disaster nursing 8-2-12

7/30/2019 Disaster Nursing 8-2-12

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DISASTER NURSING

August 2, 2012

College of Nursing & School of MidwiferyDe La Salle Health Sciences Institute


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NATURAL DISASTER

EARTHQUAKE

THYPOON

TSUNAMI

FIRE

VOLCANIC ERUPTION

LANDSLIDE,ROCKFALL,AVALANCE

FLOODING,LANDSLIDE,LOSSOF PLANT AND ANIMALS

FLOODING, EROSION,LOSSOF ANIMALS AND PLANTS

LOSS OF PLANTS AND ANIMALS,

DETERIORATION OF SOIL ,AIR

WATER POLLUTION

AIR POLLUTION, LOSS OFPROPERTY

ENVIRONMENTALEFFECTSDISASTER


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PRECAUTIONARY MEASURES:

STORM


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PUBLIC STORM SIGNAL NO. 1

Winds of 30 - 60 kphmay be expected in at

least 36 hours.

IMPACT OF THE WINDS:

small trees - branches may be

broken

banana trees - tilt or flat on

ground

Light materialpartially

unroofed


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PRECAUTIONARYMEASURES

People are advised to listento the latest Severe

Weather Bulletin issued byPAGASA every six hours5:00 a.m., 11:00 a.m., 5:00p.m., 11:00 p.m.

GENERAL NOTE:

>Business may be carriedout as usual. When thetropical cyclone is strong,

intensifying or is movingcloser, this signal may begradually increased.>Disaster preparedness is

activated to alert status.


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A moderate tropicalcyclone will affect

the locality.Winds of greaterthan 60 kph to 100kph may be

expected in at least24 hours.


coconut trees - may be tilted /

broken

big trees - uprooted

banana trees - maybe destroyed

large housespartially/totally

unroofed

old galvanized iron roofing - may

roll off


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PRECAUTIONARY

MEASURES

The sea and coastal watersare dangerous to smaller

sea crafts. Fishermen areadvised not to go to thesea.

Avoid necessary risks.

Traveling by sea or air isrisky.Stay indoors.Secure properties.

GENERAL NOTE:

>Special attentionshould be given to thelatest position, directionand speed of movementand intensity of thetropical cyclone as it mayintensify and movetowards the locality.

>Disaster preparednessagencies and otherorganization are alerted.


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A strong tropicalcyclone will affect the

locality.Winds of greater than100 kph to 185 kphmay be expected in at

least 18 hours


large # of trees - uprooted

banana trees - maybe destroyed

light to medium constructionmay be uprooted/ damage tostructure / destroyed

widespread disruption

very risky


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PRECAUTIONARYMEASURES:

>People are advised toevacuate and stay instrong buildings.>Stay away from coastsand river banks.

>Watch out for thepassage of the "eye" donot venture away fromshelter.>Suspend classes in alllevel and make sure thechildren stay in the safetyof strong buildings.

GENERAL NOTE:

>The disturbance is

dangerous to threatened oraffected communities.>The passage of the "eye" ofthe typhoon is indicated by asudden change from bad to

fair weather. Fair weather maylast for one or two hours afterwhich the worst weather willresume with very strong

winds generally coming from

the opposite direction.>Disaster preparedness andresponseagencies/organization areactivated to respondappropriately.


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A very intense typhoonwill affect the locality.

Very strong winds ofmore than 185 kph maybe expected in at least 12hours.

IMPACT OF THE WINDS:large # of trees - uprooted

coconut trees - extensive damage

widespread disruption

may be severelydamage


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PRECAUTIONARY

MEASURES:

Cancel all travel andother outdoor activities.

Stay in safety of housesor evacuation centers.

GENERAL NOTE:

The situation is potentiallyvery destructive to thecommunity.

Disaster coordinatingcouncils concerned andother disaster responseorganizations mustrespond to emergencies.


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TROPICAL CYCLONE

WARNING PRECAUTIONARY

MEASURESbefore the storm comes...

Reinforce your home to withstand wind and flooding.

Learn about typhoon and other disturbances, their signs and

warning, effects and dangers, and how to protect your family,yourself and your property.

Educate the members of your family on preparedness and

protection from tropical cyclones.

S d l f f d d


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Store adequate supply of food anddrinking water.Prepare flashlights, batteries,matches, kerosene lamps or candles

in anticipation of power failure.

During the emergency, keep yourradio on and listen to the latestreport and PAGASA bulletin and

announcement.

When a typhoon, tropicaldepression or tropical stormstrikes, stay indoors and do not go

near windows.

Check on everything that may beblown away or turned loose. Flyingobjects become dangerous during

typhoons.


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If the "eye" of the storm

passes over your place,there may be a lull lastingfor a few minutes to halfan hour. Stay in safe

place. Make emergencyrepairs if necessary, butremember the wind willblow suddenly from the

opposite direction,frequently with evengreater violence.

