• Pre-Disaster Risk Assessment
DISASTER
q A serious disruption of the functioning of
society;
q Causing widespread human, material or
environmental losses which exceed the ability
of the affected society to cope using its own
resources;
q Requires help from outside;
DISASTER RISK REDUCTION & MANAGEMENT
• the systematic process of using administrative
directives, organizations, and operational skills
and capacities to implement strategies,
policies and improved coping capacities in
order to lessen the adverse impacts of hazards
and the possibility of disaster.”
PHILIPPINE DISASTER RISK REDUCTION & plans.
MANAGEMENT ACT OF 2010
REPUBLIC ACT 10121
• Known as the "Philippine Disaster Risk
Reduction and Management Act of 2010"
• Strengthening the Philippine Disaster Risk
Reduction and Management System
• Providing for the National Disaster Risk
Reduction and Management Framework
• Institutionalizing the National Disaster Risk
Reduction and Management Plan,
appropriating funds and for other purposes.
DISASTER RISK REDUCTION & MANAGEMENT
(DRRM)
• Disaster Mitigation & Prevention
• Disaster Preparedness
• Disaster Recovery & Rehabilitation
• Disaster Response
Disaster Prevention & Mitigation
• Avoidance of hazards and the attempt to
lessen the potential impacts hazards, by
reducing vulnerabilities, exposure and
enhancing of capacities.
o Vulnerability & Hazard Analysis
o Alarm and Early Warning Systems
o Flood Forecasting
o Geo-hazard mappings
o Policy & Safety Standards
o Engineering interventions
o Flood control structures
Disaster Preparedness
Establish and strengthen capacities of communities to
anticipate, cope and recover from the negative
impacts of emergency occurrences and disasters.
• Contingency Planning
• Prepositioning of Equipment
• Enhancement of Coordination
• Training
Disaster Response
Provide life preservation and meet the basic
subsistence needs of the affected population based on
acceptable standards during or immediately after a
disaster.
• Issuance of advisories
• Evacuation
• Relief Aid & Financial Assistance
• Rescue Operations
Disaster Rehabilitation & Recovery
• Restore & improve facilities and living
conditions and capacities of affected
communities and reduce risks in accordance
with the “build back better” principle.
o Reconstruction and improvement of
houses, buildings, facilities (“Build
Back Better”)
DISASTER CONTINUUM (BEFORE, DURING &
AFTER)
BEFORE
1. Participate in the development of disaster
2. Participate in community risk assessment;
a. Elements of hazard analysis for all
hazards approach, hazard mapping,
vulnerability analysis
3. Initiate disaster prevention measures;
Prevention or removal of hazard, movement /
relocation of at risk populations, public
awareness campaigns, establishment of early
warning systems
4. Perform disaster drills and table - top exercises
5. Identify education and training needs for all
nurses.
6. Develop disaster nursing databases for
notification, mobilization and triage of
emergency nurse staffing resources.
7. Develop evaluation plans for all components of
disaster nursing response.
DURING
1. Activate disaster response plan;
a. Notification and initial response,
leadership assumes control of event,
command post is established, establish
communications, conduct damage and
needs assessment at the scene,
search, rescue and extricate, establish
field hospital and shelters, triage and
transport of patients.
2. Mitigate all ongoing hazards
3. Establish need for mutual aid relationships
4. Integrate state and federal resources
5. Ongoing triage and provision of nursing care
6. Evaluate public health needs of the affected
population
7. Establish safe shelter and the delivery of
adequate food and water supplies.
8. Provide for sanitation needs & waste removal
9. Establish disease surveillance (e.g. establish
vector control)
10. Evaluate the need for / activate additional
nursing staff.
AFTER
1. Continue provision of nursing and medical care
2. Continue disease surveillance
3. Monitor the safety of the food and water supply
4. Withdraw from disaster scene
 5. Restore public health infrastructure
6. Re – triage and transport of patients to
appropriate level care facilities
7. Reunite family members
8. Monitor long term physical health outcomes of
survivors
9. Monitor mental health status of survivors
10. Provide counselling and debriefing for staff
11. Provide staff with adequate time off for rest
12. Evaluate disaster nursing response actions
13. Revise original disaster preparedness plan.

