MODULE 1: OVERVIEW OF EMERGENCY AND
DISASTER NURSING
Emergency
● any sudden illness or injury that is perceived
by the client or significant other as requiring
immediate intervention. It continues until the
condition is stable and no longer threatens the
client’s integrity or well-being.
● a perilous situation that arises suddenly and
threatens the life or welfare of a person or group
of people, as a natural disaster, medical crisis,
or trauma situation.
EMERGENCY RESCUE
● a procedure for moving a victim from an
unsafe place to a place of safety
EMERGENCY CARE
● an episodic and crisis-oriented care provided
by healthcare professionals to patients with
serious or potentially life threatening injuries or
illnesses
SCOPE AND PRACTICE OF EMERGENCY NURSING
● The emergency nurse establishes priorities,
monitors and continuously assesses acutely ill
and injured patients, supports and attends to
families, supervises allied health personnel, and
teaches patients and family within a timelimited,
high pressured care environment.
● Nursing intervention are accomplished
interdependently, in consultation with or under
the direction of a licensed physician or nurse
practitioner.
● The entire emergency health care staff
members work as a team in performing the
highly technical, hands-on skills required to care
for patients in an emergency situation
GOLDEN RULES IN GIVING EMERGENCY CARE:
WHAT TO DO
● Do obtain consent when possible
● Do think of the worst. It is best to administer
first-aid for the gravest possibility.
● Do remember to identify yourself to the victim
● Do provide comfort and emotional support
● Do respect the victim’s modesty and physical
privacy
● Do be as calm and as direct as possible
● Do care for the most serious injuries first.
● Do assist the victim with his or her prescription
medication
● Do keep onlookers away from the injured
person
● Do handle the victim to a minimum
● Do loosen tight clothing
WHAT NOT TO DO
● Do not let the victim see his/her own injury
● Do not leave the victim alone except to get help
● Do not assume that the victim’s obvious injuries
are the only ones.
● Do not make unrealistic promises
● Do not trust the judgment of a confused victim
and don’t require to make decision
DISASTER: AN OVERVIEW
● Disaster are old as mankind
● The first description of disaster and its
management comes from the biblical story of
Noah and his ark.
● Its etymology in Greek “dus” means bad &
“aster” means star, collectively mean a calamity
due to a bad position of a star or planet
DISASTER: DEFINITION
● An emergency with greater magnitude, longer
duration, generally lower outcomes
● Extraordinary response from outside
● Creates human needs that victims cannot
alleviate without asistance
● A serious disruption of the functioning of a
community or society involving widespread
human, material, economic, or environmental
losses and impacts, which exceed the ability of
the affected community or society to cope using
its own resources
● “An occurrence, either natural or manmade that
causes human suffering and creates needs that
victims cannot alleviate without assistance”
–The American Red Cross
D – DESTRUCTION
I – INCIDENTS
S – SUFFERINGS
A – ADMINISTRATIVE & FINANCIAL FAILURES
S – SENTIMENTS
T – TRAGEDIES
E – ERUPTION OF COMMUNICABLE DISEASES
R – RESEARCH PROGRAMME AND ITS
IMPLEMENTATION
2 Types of Disaster: Natural and Man-made Disaster
DISASTER NURSING
● It is the care given to individual, families,
groups, and communities affected by disaster to
preserve health and prevent illness and other
health complications brought about by the crisis.
● It is the adaptation of professional nursing
knowledge, skills, and attitude in recognizing
and meeting the nursing, health and emotional
needs of disaster victims.
● According to Society for Advancement of
Disaster Nursing (2021), “Nurses are critical
asset to disaster planning and response
initiatives. Their unique skill sets are ideal for
helping those affected by a disaster as are their
abilities to organize, prepare families in
advance, and communicate across discipline.”
ROLES OF NURSES IN ACTUAL DISASTER
● Nurses primarily provide acute patient care
during disasters, helping treating the sick and
injured and ensure access to basic health care
service. They can also:
○ Triage patients
○ Evacuate or transfer patients to
another unit or facility
○ Communicate with patients,
volunteers and healthcare workers
 ○ Coordinate activities with outside
agencies and volunteers
○ Help set-up makeshift facilities with
limited technologies and medical
supplies
○ Provide emotional
support/psychological first aid
PHASES OF DISASTER
1. PRE-IMPACT PHASE- IT IS THE INITIAL PHASE OF
DISASTER, PRIOR TO THE OCCURRENCE A
WARNING IS GIVEN AT THE SIGN OF THE FIRST
POSSIBLE DANGER
OBJECTIVE: “Prevent the loss of lives and minimize
impact to health system”
2. IMPACT PHASE - DISASTER ACTUALLY HAPPENS;
IT IS THE TIME OF ENDURING HARDSHIPS OR
INJURY AND TRYING TO SURVIVE.
OBJECTIVE: “Save as much lives as possible”
3. POST-IMPACT PHASE - RECOVERY BEGINS
DURING THE EMERGENCY PHASE AND ENDS WITH
BOTH THE RETURN OF NORMAL COMMUNITY
ORDER AND FUNCTIONING. THIS PHASE CAN LAST
A LIFETIME ONTO SOME SURVIVORS DUE TO THE
GRAVITY OF RESULTS OF THE DISASTER
OBJECTIVE: “Prevent and control post-disaster
morbidities”
DISASTER MANAGEMENT
● It is defined as the organization and
management of resources and
responsibilities for dealing with all the
humanitarian aspects of emergencies, in
particular preparedness, response and recovery
in order to lessen the impact of disaster.
(International Federation of Red Cross and Red
Crescent Societies, 2020)
● An applied science which seeks, by systemic
observation and analysis of disasters, to
improve measures relating to prevention,
emergency response, recovery and mitigation.
● Encompasses all aspects of planning for, and
responding to disasters, including both pre and
post disaster activities
- How is the local terrain conductive to disaster
formation? (typhoon, floods, eruptions)
- What are the local industry?
- What personnel and local agencies and
organizations available for disaster
interventions?(medical personnels, hospital,
community volunteer rescuers, schools, Red
Cross)
2. Diagnose Community Disaster Threats
- Determine actual and potential disaster threats
(e.g. toxic waste, explosions, road accidents,
floods, typhoon, earthquakes)
3. Community Disaster Planning
- Develop a disaster plan to prevent or deal with
identified disaster threats
- Identify local community communication
system
- Set up of an emergency medical system and
chain of activiation
4. Implementation of Disaster Plan
- Focus on primary intervention activities to
prevent occurrence of man-made disaster
- Practice using equipment, and obtaining and
distributing supplies.
5. Evaluate Effectiveness of Disaster Plan
- Critically evalauate all aspects of disaster plan
and practical drills for speed,
effectiveness, gaps and revision
- Evaluate the disaster impact on community
and surrounding regions
- Evaluate response of personnel involved in
disaster relief efforts
4 PHASES OF DISASTER MANAGEMENT

