ppt for emergency disaster nursing

7/28/2019 PPT for EMERGENCY DISASTER NURSING

1/53

DISASTER

NURSING

GOLDEN

LECTURE

Kawkab Shishani, RN, PhDCommunity Health Nursing

[email protected]

Richard Garfield, RN, DrPH

Director WHO/PAHO Collaborating Center School ofNursing, Columbia University in the City of New York

Nicolas Padilla, MD

Universidad de GuanajuatoMexico

Ronald LaPorte, PhDDirector Telecommunications and Disease Monitoring;WHO Collaborating Center

University of Pittsburgh June 8, 2009


2/53

NURSES AND EDUCATION

Education is the most powerful weapon

which you can use to change the

world.

Nelson Mandela


3/53

MISSIONSTATEMENT

Disasters are a primary cause of morbidity and

mortality. Nurses can play an important role in

disaster mitigation, but they receive very little

training. This lecture is designed to help tointroduce to nursing the concepts of disasters and

disaster mitigation. We propose that you teach this

lecture to your nursing students to build awareness

world wide.


4/53

OBJECTIVES

1. Define a disaster

2. Discuss patterns of mortality and injury

3. Understand impact of disasters on health

4. Describe the factors that contribute to disastersseverity

5. Discuss role of nursing in disasters

6. Apply principles of triage in disaster

7. Analyze the WHO components of effectivedisaster nursing


5/53

WHATISDISASTER

Is a result of vast ecological breakdown in the

relation between humans and their environment, as

serious or sudden event on such scale that the

stricken community needs extraordinary efforts to

cope with outside help or international aid.
http://images.google.com/imgres?imgurl=http://www.oddjack.com/collage.jpg&imgrefurl=http://arisat.blogspot.com/2007/06/disasters-as-mark-of-beginning-of-reign.html&usg=__pGsFct0T90Yd6knax-RIyhUIMOM=&h=360&w=360&sz=49&hl=en&start=12&sig2=oeI4wcnrEW4kOFeL_2vC1A&tbnid=KEP8apk_QRUNAM:&tbnh=121&tbnw=121&prev=/images%3Fq%3Ddisasters%26gbv%3D2%26hl%3Den&ei=IH0vSrizKIPH-Ab5tJCICg


6/53

TYPES

Natural

Pandemics

Transportation Technological

Terrorism
http://images.google.com/imgres?imgurl=http://www.oddjack.com/collage.jpg&imgrefurl=http://arisat.blogspot.com/2007/06/disasters-as-mark-of-beginning-of-reign.html&usg=__pGsFct0T90Yd6knax-RIyhUIMOM=&h=360&w=360&sz=49&hl=en&start=12&sig2=oeI4wcnrEW4kOFeL_2vC1A&tbnid=KEP8apk_QRUNAM:&tbnh=121&tbnw=121&prev=/images%3Fq%3Ddisasters%26gbv%3D2%26hl%3Den&ei=IH0vSrizKIPH-Ab5tJCICghttp://en.wikipedia.org/wiki/Image:HurricaneRita21Sept05a.jpg


7/53

HURRICANES

The primary health hazard from hurricanes or

cyclones lies in the risk of drowning from the storm

surge associated with the landfall of the storm.

Most deaths associated with hurricanes are

drowning deaths.

Secondarily, a hazard exists for injuries from flying

debris due to the high winds.

Nurses can be instrumental in providing direct

emergency care to drowning and head injuries.
http://en.wikipedia.org/wiki/Image:HurricaneRita21Sept05a.jpg


8/53

TORNADOES

The primary hazard from a health perspective in a

tornado is the risk for injuries from flying debris. Thehigh winds and circular nature of a tornado leads to

the elevation and transport of anything that is not

fastened down. Most victims of tornadoes are affected

by head and chest trauma due to being struck by

debris or from a structural collapse. Some individuals

are injured while on the ground. Others are lifted into

the air by the tornado and dropped at another location.


