your pediatrician may schedule an
ill or injured infants. appointment for your infant to follow
• After incident happens, first thing to up with him/her in the office after
do is to call for a help. Police and your infant is discharged from the
emergency medical technicians ER, or if your infant is admitted to a
(EMTs) should arrive at the accident facility where the pediatrician has
scene. A police report can be issued privileges, your physician may visit
after an investigation has been your infant in the hospital.

• If necessary, your infant’s doctor • Climate-related exposures may lead

may refer you to additional doctors to adverse pregnancy and newborn
and specialists. You could seek the health outcomes, including
help of an orthopedist, neurologist, spontaneous abortion, low birth
plastic surgeon, or physical therapist, weight, preterm birth, increased
depending on the condition your child neonatal death, dehydration and
has. associated renal failure, malnutrition,
NEEDS OF PREGNANT WOMEN diarrhea, and respiratory disease.
• Pregnant and postpartum women IMPLICATIONS
uniquely vulnerable to the health • Hyperthermia
impacts of deforestation. In which • Injuries
deforestation may lead to extreme • Infection
hot temperature, flood and landslide. • Nutritional Deficiencies
Because of this, there are many • Ineffective Coping
physiologic and social changes that
occur as a result of pregnancy. PHYSIOLOGIC
Extreme hot temperature • Provide appropriate healthcare
• Pregnant women are vulnerable to • Provide proper sheltering
extreme temperature and are • Advise to wear loose clothing
especially susceptible to dehydration, • Provide adequate ventilation
they release labor-inducing SAFETY AND SECURITY
hormones. • Survival kits should be provided
• Also associated with adverse birth • Evaluate the emergency response
outcomes, such as preterm birth, low plan
birth weight and infant mortality. LOVE AND BELONGING
Flood 1. Offer support and encourage to join
• Floods also place pregnant women at groups for counselling
increased risk of exposure to 2. Listen to when expressing their
environmental toxins and mold, thoughts and feelings about the
reduced access to safe food and experience
water, increased risk for waterborne ESTEEM NEEDS
disease, especially gastrointestinal • Health education, such as factors
illness, as a result of flooding that may affect pregnancy, what to
• Pregnant women who develop severe do and what to avoid.
gastrointestinal illness are at high SELF-ACTUALIZATION
risk for adverse pregnancy outcomes. • Promote self-efficacy and positive
Infectious disease concepts of pregnancy and birthing.
• Women are also vulnerable to vector-
borne disease, including the Lyme GROUP H - DRINKING WATER
Disease, Dengue and Zika virus, which CONTAMINATION
causes microcephaly in fetuses. The Safe Drinking Water Act defines the term
"contaminant" as meaning any physical, chemical,
biological, or radiological substance or matter in

water. Therefore, the law defines kidney problems and high blood
"contaminant" very broadly as being anything pressure.
other than water molecules. Drinking water may
reasonably be expected to contain at least small Needs of Infants, Children, Pregnant Women
amounts of some contaminants. Some drinking • General fluid needs increase during
water contaminants may be harmful if consumed pregnancy in order to support fetal
at certain levels in drinking water while others circulation, amniotic fluid, and a
may be harmless. The presence of contaminants higher blood volume. In addition to
does not necessarily indicate that the water maintaining fluid volume needs, most
poses a health risk. municipal water contains fluoride,
CATEGORIES OF CONTAMINANTS which can aid the development of
1. Physical contaminants primarily teeth and bones in the growing fetus.
impact the physical appearance or An adequate fluid supply also ensures
other physical properties of water. that the mother has enough reserves
2. Chemical contaminants are elements to tolerate blood loss during delivery.
or compounds. These contaminants • Need for proper education of the
may be naturally occurring or man- mother and pregnant woman
made. regarding the sources, effects, and
3. Physical contaminants primarily management of contaminated
impact the physical appearance or drinking water.
other physical properties of water. • Need for proper water disinfection.
Health Effects of Drinking Contaminated • Need for safe drinking water. It is
Water important for children because they
Nitrates are more vulnerable to harm from
• In the intestines, nitrates are contaminated water. If a water
converted to nitrites, which prevent source may be contaminated with
blood from transporting oxygen. An flood waters, children, pregnant
enzyme present in the system of women and nursing mothers should
older children restores the blood's drink only bottled water, which
ability to carry oxygen. should also be used to mix baby
Cryptosporidium formula and for cooking. We also
• Pathogen that sometimes gets into recommend you sponge bathe your
water supplies. It can cause a children with warm bottled water
gastrointestinal disease that could be until you are certain your tap water is
fatal. safe to drink.
Lead • During an emergency, mothers of
• Can cause both physical and mental exclusively breastfed infants do not
developmental problems in infants need to store any food-related items
and children. Adults who have been for their babies. Exclusive
drinking lead-tainted water for a breastfeeding could be considered an
number of years can experience emergency preparedness activity.