C t ff l t b h d i


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Cut off loose tree branches and excessivefoliage or leaves.

Severe flooding may follow typhoon.

Stay away from river banks and streams.

If your house is not safe, move to a

designated evacuation center and stay thereuntil the storm has completely subsided.

Slightly open a window or door at the side

of the house opposite form where the windcomes from to avoid pressure build up.

Be calm. Your ability to meet the

emergency will inspire and help others.

Hurricane Opal hit Florida in 1995


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PRECAUTIONARY MEASURES:

FLOOD


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BEFORE THE FLOODS

Find out the frequency of

occurrence of floods in yourlocality.

All family members must know

the flood warning system in yourcommunity.

Keep informed of daily weathercondition.

Inquire on designated evacuationareas for families and livestock. Flooding in Mississippi


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Keep a stock of food whichrequires little cooking and

refrigeration; electric powermay be interrupted.

Keep a transistor radio,flashlight with spare batteries,

emergency cookingequipment, candles, matchesand first aid kit handy in caseof emergency.

Store supplies and otherhousehold effects aboveexpected flood water level.

Securely anchor weak

dwellings and items.

Flooding in Bangladesh

WHEN WARNED OF FLOOD


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WHEN WARNED OF FLOOD

Watch for rapidly rising waters.

Listen to your radio for emergency instructions.

If necessary, evacuate to a safe area before access is cut-offby flood waters.

Store drinking water in containers, water service may beinterrupted.

Move household belongings to higher levels.

Get livestock to higher grounds.

Turn off electricity at the main switch in the building beforeevacuatin and also lock our house.

DURING THE FLOOD


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DURING THE FLOOD

Avoid areas subject to sudden flooding.

Do not attempt to cross rivers of flowing streams wherewater is above the knee.

Beware of water-covered roads and bridges.

Do not go swimming or boating in swollen rivers.

Eat only well-cooked food. Protect left-over againstcontamination.

Drink clean or preferably boiled water ONLY.


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AFTER THE FLOOD

Re-enter dwellings with caution using flashlights, notlanterns or torches. There may be flammable materialsinside.

Be alert of fire hazards like broken wires.

Do not eat food or drink water until they have been

checked for flood water contamination.

Report broken utility lines (electricity, water, gas andtelephone) to appropriate agencies/authorities.


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Do not turn on the main switch or useappliances and other equipment until theyhave been checked by a competentelectrician.

If necessary, consult health authorities forimmunization requirements.

Do not go "sight-seeing" in disaster areas.Your presence might hamper rescue andother emergency operations.


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Precautionary Measures:

Landslides


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Precautionary Measures: Landslides

Plan ground cover on slopes orelse build retaining walls.

In mudflow areas, construct

channels to divert mudflowsfrom your homes.

If you are warned of an

impending landslide ormudflow, evacuate at once.


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If your are caught outside and

cannot get inside a building,stay away from the path of thelandslide, or seek refugebehind a sturdy tree or

boulder. Curl into a tight balland protect your head.

In places where landslides or

mudflows occur repeatedly,dredge rivers and waterways tominimize flooding.


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Precautionary Measures:

Tsunami


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TSUNAMI

Series of giant sea wavesgenerated by under the

sea earthquakes

Tidal waves


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A strong earthquake inyour area is a naturaltsunami warning. Do not

stay in low-lying coastalareas after a localearthquake


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During the retreat of sealevel, interesting sights areoften revealed. Fishes maybe stranded on dry landthereby attracting peopleto collect them. Also,sandbars and coral flatsmay be exposed. Thesescenes tempt people toflock to the shorelinethereby increasing the

numbers of people at riskwhen the on rushingwaves of tsunami hit thearea.


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If unusual sea conditionslike extreme lowering ofsea level are observed, it

is best to regard this aswarning for anapproaching tsunami andimmediately move

towards high grounds.


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Approaching tsunamiwaves are sometimesheralded by noticeable

rise or fall of coastalwater. This is naturestsunami warning andshould be heeded


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Never go down to thebeach to watch for atsunami. When you can

see the wave, you are tooclose to escape it.


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A tsunami is not a singlewave but a series ofwaves. Stay out of danger

areas until an all clearis issued by competentauthority


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PSYCHOSOCIAL EFFECTS OF

DISASTERDISASTER OF MENTAL HEALTH RESPONSEPRINCIPLES

Mental Health Interventions must be taken to the survivors in adisaster

Survivors and the bereaved are particularly susceptible to effortsthat appear voyeuristic

Never separate children from their families

Limit exposure to dead and mutilated

Give accurate, truthful information to victims

Protect victim privacy and limit exposure to the media

Use naturally occurring support systems

Avoid medicalizing reactions

Minimize retraumatization

Mandatory psychological debriefing is clinically contraindicated


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PSYCHOSOCIAL EFFECTS OF

DISASTERMENTAL HEALTH REFERAL

DISORIENTATION

PSYCHOSISDEPRESSION

ANXIETY

PROBLEMATICUSE OF

ALCOHOL/DRUGS

SUICIDALTHOUGHTS

INABILITY TOCARE FOR

SELF

ABUSE


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Post Traumatic Stress Disorder

Hallmarks of PTSD: (symptoms of persistent.)

