By: Bryan Mae H.

Degorio

Disaster
- is an event that inflicts significant
damage
to life and property and
that substantially
overwhelm the
communitys resources.
- unplanned
natural or man-made
incident which
significantly impacts
the public and
support capabilities
of a location

Types of Disaster:
1. Natural: Earthquake, flood,

hurricane,
tsunami and
volcanic eruption
2. Man-made: Nuclear explosion,
industrial
accident and
fire
3. Terrorism and bioterrorism

Vulnerability
assessment:
- is a structured data collection
geared
towards understanding
the levels of
potential threat,
needs and immediate
available
resources.
- 2 basic categories:
a.Relatively static infrastructures
b.Relatively dynamic socioeconomic
data

Importance of vulnerability
assessment
1. To inform the decision makers
2. To give an actual picture of the

vulnerability
3. For continuous habit of monitoring

Principles of disaster
management:
Prevent the disaster
Minimize the casualties
Prevent further casualties
Rescue the victims
First aid
Evacuate
Medical care
Reconstruction

Roles of the nurse in the

different phases of disaster:
a.Preparedness
b.Mitigation
c. Response
d.Recovery
e.Evaluation

A. Preparedness
AKA: pre-impact, or pre-disaster
It focuses on prevention, protection

and preparedness.
common activities:
a. Hazard-vulnerability assessment
b. Preparing a well organized disaster
response plan
c. Training and practices:
Drills,

education and practical

training

B. Impact

Period of time when disaster occurs,

Phase

continuing immediately following the disaster.

This can be brief when the disaster strike
suddenly and is over in minutes or lengthy as
incident continues
Inventory and recue period
a. Assessment of extent of losses.
b. Identification of remaining resources.
c. Planning for:
- use of resources, rescue victim and
minimize further injuries and
property
damage

C. Post-Impact
occurs when majority of the rescue
Phase
operation is completed.
Remedy and recovery period.
Lengthy phase may last for years.

D.Rehabilitation
restoration to pre-disaster condition.
health needs will change from casualty

treatment to primary healthcare.

Disaster Cycle and

Management

Mitigation and Prevention

refers to action or measures that can

either prevent the occurrence of the

disaster or reduce the severity of its effect.
It aims to reduce the vulnerability of the
system.
Examples:
a. Voiding property that are prone to
hazard
(personal non-structural
mitigation)
b. Installation of earthquake valve, alarm
system
c. Improved building codes

Preparedness
Is a program of long term development

activities which goals are strengthened to

overall capacity of a country or manage
efficiently all types of emergency.
Objective:
- to ensure appropriate systems,
procedures
and resources are in place
to provide prompt effective assistant.
Note:
- COMMUNITY members, resources,
organization and administration should be
the cornerstone of emergency preparedness
program.

WAYS TO ENHANCE PREPAREDNESS:

a. It is an ongoing multisectoral
activity and an integral part of the
national system responsible for
developing plans and programmes for
all phases of disaster management
Responsibilities in the national level:
1. Evaluate the risk of the country
2. Adopt standard and regulation
3. Organize communication,
information and warning system

4. Ensure coordination and response

mechanism.
5. Adopt measures to ensure financial and
other resources available.
6. Develop public education program
7. Coordinate information session with media
8. Organize disaster stimulation exercises
b. Policy development

- the formal statement of action which

includes
long term goal, assign
responsibilities and
recommend work
practice and determine criteria for decision
making

c. Personal protection

- people must be aware of what is

expected of
them in case of
emergency.
- Basic measures:
1. Do not use the telephone
2. Listen to messages broadcasted by the
radio and the various media
3. Carry out official instruction given by the
media
4. Keep family emergency kit ready

Response
includes the mobilization of the

necessary emergency services and

first responders in the disaster area.
Basic activities:
a. Search, rescue and first aid
b. Field care
c. Triage
d. Tagging/identification of dead

a. Search/Rescue and First Aid

- in some countries, specialized

search- and-rescue teams is an
integral part
of the national
disaster plan
- the members received specialized
training in confined space
environments
- Members of the team:
A cadre of medical specialist
Technical specialist
Trained canines and

their handlers

b. Field care:
- casualty collection site should be
located
close enough to the
disaster site to offer rapid treatment
but far enough to
be safe.
1. proximity to disaster site
2. safety from the hazard and upwind
location from contaminated
environment
3. protection form climatic condition
4. easy visibility for disaster victims
5. convenient exit routes for air and land
evacuation

c. Triage
- is the rapid classifying of the injured on
the
basis of severity of their injuries and
the likelihood of their survival.

- goal: To do the greatest good to

the greatest number of
people.

Different types of Triage:

1.Simple triage and Rapid Treatment
System (START)
- performed by lightly trained emergency
personnel
- it separates the injured into 4 groups:
Theexpectantwho are beyond help
The injured who can be helped by
immediatetransportation
The injured whose transport can bedelayed
Those withminorinjuries, who need help less
urgently

2. Color Coding Triage

- usually used by expert personnel

- knowledge of medical
consequences of
various
injuries ( e.g., burn, blast, or
crush injuries pr exposure to
chemical,
biological or nuclear
weapon) is
critical.

