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4.nursing Management in Disaster
4.nursing Management in Disaster
DISASTER
A. BASIC PRINCIPLES FOR DISASTERS RESPONSE
Super acute
DISASTER phase 72
hours
acute phase
72 hours-1
week
Chronic phase
(reintegration/rec
onstruction
phase 1-3 month
Super-Acute phase ; 72 hours Traige and life saving medical care by DMAT (disasters
after disasters medical assistance team), transfer patients. Mental care by
medical team, assistence for first aide reliefe station
Acute phase ; 72 hours-1 week In addition to above works, assistance for disasters site,
prevention for economic seat syndrome and infection,
public hygiene education, assistence for evacuation center
Semi-Acute phase 0,5-1 month Assistence for evacuation center and hospital in disaster
site, home visit nursing care and home based helath
education, care for patients with chronic disease, infection
control and mental care
Chronic phase In addition to above works, provide guidence for helath
(reintegration/reconstruction management and heart caring for PTSD (post traumatic
phase) 1-3 month syndrome)
Silent phase / preparedness phase Dissemination for disaster mitigation activities and
(before next disaster) training and disaster training for medical personel, self
training for disaster prevention training and
implementation)
MEANING OF CSCATTT
PRINCIPLE OF DISASTER IMPLICATION / MEANING
RESPONSE
C Command & control Command means vertical instruction, control means horizontal
linkage with other organizatitions. Head of nursing Dep. Takes the
roll
S Safety (3 S) At first, protect yourself. Next, protect the field/or disaster site
(hospital wards, orevent fire, prevent the leak of medical gas).
Lastly, protect staff, patients and visitors of the hospital
(survivors).
C Communication Information is important to make assasement. Following point
must be decided.
Who collect information? (responsible person)
What kind of information must be collected? (contents of
information)
Where are those information reported? ( flow of information)
How we get information? (by walkie-talkie, internal phones, PHS :
personal handphone system or a massenger)
How we transmit information? (must decide methode)
A assasement Filed sittuatin of disaster site ( acces status, injured persons,
dangerous area), hospital condition (damage of the ward and
operation rooms by fire on so on), ruined area, condition and
safety of materials, medical instrument and equipment with time
progress, possibility of eccaptance of patients or not must be
assesed and report the way forward to disaster response.
T Triage Do traige pf patients in disaster site, at arrival of hospital, also at
the time of trasnportations of the patients, triage is to decide
priority of emergency treatment and transportation
T Treatment Provide proper medical treatment according to priority of triage
T Transport
B. DISASTER MEDICINE
1. DISASTER BASE HOSPITAL
Function and role of disaster base hospital
1. To be able to save lives of seriously ill/injured patients. (necessary to be
equiped with highly advanced medical equipment)
4. To be able to land materials and equipment for first aid treatment to the
hospital in disaster side
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ASSESSMENT/JUDGMENT
4. ROLE OF HEAD OFFICE OF THE HOSPITAL IN DISASTER
• Bring patients to safety area of the ward and wait for the
next instructions
• Patients who can walk : bring them near the exit
• Patients who need assisstance : after patients move on to
wheel chairs and/or beds, draw them to safety area
• Patients who are in the beds: patients who can breath
even after removed artificial respirator and IV line, their
bed will be carried to safety area
D. Preparedness for disaster
• List of necessary items
• Preparedness as a nursing manager
a. understand earthquake resistance strenght of hospital buliding in advanced
b. Decide standard ruleof nursing staff to come to the hospital by free will in
disaster
c. Do survey of communiting time of each nursing staff from their houses in
advance
d. Provide disaster training regularly
e. Practice disaster simulation training in a short time every day
f. Secure and check necessary disaster goods
g. Set up disaster response team
h. Provide leaders
• Evacuation and guidance of patients in disasters
• Disaster drill
No Injuries (text on patient Palpable radial Number of Triage
artery palse
1 Middle aged man. Trapped in the wreck.
Penetrating abdominal injury. HR 130.
breathing forced
2 Middle aged woman, traumatic amputation
lower limb. HR 116. pale. Severe pain
3 Young girl, soft tissue injuries in face and
ahands. Crying. HR 80. breathing OK
4 Small boy, severely trapped. Abdominal pain,
pre shock. HR 140. breathing weak
5 Middle aged woman, open fracktur left femur,
severe pain. HR 116. breathing OK
6 Eldery man with severe multiple maxillofacial
injuries with fractures. HR 180. breathing
forced
7 Young man, open fracture left lower arm. HR
104. peripheral circulation OK. Breathing OK
8 Old man with chest pain and a big haematoma
on the right side of the chest. HR 88. breathing
forced. coughing
9 Old man, fracture of the left neck of the femur.
Chest pain. HR 100. breathing OK
10 Old man, soft tissue injury ear and face.
Fracture of the radius. Hr 84. breathing Ok
11 Young woman, no visible injuries. Very pale.
Freezing but awake. HR 124., weak. Breathing
OK
12 Middle age woman. Soft tissue injuries in
face. HR 88. breathing Ok
13 Young man, open frackture of the skull.
Responds weakly to talk. Hr 84. breathing Ok
Thank you