1. re xperiencing of traumatic event

2. avoidance of situation/stimuli that areassociated with trauma

3. increased arousal


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CSIM STRATEGIES

Pre incident education/mental preparedness training

Individual crisis intervention and on scene support

Demobilization after large scale events

Defusing

Debriefing - CISD

significant others support for families and children

Follow up services and referrals

C i i l id S


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Critical Incident Stress

Debriefing (CISD)

psychological first aid

Goals:

1. reduction of distress2. group cohesion

emphasis: to inform and empower

theoretical foundation: crisis intervention andgroup therapy


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7 Phases of CISD

1. Introduction

2. Fact

3. Thought4. Reaction-feelings

5. Symptoms of distress

6. Teaching7. Re entry


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CISD1. Introduction

* orientation to CISD procedure and approach

* rules of the session

2. Fact

* allows client to talk about extremely brief

overview of the fact* WHAT HAPPENED?

* WHAT DID YOU DO AT THE SCENE?


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Sample Introduction

Everyone reacts to critical incidents differently. The purpose

of this meeting is to help you better understand any reactions

you may have regarding the incident. Please understand

that what is done in this meeting is not therapy and is not

designed to prevent serious complications like post traumatic

stress disorder. This is also not meant to be a critique of the

event or judgment of others. Your participation in this group

is voluntary. You are not required to participate. Everything

said in this room stays in this room. Finally, it is importantthat only emergency service personnel who were involved in

the incident are now in the room. Is there anyone here who

was not involved or who you do not recognize as part of the

incident?


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CISD3. Thought

* touching on the emotional aspect begins

* WHAT WENT THROUGH YOUR MIND?

4. Reaction

* most intense phase; focuses on the impact ofcrisis to the participants

* WHAT WAS THE WORST PART OF THEINCIDENT FOR YOU?

* WITHOUT CHANGING THE OUTCOME,WHAT PART WOULD YOU ELIMINATE?


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CISD

5. Symptoms of Distress

* allows participant to describe the physical,cognitive, emotional & behavioral s/s of distress

* WHAT HAVE YOU BEENEXPERIENCING SINCE THE INCIDENT?

6. Teaching

* provides explanation of participants reactions

and stress mgt info


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CISD* other pertinent topics may be addressed (suicide,

communication, isolation, etc)

* The ff. may be given as concrete advice (ARC):

1. Do not isolate self from others.

2. Prevent self from becoming obsessed/fixated with theincident.

3. Eat well, exercise.

4. Assess the need for time off.

5. Dont have unrealistic expectations for healing & recovery.6. Learn about what you are going through.

7. Get help if necessary.


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CISD

7. Re entry

* summarizing what have been discussed

* emphasis on positive learning aspects

* reminding of confidentiality

DISASTER NURSING TIMELINE


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DISASTER NURSING TIMELINE

DISASTER

PHASE PREIMPACT IMPACT POST IMPACTTIME

(0-24HRS) (24-72HRS)

GREATER THAN 72HRS

DISASTER

CONTINUU

MPLANNING

PREPAREDNESS

PREVENTION

WARNING

RESPONSE

EMERGENCY

MANAGEMENT

MITIGATION

RECOVERY

REHABILITATION

RECONSTRUCTIO

N

EVALUATIONNURSING

ACTION

Participation in the development ofcommunity disaster plans

Participate in the community risk

assessment

Initiate disaster prevention measures

Perform disaster drills and table top

exercises

Identify educational and training needs

for all nurses

Develop disaster nursing databases for

notification, mobilization and triage of

emergency nurse s5taffing resources

Develop evaluation plans for all

components of Disaster Nursing

Response

Activate disaster response

plan

Mitigate all ongoing hazards

Activate agency disaster

plans

Establish need for mutualaid relationships

Integrate government

resources

Ongoing triage and

provision of nursing care

Evaluate public health needs

Continue provision of

nursing and medical care

Continue disaster surveillance

Monitor safety of the food

and water supply

Withdraw from disasterscene

Restore public health

infrastructure

Re-triage and transport of

patient to appropriate level

care facilities

Reunite family members

Establish safe shelter anddelivery of adequate foodand water supplies

Provide for sanitation

needs and waste removal Establish disease

surveillance Establish vector control Evaluate the need

for/activate additionalnursing staff

Monitor long term physicalhealth outcomes forsurvivors

Monitor mental healthstatus of survivors

Provide counseling anddebriefing for staff

Evaluate Disaster NursingResponse Action

Revise original disasterpreparedness plan


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Thank you for listening

disaster nursing 8-2-12

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