PRINCIPLES OF DISASTER MANAGEMENT

● Prevent the occurrence of disaster whenever
possible
● Provide first aid to the injured
● Provide definitive medical care
● Disaster management is the responsibility of all
sphere of government
● Rescue the victims and minimize the number of
casualties if the disaster cannot be prevented
● Evacuate the injured to medical facilities
● Disaster management planning should focus on
large scale events
● Promote reconstruction of lives

ROLES OF NURSES IN
DISASTER MANAGEMENT
1. Assess the Community
- Is the a current community disaster plan in
place?
- Previous disaster experience?

MODULE 2: PHILIPPINE DISASTER RISK PROFILE
PHILIPPINE DISASTER
RISK PROFILE
● According to WorldRiskIndex, that calculates
disaster risk for 193 countries in 2022,
Philippines is the top country at the highest
risk for disaster with a disaster risk index of
46.82, followed by India (42.31) and Indonesia
(41.46)
● Philippines is situated along the Eurasian and
Pacific plates, with extensive fault lines
generate an average of 20 quakes per day,
mostly minor ones.
● Located in the typhoon belt, with average of
18-22 typhoons a year; its 289 kms. of coastline
es exposed to storm surges, tsunami, and sea
level rise
● Flooding is a perennial problem due to:
○ Unplanned and unregulated
development ventures (housing,
mining, illegal fish ponds)
○ Informal settlers living in waterways
○ Denuded forest due to illegal logging,
leading to soil erosion
○ Poor waste management
- Effects of El Nino and La Nina can
cause inundations, landslides and
drought which affects food security
and energy
PERCEIVED IMPACT OF CLIMATE CHANGE
● Current climate change trends exhibited
increasing temperatures with an average of 0.01
degrees Celsius per year increase from
1971-2000
● Climate change projections from 2020 to 2050
would impact domestic water supply, irrigation,
hydropower generation, watersheds and fishery,
and even flood control operations
● Climate change is expected to further aggravate
the present condition of the Philippine
ecosystem
● Human security is threatened due to increase
disaster risks
THE PHILIPPINE DISASTER RISK
REDUCTION MANAGEMENT (DRRM) SYSTEM
● The Philippines was the first in Asia to have
enacted its own disaster risk reduction and
management thru RA 10121.
● The National DRRM Framework is a conceptual
paradigm on how “whole of society” can works
towards “Safer, adaptive and
disaster-resilient Filipino communities
towards sustainable development.”
RA 10121
● a.k.a the Philippine Disaster Risk Reduction
and Management Act of 2010
● An act strengthening the Philippine disaster
risk reduction and management system,
providing for the National Disaster Risk
Reduction Management Council as the head
agency (NDRRMC) and institutionalizing the
National Disaster Risk Reduction and
Management Plan from national to local levels
● A law that requires the country’s government
and its citizens to be prepared for disaster
NDRRMC
● The council is empowered to the following
functions:
- Develop vertical and horizontal coordination
mechanism
- Formulate national agenda for institutional
capability building and disaster plans
- Initiate research and technology development
- Task the Office of Civil Defense to conduct
periodic assessment and performance of
member agencies
- Coordinate the implementation of the country’s
obligation with disaster management treaties
ROLE OF LGU
● Under the RA 10121, there shall be a DRRM
Council for each region, LGUs, to provincial to
barangay level, are also mandated to from and
operate DRRM councils.
● Each of these offices must come up with a local
disaster risk reduction and management plan
covering aspects of disaster preparedness,
response, prevention and mitigation, and
rehabilitation and recovery
SCOPE AND ACTIVATION
● Barangay Development Council – if one
barangay is affected
● City/Municipal DRRMC – if two or more
barangays are affected
● Provincial DRMMC – if two or more
cities/municipalities are affected
● Regional DRRMC – if 2 or more provinces are
affected
● National DRRMC – of 2 or more regions are
affected
INCIDENT COMMAND SYSTEM
● It is a standardized approach, on-scene,
all-risk incident management concept to the
command, control and coordination of
emergency response
INCIDENT COMMANDER
- the person in charge at the incident
- must be fully qualified for the incident
Essential Health Service Packages
1. Medical and Public Health
- Treatment of Injuries and Diseases, Maternal, Newborn
and Child Health, Sexual Reproductive Health (SRH)