PANDEMIC RESPONSE
Pandemic Problems
1. Lack of Training (protocols on handling
patients, documentation)
2. Improper donning and doffing of PPEs
3. Lack of supplies (alcohol, disinfectant and etc.)
4. Lack of Isolation Facilities
5. Lack of oxygen supplies
6. Lack of Manpower, benefits for the
Responders
7. Lack of Transportation (Public transport,
ambulances)
8. Lack of Testing Facilities
9. Border Control
10. Policies and Guidelines Implementation
11. Leadership
12. Disconnect between managers and public
13. Communication
14. Malversation of funds
15. Recognition of the possibility of a Pandemic
INCIDENT COMMAND SYSTEM (ICS)
Mass Casualty Incidents (MCI)
• Any call involving three or more patients
• Any situation that requires a mutual aid
response
• Any incident that has the potential for one of
these situations
• an incident where the number of patients
exceeds the amount of healthcare resources
available.
Triage
• “Triage” means “to sort” patients based on the
severity of their injuries.
• Assessment is brief and patient condition
categories are basic.
• Primary triage is done in the field. Secondary
triage is done as patients are brought to the
treatment area.
• Preliminary assessment of patients in order to
determine the urgency and nature of
treatment.

Incident Command System (ICS)

• A standardized approach to the command,
control, and coordination of emergency
response providing a common hierarchy within
which responders from multiple agencies can
be effective.
Initially developed to address problems of inter-
agency response
Use in all-hazards situations, ranging from active
shootings to hazmat scenes

The purpose of the ICS is to:

• Ensure responder and public safety Triage System
• Achieve incident management goals 1. Simple Triage and Rapid Treatment (START)
• Ensure the efficient use of resources 2. S.A.L.T.
a. Sort, Assess, Lifesaving interventions,
transport/treatment.
Key Concepts of the ICS 3. Jump START Triage
1. Unity of Command a. pediatric version of START
2. Flexible and Modular Organization 4. Canadian Triage and Acuity Scale (CTAS)
3. Common Terminology
4. Management by Objective
5. Span of Control
6. Coordination
7. Incident Action Plans / Emergency Plan
8. Resource Management
9. Integrated Communications

Sample Command Structure

TRIAGE TAPES / TAGS

MCI Basics
• During a large scale incident such as a mass
casualty, it is important to have a MCI
notification system. Successful MCI
notification systems will:
o Internally: alert staff to activate MCI
protocols and prepare for a potential
surge of patients
o Externally: increase community
awareness
• Some patients may arrive to the hospital
without having been assessed/ triaged at the
scene
• MCI response requires efficiency and
coordination
• Non-clinical personnel (including hospital
volunteers) can assist in moving patients to
designated areas based on level of care
• Help gather patient information in the
emergency treatment area
• Staff should review patients in clinical
assignment for any potential discharges/
transfers to make room for potential MCI
admissions, a process known as “surge
discharge”

Role of a Triage Nurse

• Assessment of patients and determining
• acuity
• Communicating with other healthcare
professionals
• Determines treatment location
• Initiating treatment protocols
• Monitoring and reassessment
• Participating in patient flow
• Documenting
After a major disaster, health personnel are often
called up to participate in a coordinated response to
save lives and prevent unfavorable outcomes to
community especially in vulnerable populations.
They are responsible for initiating the public health
response during the first 24 hours of an emergency or
disaster and coordinating with the existing emergency
response structure in specific types of incidents such
as floods, earthquakes and other calamities.

Collaboration between emergency managers,

community planners, and public health officials
can lead to:
• Identifying toxic sites within the flood plain or near
potable and well water sources.

DEPARTMENT OF SOCIAL WELFARE AND

DEVELOPMENT (DSWD)
• It is the primary government agency mandated
to develop. implement, and coordinate social
protection and poverty-reduction solutions for
and with the poor, vulnerable, and
disadvantaged.
• Its role and function is to assist families in
rebuilding their homes and livelihoods through
its rehabilitation programs. In times of disaster
and calamities, the DSWD mobilizes its
resources to provide relief assistance and
rehabilitation support to affected communities
in any crisis situations like floods, typhoons,
earthquake, volcanic eruptions and others.
• DSWD's response cluster provide immediate
relief assistance such as in the form of food,
water, shelter materials like tent. clothes, and
hygienic materials, medical assistance and
psychological support.