Effects of Contaminated Drinking Water diseases such as cholera, dysentery,

On pregnant women and newborn typhoid and polio and is estimated to
• According to the study of Currie et al cause 485,000 diarrheal deaths each
(2013) living in a water district with year.
contaminated water during pregnancy Drinking Water Management
is associated with an increase in low • Improve sanitation facilities by
birth weight of 14.55% among less providing toilets and latrines that
educated mothers. Similarly, flush into a sewer or safe enclosure.
potential exposure to contaminated • Promote good hygiene habits through
water increases the incidence of education. Proper hand washing with
prematurity by 10.3% among less soap and water can reduce diarrhea
educated mothers. cases by up to 35 percent.
Biological contaminants such as: • Implement rainwater harvesting
• Escherichia coli (E. coli): systems to collect and store
dehydration, pyelonephritis, severe rainwater for drinking or recharging
bleeding, miscarriage or preterm underground aquifers. Build wells to
delivery and neonatal meningitis extract groundwater from
• Toxoplasma gondii: affects mainly underground aquifers.
the eyes and the nervous system of • Provide home water-treatment
the fetus; can progress to behavioral capability through the use of filters,
abnormalities, hearing loss, visual solar disinfection, or flocculants, to
impairment, and mental retardation. make drinking water safe.
• Exposure to drinking water • Promote low-cost solutions, such as
contaminants such as lead, nitrates, chlorine tablets or plastic bottles
pesticides and even the byproducts that can be exposed to sunlight, to
of processes that disinfect water improve water quality.
supplies can harm the baby by
retarding growth, stunting mental TRANSPORT DISASTER
development and causing birth • Infants and toddlers can be severely
defects affected by trauma. An example of a
On children traumatic and life-threatening
• Children are also susceptible to situation might be a car accident,
gastrointestinal and stomach bushfire, sudden illness, a fatality in
illnesses like nausea, vomiting, the family, violent crime, or abuse of
cramps, diarrhea, and headaches by children.
drinking contaminated water. • Before the age of three, trauma can
• Contaminated water causes parasites profoundly affect key aspects of
in children which also contribute to child development. Rebuilding the
chronic malnutrition with children family’s safety, security, and
unable to absorb sufficient nutrients. nurturing environment will aid the
• Microbiologically contaminated baby or toddler in their recovery.
drinking water can also transmit

• It is necessary to establish a regional ✓ Examine their hips to check

neonatal/pediatric transport the joints.
network, in order to provide a ✓ Check for respiratory rate
platform for effective information of an infant.
communication and resource sharing. • Once the EMT arrives, they will
Needs of an Infant quickly assess his or her condition.
1. Infantile/Pediatric Transport (Safety Allow them to take the child out
Needs) of the car seat and perform an
examination and determine the
This service provides safe
• extent of the injury.
transportation of the pediatric 3. Immediate Medical Treatment (Safety
victims with transporting team Needs)
members that are knowledgeable • After your child has been treated
and skilled in the needs of the by emergency room doctors, it is
critically ill or injured infants. important that you follow up with
• After incident happens, first his or her primary care physician
thing to do is to call for a help. to ensure proper treatment.
Police and emergency medical • Your pediatrician may schedule an
technicians (EMTs) should arrive appointment for your infant to
at the accident scene. A police follow up with him/her in the
report can be issued after an office after your infant is
investigation has been conducted. discharged from the ER, or if your
In the event your child’s condition infant is admitted to a facility
requires hospitalization where the pediatrician has
2. Physical Assessment (Safety Needs) privileges, your physician may visit
• After a neonatal/pediatric your infant in the hospital.
transport. The thing that you • If necessary, your infant’s doctor
should do is to check on the infant. may refer you to additional
• Try not to move him or her if doctors and specialists. You could
seriously injured, until EMT seek the help of an orthopedist,
arrives. neurologist, plastic surgeon, or
• It may be possible for you to calm physical therapist, depending on
the infant or do basic assessment the condition your child has.
such as checking up for vital signs 4. Monitoring Symptoms (Safety Needs)
while waiting for the EMT’s to • Mild Injuries
arrive: ✓ Head Injuries is most likely
✓ You look into your infant’s minor if he or she is awake
eyes with a special torch to and responding to you. Cold
check how their eyes look compresses will assist in
and move. reducing swelling: apply
✓ Listen to infant’s heart to them for 20 minutes to
check their heart sounds. relax the affected areas.