9/53

FLOODS

Floods may originate very quickly following a quick rain

storm, or they may develop over a short period followingan extended period of rain or quick snow melt

The primary hazard from flooding is drowning

Longer term health concerns from flooding is the

development of disease from contaminated water andlack of hygiene.


10/53

EARTHQUAKES

A significant global concern

The primary health concern:

Injuries arising from structural collapse Most injuries occur amongst individuals trapped at the

time of the earthquake

Well known prevention strategy is to prevent buildings

from collapsing There is a recognized need to develop better rescue

strategies for retrieving individuals from collapsed

buildings


11/53


12/53

VOLCANOES

Rare, but can be catastrophic when they occur

Over the 25 year period (1972-1996), there was an

average of 6 eruptions per year, causing an

average of 1017 deaths and 285 injuries

Health outcomes are associated with volcanic

eruptions:

Respiratory illnesses from the inhalation of ash

For individuals close to the volcano, somedanger exists from lava flows, or more likely mud

flows


13/53


14/53


15/53

VULNERABILITIES, NEEDS, AND ABILITIES VARY


16/53

0

1000000

2000000

3000000

4000000

5000000

6000000

7000000

8000000

9000000

10000000

1900

1905

1910

1915

1920

1925

1930

1935

1940

1945

1950

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

Conflict Natural Disasters


17/53


18/53

MAN-MADE THREAT

Unpredictable Challenges

Disruptive

Unexpected

Targeting weaknessesVery rare, impossible to conceive before event

Threats to Civilians, Information

Infrastructure
http://images.google.com/imgres?imgurl=http://www.greenpeace.org/raw/image_full/india/photosvideos/photos/tons-of-chemicals-lie-abandone&imgrefurl=http://www.greenpeace.org/india/photosvideos/photos/tons-of-chemicals-lie-abandone&usg=__Y2mETytwBye1iEA-3aDZpjIbxdE=&h=350&w=430&sz=76&hl=en&start=85&sig2=Puay2YzDx1975Guqt_Mg2A&tbnid=YEZh5xGQfK9tnM:&tbnh=103&tbnw=126&prev=/images%3Fq%3Dbhopa%2Bindia%26gbv%3D2%26ndsp%3D20%26hl%3Den%26sa%3DN%26start%3D80&ei=kn8vSv21CdmD-AbA88CMCghttp://images.google.com/imgres?imgurl=http://briancabral.com/Images/Bhopal.jpg&imgrefurl=http://briancabral.com/BrianCabral/Global&usg=__S47lLMSUqW0hIGqXy68CXplzWHc=&h=342&w=500&sz=68&hl=en&start=156&sig2=G4ZLF_CQHP8phCg2vukCkA&tbnid=xosK6pQfZhI_bM:&tbnh=89&tbnw=130&prev=/images%3Fq%3Dbhopa%2Bindia%26gbv%3D2%26ndsp%3D20%26hl%3Den%26sa%3DN%26start%3D140&ei=pn8vSpiTO8HR-AaRnaWaCg


19/53

COMPONENTSOFDISASTERDEBRIS

Building Debris

Household Debris

Vegetative Debris

Problem Waste Streams


20/53

MYTHSASSOCIATEDWITHDISASTERS

Any kind of assistance needed in disasters A response not based on impartial evaluation contributes to

chaos

Epidemics and plagues are inevitable after everydisaster Epidemics rarely ever occur after a disaster Dead bodies will not lead to catastrophic outbreaks of exotic

disease

Proper resumption of public health services will ensure thepublics safety (sanitation, waste disposal, water quality, andfood safety)

Disasters bring out the worst in human behavior The majority responses spontaneous and generous

The community is too shocked and helpless Cross-cultural dedication to common good is most common

response to natural disasters


21/53

PATTERNSOFMORTALITYANDINJURY

Disaster events that involve water are the most

significant in terms of mortality

Floods, storm surges, and tsunamis all have a

higher proportion of deaths relative to injuries

Earthquakes and events associated with high winds

tend to exhibit more injuries than deaths

The risk of injury and death is much higher in

developing countries at least 10 times higher

because of little preparedness, poorer

infrastructure.