2. Water Sanitation and Hygiene (WASH)
3. Nutrition
- Nutrition in Emergencies (NIE)
4. Mental Health and Psychosocial Support (MHPSS)
- Psychological First Aid
CURRENT DOH – Health Emergency
Management Bureau VISION
 ● DOH VISION: “Disaster Safety that
starts in the hands of the community”
● 5K
“Kaligtasang Pangkalusugan sa
Kalamidad sa Kamay ng Komunidad”
HAZARD
● A source of danger; potential threat to public
safety
● A dangerous phenomenon, substance, human
activity or condition that may cause loss of life,
injury or other health impacts, property damage,
loss of livelihoods and services, social and
economic disruption, or environmental damage.
RISKS
● The combination of probability of an event
and its negative consequences
● The potential CONSEQUENCES of
EXPOSURE to a hazard
Examples: predetermined medical conditions, breakdown
of security, damage to infrustractures
VULNERABILITY
● The characteristics and circumstances of a
community or system, that makes it susceptible
to the damaging effects of a hazard exposing
to risks
● Ex: Access to health care, poverty, lack of
access to safe water, unsafe infrastructure,
illiteracy, environmental degradation, unskilled
health workforce
COMMUNITY
● It is best defined as a group of people who,
regardless of the diversity of their backgrounds,
have been able to accept and transcend their
differences, enabling them to communicate
effectively and openly, and to work together
towards goals identified as being for the
common good
CAPACITY
● the combination of all the strengths,
attributes and resources available within an
organization, community or society to manage
and reduce disaster risks and strengthen
resilience (UNISDR, 2015)
● Ability of coping and responding to reduce loss
EMERGENCY PREPAREDNESS
● The knowledge and capacities developed by
governments, professional response and
recovery organizations, communities and
individuals to effectively anticipate, respond to,
and recover from, the impacts of likely, imminent
or current hazard events or conditions during
extreme emergencies and disasters
PREVENTION
● activities and measures to avoid existing and
new disaster risks
MITIGATION
● lessening or minimizing the adverse impacts
of a hazardous event
EMERGENCY AND DISASTER
PREPAREDNESS PLAN
● a formal plan of action usually prepared in
written form for coordination during the event of
a disaster within the institution or the
surrounding community.
DISASTER
● Result of the combination of the: exposure to
a hazard; the conditions of vulnerability that are
present; insufficient capacity or measures to
reduce or cope with the potential negative
consequences
RESPONSE
● The provision of emergency services and
public assistance during or immediately after a
disaster in order to save lives, reduce health
impacts, ensure public safety and meet
subsistence needs of the people affected
PHASES OF DISASTER RESPONSE
1. Alarm Phase - it is concerned with the immediate
activation of adequate and appropriate resources
2. Work or Implementing Phase
- LOCATE
Determine where the victims are
- ACCESS
the situation of victims/place of disaster
- STABILIZE
manage victims with life-threatening injuries
- TRANSPORT
transfer victims to medical facilities
RECOVERY
● It is the restoration, and improvement of
appropriate facilities, livelihoods, and living
conditions of disaster-affected communities,
including efforts to reduce disaster risk factors
● BUILDING BACK BETTER
4 steps in Disaster Risk Reduction Management Plan
1. Reflect back
(Learning from experience)
2. Look up to day to day issue to see
big picture of future (Environmental Scan)
3. Prioritize where to go and focus resources in the
future to achieve mission
- MISSION
- VISION
- GOAL
- Objectives
- Strategies
- Action Plan
4. Develop the Strategic Plan for Health Emergency
Management
BIOETHICS IN EMERGENCY AND DISASTER/
TRAUMA CARE
SEE ONE -> TREAT ONE -> SAVE ONE
III. EMERGENCY ASSESSMENT AND CARE
Emergency Assessment
- A systematic approach to the assessment of an
emergency patient is essential. Usually, the most dramatic
injury is not the most serious. The primary and secondary
surveys provide the emergency nurse with a methodical
approach to help identify and prioritize patient needs.
- Conscious, assess the rate and quality of breathing
(Does it rise and fall? Does it appear a shortness of
breath)
For unconscious patient:
- use the look listen and feel approach
- place the side of the face next to patient’s nose and
mouth
- see the chest rise and fall
- feel the movement of air on cheek

