12629

PRESENTED BY: PRATEEK BANDHU (12627)YOGESH KUMAR (12628)

YAJAN CHAUDHARY (12629)KANISHKA (12630)

DISASTER MANAGEMENT AND ROLE OF

MEDICAL PREPAREDENESS

(W.H.O.): “An occurrence of a severity and magnitude that normally results in death, injuries and property damage that cannot be managed through the routine procedure and resources of government.”FEMA (Federal Emergency Management Agency): “ A disaster can be defined as an occurrence either nature or man made that causes human suffering and creates human needs that victims cannot alleviate without assistance.”

DEFINITION OF DISASTER

Definition of Disaster Nursing

Disaster Nursing can be defined as the adaptation of professional nursing skills in

recognizing and meeting the nursing physical and emotional needs resulting from a disaster.

The overall goal of disaster nursing is to achieve the best possible level of health for the

people and the community involved in the disaster.

‘DISASTER’ alphabetically means

D - DestructionsI - IncidentsS - SufferingsA - Administrative, Financial Failures.S - SentimentsT - TragediesE - Eruption of Communicable diseases.R - Research programme and its implementation

PRINCIPLES OF DISASTER NURSING Prevent the disaster

Primary preventionSecondary preventionTertiary prevention

Minimize casualties Prevent further casualties Rescue the victims First aid Evacuate Medical care Reconstruction

Death of 3 million people

Economic loss increased due to

disaster like flood

In Indian scenario,

34million people affected per

year and 5116 death per year.

In US, economic loss is 400

million dollar and 3 million people died.

THE GLOBAL SCENARIO

EPIDEMIOLOGY OF DISASTER

AGENT

HOSTENVIRONMENT

Primary Agents

Secondar

y Agents

AGENTS OF

DISASTER

POLICIES RELATED TO EMERGENCY/DISASTER MANAGEMENT

1. “First come, first treated” principle will not be followed during emergencies.

2. Triage protocol3. ABCDE care is provided

AirwayBreathingCirculationDisability limitationExposure / environmental control

4. Trauma team and trauma code5. Management of cardiopulmonary arrest6. Emergency medicine records7. Chain of command in the team and system8. Alternative chains and flexibility standards9. Procedures involving medico-legal issues10. Disaster preparedness11. Disaster drills12. Infection control measures13. Quality management of disaster services

DISASTER MANAGEMENT CYCLE/PHASESPreparednes

s

Response

Recovery

Prevention

Disaster

DISASTER PREPAREDNESS Personal preparedness Professional preparedness Community preparedness

DISASTER MANAGEMENT TEAM Medical Superintendent Additional Medical Superintendent Nursing superintendent Chief medical officer (Casualty) HOD’d of all the dept.s Blood bank incharge Security officers Dietician Transport officer Sanitary personnel

EQUIPMENTS Resuscitation equipment Disposable needles, syringes & gloves Dressing & suturing materials and splints Oxygen delivery devices Suction catheter and machine ECG monitors, defibrillators and ventilators Cut down sets, tracheostomy sets and lumbar

puncture sets Linens and blankets

GUIDELINES/ELEMENTS OF DISASTER PLANS Chain of authority Lines of communication Routes & modes of transport Mobilization Warning Evacuation Rescue & recovery Triage Treatment Support of victims and families Care of dead bodies Disaster worker rehabilitation

TRIAGE PROTOCOL/SYSTEM

Red: High priority for treatment & transfer

Yellow: Medium Priority

Green: Ambulatory patients

Black: Dead or Moribund patients

RESOURCES FOR DISASTER MANAGEMENT

Administrative system Policies, procedures and protocols Physical facilities Components & equipments Emergency/Disaster medical systems Staffing and training Resources for disaster drills Effective evaluation system

COORDINATION & INVOLVEMENT OF VARIOUS GOVT. AND NON-GOVT. ORGANIZATION India

National disaster management authority of India

Emergency Management and research Institute Worldwide

International association of emergency managers

Red cross/red crescent United Nations World bank European union International recovery platform

ROLE OF MEDICAL PREPAREDENESS Assess the community Diagnose community disaster threats Community disaster planning Implement disaster plans Shelter management plans Evaluate the effectiveness of disaster

plans

LEGAL ASPECTS OF DISASTER NURSING Licensure Good Samaritan

law Good rapport Standard care Standing order Written consent

for operation and procedures

Correct identity Drug

maintenance Self discharge of

the patient Documentation Protection of

patient property Reporting

IMPACT ON HEALTH AND AFTER EFFECTS Social reaction Communicable diseases

Population displacements

Climatic exposure

Food & Nutrition

Water supply & sanitation

Mental health Damage to the health infrastructure

POST TRAUMATIC STRESS DISORDER (PTSD)

PTSD is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma.