22/53

DISPLACEMENTOFDISASTERVICTIMS

Mass Shelters

Shelter management:

Organized team (chain)

Sleeping area and necessities

Water and food handling

Sanitation (toilets, showers,..)

Special care to children and elderly

Health services (physical, mental)


23/53

DISASTERANDHEALTH

In a major disaster water treatment plants,

storage & pumping facilities, & distribution

lines could be damaged, interrupted or

contaminated. Communicable diseases outbreak due to:

Changes affecting vector populations (increase vector),

Flooded sewer systems,

The destruction of the health care infrastructure, and The interruption of normal health services geared

towards communicable diseases


24/53

DISASTERANDHEALTH

Injuries from the event

Environmental exposure after the event (no shelter)

Malnutrition after the event (feeding the population

affected) Excess NCD mortality following a disaster

Mental health (disaster

syndrome)


25/53

MENTALWELLNESS

Little attention is paid to the children

Listen attentively to children without denying their

feelings

Give easy-to-understand answers to their questions In the shelter, create an environment in which

children can feel safe and secure (e.g. play area)


26/53

MENTALWELLNESS

In any major disaster, people want to know where their

loved ones are, nurses can assist in making links.

In case of loss, people need to mourn:

Give them space,

Find family friends or local healers to encourage

and support them

Most are back to normal within 2 weeks

About1% to 3%, may need additional help


27/53

THEMOSTVULNERABLE


28/53

THE PHASESOF DISASTER

Mitigation:

Lessen the impact of a disaster before it strikes

Preparedness:

Activities undertaken to handle a disaster when it strikes

Response:

Search and rescue, clearing debris, and feeding and

sheltering victims (and responders if necessary).

Recovery:

Getting a community back to its pre-disaster status


29/53

MITIGATION

Activities that reduce or eliminate a hazard

Prevention

Risk reduction

Examples

Immunization programs

Public education


30/53

PREPAREDNESS

Activities that are taken to build capacity and

identify resources that may be used

Know evacuation shelters

Emergency communication plan

Preventive measures to prevent spread of disease

Public Education


31/53

RESPONSE

Activities a hospital, healthcare system, or public

health agency take immediately before, during, and

after a disaster or emergency occurs


32/53

RECOVERY

Activities undertaken by a community and its

components after an emergency or disaster to

restore minimum services and move towards long-

term restoration.

Debris Removal

Care and Shelter

Damage Assessments

Funding Assistance
http://en.wikipedia.org/wiki/File:Deconference-2002-triage-tag.jpg


33/53

WHATIS TRIAGE?

French verb trier means to sort

Assigns priorities when resources

limited

Do the best for the greatest

number of patients
http://en.wikipedia.org/wiki/File:Deconference-2002-triage-tag.jpg


34/53

WHYIS DISASTER TRIAGENEEDED

Inadequate resource to meet immediate needs

Infrastructure limitations

Inadequate hazard preparation

Limited transport capabilities

Multiple agencies responding

Hospital Resources Overwhelmed


35/53

ADVANTAGESOF TRIAGE

Helps to bring order and organization to a chaotic

scene.

It identifies and provides care to those who are in

greatest need

Helps make the difficult decisions easier

Assure that resources are used in the most

effective manner

May take some of the emotional burden away from

those doing triage


36/53

WHODECIDESINTRIAGE

Nurses dont act for legal fears of being blamed for

deaths, and lack of clarity on where they fit in the

command structure

Nurses function to the level of their training and

experience.

If nurses they are the most trained personnel the

site, they are in charge.


37/53

ARENURSESPREPARED??