✓ When your child is sleeping, infant suffers severe injuries as a

let him or her sleep, but result of the accident.
make sure you check on him Needs of a Children
every two to three hours. • Every four minutes, a child is
• Baby Bumps on the Head prematurely lost on the roads of
✓ Keep a close eye on your this world. Many more are injured,
child after they fall and hit often severely.
their head, especially if • Transportation accidents are a
they are alert and react to harrowing and dangerous
you experience for the people
• Serious Injuries involved, but it can be more
✓ Brain injuries can impact terrifying for parents with
memory, judgment, children inside the vehicle as well.
equilibrium, and reaction • Every four minutes, a child is
time, as well as sleep. prematurely lost on the roads of
Additionally, they can this world. Many more are injured,
increase sensitivity to often severely.
sound and light as well as • Transportation accidents are a
cause headaches. harrowing and dangerous
5. Nutrition (Physiological Needs) experience for the people
• BREASTFEEDING remains the involved, but it can be more
best way of feeding an infant, terrifying for parents with
especially if clean water is not children inside the vehicle as well.
available. 1. Thorough Assessment (Physiological
• Mother is injured: Needs)
✓ Assist in breastfeeding by: • After a transportation accident,
✓ Holding the infant in place the first thing that you should do
✓ Manually expressing breast is to check on the child. Try not to
milk or use of breast pump move him or her if seriously
• Mother died in a disaster injured, until medical help arrives.
✓ Alternatives for breast • Once the paramedic arrives, allow
milk: them to take the child out of the
✓ Donated breast milk car seat and perform an
✓ Formula examination and determine the
6. Filing a Compensation Claim (Safety extent of the injury.
Needs) 2. Providing appropriate care for injured
• The victim may be entitled to children (Physiological Needs) •
financial compensation for the • Providing caretaker knowledge on
damages experienced. safe immediate stabilization of
• Getting compensation can help injuries
offset the costs of medical • Training prehospital and
treatment or rehabilitation if the facilitybased providers in the

physiologic differences between • This would ensure that a trained

children and adults professional would examine your
• Equipping emergency vehicles with child and see if their conditions
child-sized medical equipment and have changed since the accident.
supplies It would make sure that there are
• Making hospitals as additional records of your child’s
“childfriendly” as possible. condition after the accident.
3. Supervise children around the roads 6. Help Recover from Trauma (Safety and
(Safety Needs) Love and Belonging Needs)
• Supervision would include, for • Provide children with
example, ensuring that children opportunities to talk about what
use helmets, car seats, and they went through or what they
seatbelts and abide by the about it. Encourage them to share
protocols established for school concerns and ask questions.
safety zones • Younger children might go might
• Parents and other caregivers can go back to their infantile
play an important role in helping behaviors while older children
the children in their care to might develop nightmares,
interpret what is happening behavior problems, depression
around them. symptoms, and headaches.
4. Filing of Accident Reports (Safety • Improving access to counselling
Needs) services both to mitigate the
• The police are required to be psychological impact of road
called immediately for any type of traffic injury on children and
transportation accidents. Once their families and to address
the police arrive, discuss the practical considerations, including
accident in detail. legislative and financial queries.
• The police will then file and Needs of Pregnant Women
accident report and investigate • Disasters can adversely affect the
the case to establish who’s at physical and mental health of
fault and help move towards pregnant women, including preterm
insurance claim for the child’s labor and intrauterine growth
injuries. retardation, particularly when they
5. Doctor’s Follow- up Visit (Safety have to evacuate to a public shelter.
Needs) Thus, nurses should provide
• Child should be taken for a appropriate health care for disaster-
followup check with their affected pregnant women, including
pediatrician within a couple of preparing nutritious food for health
days after the accident whether promotion, preparing proper
or not you notice the symptoms of sheltering, and providing counseling
an injury. services to relieve stress. Moreover,
the nurse should play a role in

disaster preparedness for pregnant • Documentation and disposition

women in all disaster phases: pre- should be made as quickly as
impact, impact and post-impact. possible.
• Research increasingly shows that the 2. Referral and Transfer (Safety Needs)
stress of a transport disaster can • Hospitals with maternity services
cause long-lasting damage. Hence, should develop specific strategies
transportation interventions seek to for stabilizing and transporting
decrease delay in reaching a health obstetric patients in an event of
facility for emergency obstetric care transportation accidents in the
and are believed to contribute to rail, subway, bridge, or airplane.
reductions in such adverse pregnancy • Moreover, obstetric units should
and childbirth outcomes as maternal have a designated safe location
deaths, stillbirths, and neonatal for laboring patients who cannot
mortality. be transported because of
1. Primary and Secondary Assessment imminent delivery. This plan
(Safety Needs) should include an identified
• The most common alternative site for delivery if the
pregnancyrelated traumas are labor and delivery unit is damaged
minor incidents, including motor and a system to ensure the
vehicle crashes and mild blunt necessary equipment can be
abdominal trauma. These transported quickly to the
situations require clinical alternative site.
judgment about the extent of 3. Management (Safety Needs)
maternal and fetal assessment. • Injured pregnant women with an
• In major trauma, the primary unsecured airway are at increased
assessment should focus on risk for aspiration of gastric
airway, breathing, and circulation. contents. A nasogastric tube
Once the primary assessment has should be inserted in a
been completed, a secondary semiconscious or unconscious
assessment should include injured pregnant woman to
obstetric and nonobstetric prevent aspiration of acidic
injuries and fetal well-being. gastric content.
• Triage is essential in the • Marked increases in basal oxygen
aftermath of the disaster and consumption and extreme
should include early assessment, sensitivity of the fetus to
urgency determination, and maternal hypoxia mandate
immediate transfer to an supplemental oxygen by a nasal
appropriate facility. cannula, mask, or endotracheal
• Priority of care should be based tube to all pregnant trauma
on triage acuity viewed in light of patients to maintain oxygen
current conditions and capacity saturation above 95%.
for safe transport.