Symptoms: Flashbacks and nightmares

DIAGNOSIS OF PTSD History of exposure to a traumatic event Persistent re-experiencing Persistence avoidance and emotional numbing Persistent symptoms of increased arousal not

present before Duration of symptoms for more than 1 month Significant impairement

MANAGEMENT OF PTSD Provide sense of safety Calm the patient Improve self efficacy of the patient Make social connectedness Give hope

Host factors

1. Age

2. Immunization status

3. Degree of mobility

4. Emotional stability

Environmental factors

1. Physical Factors

2. Chemical Factors

3. Biological Factors

4. Social Factors

5. Psychological Factors

Factors affecting disaster

Preimpact phase

Impact

Phase

Post impact phase

Rehabilitati

on

Phases of Disaster

Disaster Response

Disaster Preparedness

Disaster Mitigation

three fundamental aspects of disaster management

Disaster Impact

Mitigation

Preparedness

Reconstruction

Rehabilitation

Response

Risk reduction phase before a

disaster

Recovery phase after a disaster

DISASTER MANAGEMENT CYCLE

DISASTER IMPACT AND RESPONSE

Search, rescue and first aid

Field care

Triage

Tagging

Identification of dead

The type and quantity of humanitarian relief supplies are usually determined by two main factors : (1) the type of disaster, since distinct events have different effects on the population(2) the type and quantity of supplies available locally.

There are four principal components in managing humanitarian supplies: (a) acquisition of supplies (b) transportation(c) Storage (d) distribution.

Relief phase

Overcrowding and poor sanitation

Population displacement

Disruption and the contamination of water supply, damage to sewerage system and power systems

Disruption of routine control programmes

Ecological changes

Displacement of domestic and wild animals

Provision of emergency food, water and shelter

EPIDEMIOLOGIC SURVEILLANCE AND DISEASE CONTROL

VACCINATION

NUTRITION

Rehabilitation

Water supply

Food safety

Basic sanitation and persona

l hygiene

Vector control

DISASTER MITIGATION IN HEALTH SECTOR

Emergency prevention and mitigation involves measures designed either to

prevent hazards from causing emergency or to lessen the likely effects of

emergencies.

These measures include :-Flood Mitigation WorksAppropriate Land-use PlanningImproved Building Codes Reduction Or Protection Of Vulnerable Population And Structures.

Disaster preparedness

Emergency preparedness is “a programme of long term

development activities whose goals are to strengthen the overall

capacity and capability of a country to manage efficiently all types of emergency. It should bring about an orderly transition from relief through recovery, and back to

sustained development”.

The reasons of community preparedness are:-(a) Members of the community have the most to lose from being vulnerable to disasters and the most to gain from an effective and appropriate emergency preparedness programme(b) Those who first respond to an emergency come from within the community. When transport and communications are disrupted, an external emergency response may not arrive for days

(c) Resources is most easily pooled at the community level and every community possesses capabilities. Failure to exploit these capabilities is poor resource management

(d) Sustained development is best achieved by allowing emergency-affected communities to design, manage, and implement internal and external assistance programme.

Policy development The policy development is “the formal statement of a course of action”. Policy is strategic in nature and performs the following functions:a. establish long - term goals;b. assign responsibilities for achieving goals;c. establish recommended work practice; and d. determine criteria for decision making.

PERSONAL PROTECTION IN DIFFERENT TYPES OF EMERGENCIES

A number of measures must be observed by all persons in all types of emergency:- Do not use the telephone, except to call for help, so as to leave telephone lines free for the organization of response.- Listen to the messages broadcast by radio and the various media so as to be informed of development.- Carry out the official instructions given over the radio or by loudspeaker.- Keep a family emergency kit ready. In all the different types of emergency, it is better:- To be prepared than to get hurt;- To get information so as to get organized;- To wait rather than act too hastily.

INTERNATIONAL AGENCIES PROVIDING

HEALTH HUMANITARIAN

ASSISTANCE

Community measures in Disaster

Community Participation

Mock trails/training

Mass awareness

Education

a. Setting up the first aid postb. Causality evaluation

c. Basic hygiene and sanitationd. Safety measures

e. Maintenance of food and water supply f. Maintenance of law and order.

g. Provision of sheltersh. Rescue streaming

i. Significance of traffic control and communicationj. Use of fire services

k. Hazards of radiation and preventive measuresl. Prevention of future disasters.

m. Grant in aid n. Rehabilitation

ROLE OF NURSE ADMINISTRATOR IN DISASTER MANAGEMENT

Preserving Open Lines of Communication

Ensuring Quality Patient Care

Providing Current Education

Influencing Policy and Financial Decisions

Providing Security for Staff, Patients, and Families

THANK YOU.