- if having difficulty in breathing or with unusual breath

sounds, check for foreign objects and remove
- If breathing is absent, the next step is a carotid pulse to
assess if there's a circulation. ( if a carotid is present but
the patient is not breathing or only gasping perform rescue
breathing)

A. PRIMARY ASSESSMENT Circulation (heartbeat): Check for signs of adequate

- sometimes called the primary patient assessment or the circulation, including pulse rate, quality, and capillary refill.
initial patient assessment - Unconscious, check for carotid pulse
- to identify life-threatening issues that require immediate
attention.
1st Step:
Form a General Impression
- Note the sex and the age
- determine trauma or illness (if u cannot determine, treat
as the trauma patient)
- Patient's Level of Consciousness - place your index and middle finger together and touch
the larynx (Adam's apple) in the patient’s neck.
2nd Step: Assess the Level of Responsiveness - Slide your 2 finger off the larynx toward patient’s ear
- Introduce yourself (if unconscious, gently touch or shake - If u cannot feel the carotid pulse within 5-10 secs begin
the patient’s shoulder to get a response) CPR.
- Ask patient’s name -Conscious, assess for radial pulse
Patient’s level of consciousness using the four-level AVPU
scale:
Alert: able to answer the ff. Question
Verbal: “responsive to verbal stimuli” even if tha patient
reacts only to loud sounds
Pain: A patient who is responsive to pain will not respond
but will move or cry in response to pain. Tested by - place your index and middle finger on wrist at the thumb
pinching the earlobe or skin over the collarbone, side
Unresponsive: No response to verbal or stimuli For Infant: Check brachial pulse for 5-10 secs