• Insertion of 2 large bore needles spirituality, something that health

(14–16 gauge) is recommended for care professionals can encourage
all seriously injured trauma and support within the hospital
patients to facilitate initial rapid setting in a transport accidents
crystalloid infusion, intravascular situation.
volume expansion, and possible • Health care providers need to
further blood transfusion as recognize, respect, and
required. understand the significance of
• In cases of maternal hypotension, personal spiritual beliefs and
vasopressors should be avoided practices to provide holistic care.
unless the patient is unresponsive • Should a mother and/or her baby
to replenishment of intravascular die during the disaster, the nurse
volume by fluid administration. To should acknowledge the losses,
further facilitate the evaluation giving value to the life, even if yet
of maternal hypovolemia, the to be born.
pregnant trauma patient should be • Professionals should recognize
undressed and a thorough that their actions and should
examination for sources of blood focus on healing, caring, comfort,
loss should be undertaken. and support.
4. Spiritual Interventions (Love and • The bereaved want to make
Belonging Needs) meaning of the experience.
• Discuss spirituality and explore Spiritual rituals, such as baptism
spiritual issues of the pregnant for Christians, naming, blessing,
women which can be beneficial in and funerals, help them make
making meaning and reducing meaning.
stress during an accident. • If possible, funeral rites and
• Provide support and resources burial rituals should be followed,
women need to engage in spiritual which may be a challenge in a
practices such as prayer, disaster.
meditation, and ritual practices 5. Prevention of Injury (Safety Needs)
that strengthen and maintain • The American College of
relationships with what is held Obstetricians and Gynecologists
sacred. (ACOG) state that pregnant
• Spiritual direction and counseling women who are occupants in motor
could also be provided when vehicles should wear lap and
needed, providing an empathetic shoulder seat belts and should not
presence that enables women to turn off air bags.
explore and express their deepest • Proper seat belt use should be a
thoughts, fears and hopes during major prenatal counseling issue.
the accident. The lap belt should be placed as
• Interaction with loved ones was an low as possible under the
important component of their protuberant portion of the

abdomen and the shoulder belt

positioned off to the side of the
uterus, between the breasts and
over the midportion of the clavicle
• Air bag deployment reduces injury
to pregnant women and does not
increase the risk of adverse
pregnancy outcomes.

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3:DISASTER MENTAL HEALTH AND HIGH-VULNERABILITY POPULATIONS NCM 120

Lecturer: Ms. Ma Concepcion Sekito, RN || March 30-31, 2023

A little preparation can make a big

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care. Nurses should be aware about • As estimated 15,000 to 20,000

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PPE o If the infant/toddler stopped

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• Discard clothing that may have been 1. Create an interdisciplinary team

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• Instruct to use flashlight instead of Secure vaccine for infants and

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• Distract them with toys. • Educate family members to attend

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or concentrate in areas of the mother's Abraham H. Maslow, (born April 1,

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 Teething tablets or gel

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by responding to their babies when they - stunted growth

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● Children can be exposed to ● Explain what is happening. Assess

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have basic knowledge of radiation, teachers • 1 XL Disposable Apron without Sleeves

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o If the eye is affected, wash the cases of severe exposure, later

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• If a person breathes large • While safely carrying the infant, move

GROUP E: STRUCTURAL COLLAPSE DURING

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o Watch out for signs of o Let the child express the

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4. Insect-related Illness c) Energy Sources

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• Tree planting • Join environmental organization such

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NEEDS OF AN INFANT conducted. In the event your child’s

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• If necessary, your infant’s doctor • Climate-related exposures may lead

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Effects of Contaminated Drinking Water diseases such as cholera, dysentery,

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• It is necessary to establish a regional ✓ Examine their hips to check

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✓ When your child is sleeping, infant suffers severe injuries as a

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physiologic differences between • This would ensure that a trained

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disaster preparedness for pregnant • Documentation and disposition

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• Insertion of 2 large bore needles spirituality, something that health

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abdomen and the shoulder belt

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