RED

URGENT

DELAYED
OR
YELLOW
EXPECTANT

Casualties who require

immediate lifesaving
interventions (airway, breathing,
circulation)
Casualties who do not require
immediate
life-saving interventions and for
whom
treatment can be delayed
Casualties who are not expected to
survive
due to the severity of injuries
complicated
by the conditions and lack of
resources

Individuals who require minimal or

GREEN
MINOR
no
1. IMMEDIATE (Red): Highest priority medical
3. MINOR
(Green): Third priority
care
2. DELAYED (Yellow): Second priority 4. DEAD/DYING (Black): Lowest priority
BLACK
DECEASED

Evacuating patients after triage:

A.Modes of evacuation:
- ground transport, helicopter or large fix
wing aircraft

b.Indications for evacuation:

The decompress the area
To improve care for most critical casualties by
removal to off-site medical facilities
To provide specialized care for casualties such
as those with burns and crush injuries

c. Reasons to delay/defer evacuation:

Contaminated casualties, transmissible
diseases and unstable casualties

Principles to follow when evacuating

patients:
a.Survey the scene for potential hazard, # of
patients and need for specialized help
b.Call for medical or technical back-up as
needed.
c. Protect rescuers first: treat gas spills,
remove power lines, etc
d.Implement hazardous material
management protocol
e.Stabilize vehicle before entry
f. Triage patients and assign to available
medical personnel

g. Perform primary survey and treat

airway difficulties and severe bleeding
first.
h.If patient has no pulse or respiration and
extrication is necessary before CPR is
provided, the patient should be
considered dead.
i. Apply cervical collar , immobilize spine
prior to extrication.
j. Perform quick secondary survey, splint
extremities with fractures.
k. Expedite safe extrication by specialist.
l. Perform a complete secondary survey.

c. Tagging of patients

- patients should be identified with

tags stating their name, age, place of
origin, triage category, diagnosis and
initial treatment.
d. Identification of dead

- care of dead includes:

Removal of the dead from the disaster
scene.
Shifting to the mortuary.
Identification
Reception for the bereaved relatives

Recovery Phase
- recovery efforts are concerned with
issued
and decisions that must
be made after immediate needs
are addressed.
- it differs from the response phase in
its
focus.
- 4 Rs are usually followed:
a. RESCUE, RELIEF,
REHABILITATION,
and
RECONSTRUCTION

a. Rescue operations

- it usually starts with local

residents
and is usually
supported by trained
and
skilled staff. This is usually
complemented by NGO
- lasts for 48-72 hours when the
rate of
survival of
trapped victims is high
- after 3 days, other priorities are
taking
over

b. Relief operation

- begins when the assistance from

the
outside starts to reach the
disaster area.
- it includes food, water, shelter and
sanitary
equipments
- things to consider:

Acquisition of supplies
Transportations
Storage
Distribution

Lifeline services minimum

requirements:
Water
- Potable: 20L/day/person (increased by
20% for increased temperature
and
physical exertion)
- Sanitation: 5L/day/person
Food
- Adult: 1900 kcal/person/day
- children varies by age
Emergency/Temporary shelter
- 3.5 m/person

c. Rehabilitation/Reconstruction
- it aims to restore the communities
to the pre-earthquake status.
- social and other infrastructure is
restored
and the economy is
revitalized.
- this may last for several years.
- long term objectives is to build a
safer and sustainable livelihood.

Psychological Response to
Disaster
this is common sequellae after a

disaster.
it is important that planners, and policy
makers understand the importance of
psychological issues.
Characteristics of disaster that affects
mental health:
a. Little or no warning
b. Serious threat to personal safety.
c. Potential unknown health effects.

d. Uncertain duration of event.

e. Human error or malicious intent.
f. Symbolism related to terrorist target
Factors affecting individual response to
disaster:
a. Physical and psychological proximity to the
event
b. Exposure to gruesome or grotesque situation.
c. Diminish health status prior to or as a result
of the disaster
d. Magnitude of loss.
e. Trauma history.

Factors affecting the collective response to

disaster:
a. Degree of community disruption
b. Pre-disaster family and community stability.
c. Community leadership.
d. Cultural sensitivity of recovery efforts.
Psychological Sequelae of Disaster:
a. Mild stress response to full blown posttraumatic
stress disorder (PTSD)
b. Major depression to acute stress disorder.
Note: 15-25% of those directly impacted will
subsequently develop diagnosable mental
disorder

Interventions:
a. In cases of no diagnosed mental
disorder,
educational
materials that help
people understand what they and
their families are experiencing
b. Brief crises counseling should be
provided,
followed by referral
treatment is
indicated.