3rd Step: Perform a rapid exam (ABC’s approach)

Airway: Ensure the airway is clear and assess for any

obstructions. To correct any serious airway problems.
- If alert and able to answer, the airway is opne
- if unconscious, open the airway
A irway Open
▪ NO suspected spinal cord injury - Head tilt chin lift
Description of skin color
maneuver(with medical problem)
- Pale/whitish/light- decreased circulation, could be
▪WITH suspected spinal cord injury- Jaw thrust maneuver
caused by blood loss, poor blood flow, or low body
(with trauma)
temperature
- Flushed/Red - excess circulation
Breathing:
- Blue/cyanosis - lack of oxygen and possible airway
Assess the patient's breathing rate, depth, and effort. Look
problems
for signs of respiratory distress such as wheezing, chest
- Yellow/Jaundice - liver problems
retractions, or cyanosis (bluish discoloration of the skin).
 B. SECONDARY ASSESSMENT
- can be done unconscious and conscious
- Unconscious, assess the abc
- Assume all unconscious, injured patients have spinal
injuries
1, Assess the head
- Examine the scalp (do not move the patient’s head)
- Find actual wound
- Check the entire head for bumps, areas of tenderness
and bleeding
2. Assess the eyes
- Cover one eye for 5 secs and watch the pupil (normal
reaction is to constrict within about 1 sec)
3. Assess the nose
- Tenderness or deformity (which indicate a broken nose)
- See if there is any blood or fluid coming from the nose
4. Assess the mouth
- recheck the mouth for foreign objects and loose teeth
- be ready to manage vomiting
- determine unusual odors (diabetes may have a fruity
breath odor)
- remember to place any unconscious patient, in recovery
position
5. Assess the neck
- Touch the vertebrae to see whether gentle pressure
produces pain.
- Check the neck vein, swollen neck veins may indicate
heart conditions or major trauma to the chest
6. Assess the face
- color of the facial skin, its temperature, and whether it is
moist or dry.
- Note for bumps, bruises, cuts, etc.
7. Assess the chest
-conscious, ask to take a deep breath and tell if there’s
any pain. (Note DOB)
- look and listen fpr signs of DOB (coughing, wheezing or
foaming at the mouth)
- Noting any injuries, bleeding, or section of the chest that
move abnormally, unequally and painfully (may be a sign
of flail chest)
-Apply firm but gentle pressure to the collarbone to check
fracture
8. Assess the abdomen
-Look for signs of external bleeding, penetrating injuries or
protruding parts such as intestines
- Observe stomach remain rigid (rigidity and swelling is
often a sign of abdominal injury)
9. Assess the pelvis
- check the genitalia for external injuries (it must be done if
there is any suspicion of injury)
- check for brusing, bleeding or swelling
- no pain, gently press the pelvic bone
- pain or tenderness, severe injury
10. Assess the back
11. Assess the extremities
- look for bleeding and deform
- Watch face and listen if theres pain shown
- Check for normal movement
- check for sensation
- check for presence of pulse and capillary refill
Once the life-threatening conditions have been addressed
in the primary assessment, the secondary assessment
focuses on a more detailed evaluation of the patient's
condition. This includes:
History taking: Gathering information about the patient's
medical history, current symptoms, and any potential
contributing factors.
Physical examination: Performing a more comprehensive
examination of the patient's body systems, including vital
signs, head-to-toe assessment, and specific examinations
based on the patient's presenting complaint.
Diagnostic testing: Ordering tests such as X-rays, blood
tests, or other investigations to confirm suspected
diagnoses.
C. TRIAGING
Triage:
A triage tag is a tool first responders and medical
personnel use during a mass casualty Incident
S.T.A.R.T, one of the 5 S’s, is an acronym for
Simple Triage And Rapid Treatment.
“Triage” in French means “To Sort”
Virginia Triage Tag Concept
1. Red: highest priority – immediate
2. Yellow: second priority – delayed
3. Green: third priority – minor
4. Black: lowest priority – dead
1. Red: Poor respirations, perfusion, mental status, and
severe burns (life-threatening injuries)
- May survive with immediate life-saving
measures
- Imminent risk asphyxiation or shock but can be
stabilized
2. Yellow: Burns, major or multiple bone/back injuries
(potentially life-threatening)
-Should survive if given care w/in a few hours 1 to 2 hours
-Severely debilitating injury
Stable abdominal WITHOUT significant bleeding
Eye and central nervous system (CNS) injuries
Closed or open fractures
Open chest wound (without respiratory distress)
Not involving face,hands feet and genitalia 2nd or 3rd
degree burn
Debridement is necessary (combat wounds)
Maxillofacial wounds WITHOUT airway compromise
Genitourinary tract disruption
Soft tissue injuries
Vascular injuries with adequate collateral circulation;
fractures requiring open reduction, débridement, and
external fixation
3. Green: Minor painful, swollen deformities, minor soft
tissue injuries
-Walking wounded: minor injuries that do not require rapid
care
Minor laceration, contusions and abrasions
Walking wounded
Small lacerations without significant bleeding
Behavioral disorders
Psychological disturbances
Sprains and strains:
Minor combat stress problems
Burns, first or second degree UNDER 20% of TBSA and
not involving critical areas such as hands, feet, face,
genitalia, or perineum
Upper extremity fractures without neurovascular
compromise
Suspicion of blast injury
Symptomatic but unqualified radiation exposure
4.Black: Deceased or non-salvageable
- Deceased or severely injured patients unlikely
to survive
- Unresponsive with no circulation
Chances of survival are unlikely even with definitive
care
Unresponsive patients with penetrating head wounds
High spinal cord injuries – C8
Wounds involving multiple anatomical sites and organs,
2nd/3rd degree burns in excess of 60% of body surface
area
Seizures or vomiting within 24 hours after radiation
exposure
Profound shock with multiple injuries
Agonal respirations; NO pulse, NO blood pressure,
pupils fixed and dilated.
● Requires intervention i.e., Antibiotic, pain meds,
sutures, wound repairs, casts
● Febrile child > 3mos, minor burns, simple
fractures, pneumonia, post seizures, mild-mod
RDS, simple trauma
4. Non-urgent: stable requires care in 4-6 hrs,
● No risk of mortality or permanent fxn loss
● URI, diaper rash, thrush, impetigo, conjunctivitis,
sore throat, OM
D. PRINCIPLES OF RESCUE AND
EXTRICATION
Rescue and extrication involve safely removing a patient
from a dangerous situation. This could involve removing
them from a car accident, collapsed building, or other
hazardous environment. The key principles of rescue and
extrication include:
Scene safety: Ensuring the safety of rescuers and
bystanders before approaching the patient.
Patient assessment: Quickly assessing the patient's
condition to determine the best course of action.
Minimizing further injury: Avoiding any actions that could
worsen the patient's injuries during the extrication process.
Proper techniques: Using appropriate techniques and
equipment to safely remove the patient from the situation.

Triage categories
1. Resuscitation: Immediate Resuscitation
2. Emergent: if not Tx’d NOW life, limb and life
threatening.
3. Urgent: if not Tx’d in 1-2 hr potential significant
morbidity, pain
4. Non-urgent: stable requires care in 4-6 hrs, no
risk of mortality or permanent fxn loss

1. Resuscitation: Immediate Resuscitation

● Cardiopulmonary arrest
● Respiratory failure
● Status epilepticus
● Unresponsiveness

2. Emergent: if not Tx’d NOW life, limb and Sight

threatening
● ACETAMINOPHEN OR DRUG TOXICITY OR
OVERDOSAGE
Acetaminophen – give acetylcysteine
OPIATES/narcotic like morphine and meperidine
– give narcan or naloxone
Warfarin – give Vitamin K
Heparin – give Protamine sulfate
● Emergent case like: ELDERLY with chest pain,
DOB, Diaphoresis
● Any altered LOC Mod-Sev dehydration
● RDS Febrile infant < 3 mos

EX: Toxic ingestion, asthma distress (diminished breath

sound) DKA, r/o sepsis, suspected abuse

3. Urgent: if not Tx’d in 1-2 hr potential

● Significant morbidity, pain
EDN LEC - Care for direct victims (prioritization of nursing
DISASTER care)
● Extraordinary response from outside - Health promotion especially to vulnerable
● Creates human needs that victims cannot members of the community (children and
alleviate without asistance elderly)
- Responsible for psychological support to victims
MAIN FEATURES OF DISASTER
● Unpredicatbility Post impact phase
● Unfamiliarity - Beginning of recovery
● Speed - Return of normal community order and
● Urgency functioning (pag wala nang threat at pwede na
● Uncertainty mag resume and community)
- May last a lifetime (pwede ma ka recover ng
WHEN IS AN EVENT A DISASTER mabilis
1. At least 20% of the population are affected in need Ex: Victims of atomic bomb in Hiroshima (kasi meron
2. A greater number or atleast 40% of the means paring places na radio active)
livelihood
3. Major road and bridges are destroyed and 4 stages of emotional response
impassable 1. Denial - victims may deny the magnitude of the
4. Widespread destruction of fish ponds, crops problem (may appear unconcerned)
Agricultural products 2. Strong emotional response
5. Epidemics 3. Acceptance
- NDCC MEMO ORDER NO.4 1998 4. Recovery - victims feel they are back to normal

TYPES OF DISASTER DISASTER NURSING

Natural Disaster - Meeting the nursing, health and emotional
- Effect of natural hazard needs
1. Biological (epidemic, insect infestation, animal - Holistic approach
stampede) Goals
2. Geophysical (earthquake, volcano, dry mass - best possible level of health
movement) 1. Meet immediate basic survival needs
3. Hyrodological (flood, wet mass movement) 2. Identify the potential for a secondary disaster
4. Meteorological (storm, cyclone, local storm) 3. Appraise both risks and resources in the
5. Climatological (extreme temp, drought, wildfire) environmemt
4. Correct inequalities in access to health care or
Man made Disaster appropriate resources
1. Technological - malfunction of man made structure or 5. Empower survivor to participate in and advocate
“human error” (dam failures, transport failure, fire) for their own health and well being
2. Industrial - caused by chemical, mechanical, civil, 6. Respect cultural, lingual and religious diversity
electrical in individuals and families and to apply this
3. Warfare (war, terrorism) principles in all health promotion activities
7. Promote highest achievable quality of life for
PHASES OF DISASTER survivors
Pre Impact phase
- initial phase of disaster PRINCIPLES OF DISASTER NURSING
- Prior to actual occurrence ICN FRAMEWORK
- Warning is given at the sign of the first possible danger to Level 1: any nurses who has completed a program
a community Level 2: any nurse who has achieved the Level 1
Example: Meteorological disasters can be predicted competencies
(newscasting) Ex: - supervisor or head nurse
- Nurse designated for leadership
Role of disaster nurse - preparedness/response nursing
- Assist in preparing shelter and emergency aid
station Level 3: achieved level1 and 2 and is prepared to respond
- Establishing contact with other emergency to a wide range of disaster and emergencies nand to
service group serve on a deployable team
Ex: frequent responders (marami nang experience)
Impact phase - military nurses
- Disaster actually happens - nurses conducting comprehensive disaster nursing
- Enduring hardship or injury research
- May last several minutes of for days or weeks
- Emergency operation center is established 4 AREAS OF DISASTER NURSING COMPETENCIES
and put in operation (center of communication
for health needs)

Role of disaster nurse

8 DOMAINS OF DISASTER NURSING COMPETENCIES
DISASTER MANAGEMENT
• Continuous and integrated process of planning, organizing, coordinating, and
implementing measures which are necessary or expedient for:
• Prevention of danger or threat of any disaster
• Reduction of risk of any disaster or its severity or consequences
• Capacity-building
• Preparedness to deal with any disaster
• Prompt response to any threatening disaster situation or disaster
• Assessing the severity or magnitude of effects of any disaster
• Evacuation, rescue and relief
• Rehabilitation and reconstruction
PRINCIPLES OF DISASTER MANAGEMENT GOALS OF DISASTER MANAGEMENT
1. Reduce or avoid losses from hazards
2. Assure prompt assistance to victims
3. Achieve rapid and effective recovery
DISASTER MANAGEMENT CYCLE
MITIGATION
- Eliminate or reduce the probability of disaster occurrence
- Reduce the effects of unavoidable disasters
- Shaping public policies and plans
PREPAREDNESS
• Achieve a satisfactory level of readiness
• Can also take the form of ensuring that strategic reserves of food, equipment, water,
medicines and other essentials are maintained in cases of national or local catastrophes
RESPONSE
- -Efforts to minimize the hazards created by the disaster
- Actual implementation of the disaster plan
- Activities need to be continually monitored and adjusted to the changing situation
- Aim is to provide immediate assistance to
• maintain life;
• improve health;
• and support the morale
RECOVERY
- Returning the community to normal
- Rehabilitation of livelihoods, restoration of social and economic activities, and
reconstruction of shelter and infrastructure
- ACTIVITIES: Debris removal, care and shelter, damage assessments, funding assistance
DISASTER
WHEN IS AN EVENT A DISASTER?
1. At least 20% of the population are affected and in need of emergency assistance or whose
dwelling units have been destroyed.
2. A great number or a least 40% of the means of livelihood such as bancas, fishing boats, vehicles
aNd the like are destroyed.
3. Major roads and bridges are destroyed and impassable for at least a week, thus disrupting the
flow of transport and commerce.
4. Widespread destruction of fish ponds, crops, poultry and livestock, and other agricultural products
5. Epidemics
NDCC Memo Order No. 4, Mar 4, 1998
EXPOSURE
The degree to which the element at risk is likely to experience hazard events of different magnitude
VULNERABILITY
The characteristics and circumstances of a community, system or asset that make it susceptible to
the damaging effects of a hazard This may arise from various physical, social, economic and
environmental factors
CAPACITY
Is the combination of all strengths and resources available within the community, society or
organization that can reduce the level of risk or effects of a disaster
DISASTER= (VULNERABILITY + HAZARD) /CAPACITY
Disaster occurs when hazards meet vulnerability.
"Disaster is a crisis situation that exceeds the capabilities." (Duarentelli, 1985)
Philippine Risk profile and preparedness
THE PHILIPPINES
One of most disaster-prone country. 12th among 200 countries (UN ISDR)
Located along the typhoon belt in the pacific making it vulnerable to typhoons and tsunami.
Average of 20 typhoons yearly (7 destructive) Located along the Pacific Ring of Fire, between 2
tectonic plates (Eurasian and Pacific) which are volcanic and earthquake generators. 22 active
volcanoes (5 most active)
ARE WE PREPARED?
CRITICAL CONCERNS
1. Does your institution have an existing disaster response team/safety committee? If yes, is it
functional?
2. Do we conduct emergency/disaster drills regularly?
3. Do we have emergency response plan?
4. Do we have a preparedness/ contingency plan in the event of any disaster?
5. Are there personnel/ employees trained in first aid, firefighting or rescue?
6. Does the institution have any rescue equipment and other emergency paraphernalia?
7. Do we have an institutionalized warning system?
8. Are there identified evacuation areas within the premises of the institution?
Philippine Risk Reduction and Management
R.A. 10121
Disaster legislation back in 1978, focusing heavily on preparedness and response.
Philippine Disaster Risk Reduction and Management Act of 2010 (RA 10121), expecting paradigm
shift emphasizing disaster management to a disaster risk management approach, with much greater
importance given to reducing risk.
Approved on May 27, 2010
Systematic process of using administrative decisions, organization, operational skills and capacities
to implement policies, strategies and coping capacities of the society and communities
WHAT MUST BE DONE TO REDUCE RISK?
- Institutionalize local DRRM office
- -Establish early warning system
- Formulation of communication protocol
- Formulation of evacuation procedures at the community level and establishments
- Organize local DRRMC and define the functional roles and responsibilities of members and
task units
- Establish standard operating procedures (SOPs) Hazard awareness through community-
based trainings and seminars
- Integrate disaster risk reduction into the Comprehensive Land Use Plan (CLUP) and land use
planning Integrate hazard, risk and vulnerability assessment into the development plan
- Integrate hazard, risk and vulnerability assessment into the development plan
- Cluster approach on recovery program
- Good working relationship with warning agencies and the local media Installation of rain
gauges on mountain slopes
(DENR-MGB CAR recommended 150mm of rainfall observed within 24 hrs for evacuation)
- Strengthening of the LGU capabilities on disaster management
- Updating hazard profile of all municipalities and to analyze data on human induced disasters
for public safety studies
- Effective flow of communication system to ensure that accurate flow of information before,
during and after disaster