38/53

HEALTH WORKER DENSITYBYREGION

2. 3

2. 6

4. 2

6. 9

8. 7

9. 9

10.3

0. 8

0 2 4 6 8 10 12

E u r o p e

N o r t h A m er i c a

W e s t e r n Pa c i f i c

M i d d l e E as t

G l o b a l

S &C e n t r a l A mer i c a

A s i a

S ub - S ah ar a n A f r i c a

Workers per 1,000 population

NURSES


39/53

NURSES


40/53

KILLED BY DISASTERS


41/53

ROLEOFNURSINGINDISASTERS

Disaster preparedness, including risk assessment and

multi-disciplinary management strategies at all

system levels, is critical to the delivery of effective

responses to the short, medium, and long-term healthneeds of a disaster-stricken population.

International Council of Nurses (2006)


42/53

NURSES ROLESINDISASTERS

Determine magnitude of the event

Define health needs of the affected groups

Establish priorities and objectives Identify actual and potential public health problems

Determine resources needed to respond to theneeds identified

Collaborate with other professional disciplines,governmental and non-governmental agencies

Maintain a unified chain of command

Communication


43/53

COMMUNICATIONISASUCCESSKEY

Nursing organizations must have a comprehensive

and accurate registry for all members

Have a structured plan:

Collaborate and coordinate with local authorities

Have a hotline 24x7

Inform nurses where to report and how (keep records)

Make sure have a coordinator to prevent chaos

Ensure ways to maintain communication between

nurses and their families


44/53


45/53

CORECOMPETENCIESINDISASTERNURSING

TRAINING

Ethical and legal issues, and decision making;

Care principles;

Nursing care;

Needs assessment and planning; Safety and security;

Communication and interpersonal relationships;

Public health; and

Health care systems and policies in emergencysituations

(WHO, 2008)


46/53

TOPICSTHATMUSTBECOVEREDBYDISASTER

NURSINGTRAINING

Basic life support

System and planning for settings where nurses

work

Communications (what to report and to whom)

Working in the damaged facilities and with

damaged equipment

Safety of clients and practitioners

Working within a team (understand each membersrole and responsibility)

Infection control

Mental and psychosocial support

(WHO, 2006)


47/53

SUPERCOURSE INITIATIVE Supercourse is a Library of Lectures to

empower educators

Twenty Nobel Prize winners, 60 IOM members

and other top people contributed lectures. Gil

Omenn, AAAS former president, Vint Cerf, thefather of the Internet, Elias Zerhouni, head of NIH,

etc. , Ala Alwan, Assistant Director General of the

WHO

With the growing number of nurses in the network,there was a need to establish a DisasterNursing

Supercourse to emphasize the contribution of

nursing to global health


48/53

BUILDINGDISASTERNURSING SUPERCOURSE

Reasons:

Nurses form the largest health care professional

group

Nurses are the main health professionals in

touch with the community

Shortage in number of structured nursing

programs in disaster preparedness

Nurses deal with the physical stresses of a

disaster, and more importantly the fear,

stress and uncertainties of disasters


49/53


Reasons:

Nurses receive little training in disaster

preparedness, prevention and Mitigation

(general not specialized training) Expected increase in disasters and in numbers

of causalities in particular in developing countries

Developing countries has the highest burden and

has limited resources


50/53


How:1. Provide training for future generations of

nurses who might be engaged in a disaster

2. Collaborate with WHO

3. Build disaster nursing lectures to train nursesworldwide

4. Promote partnerships among instructors at

schools of nursing in the world in the area of

disaster nursing5. Offer up to date evidence based scientific

knowledge to enhance faculty training


51/53

Most of all, if gains in health and nutrition during

emergencies are to be sustained, graduates need to

understand the importance of capacity building of

national staff and institutions.

Salama et al, Lessons Learned from Complex Emergencies


52/53

DISASTER NURSING SUPERCOURSE

oTo join the Nursing Supercourse, please visitwww.pitt.edu/~super1

or e-mail

[email protected].

oMembership in the Global Health Network

Supercourse will allow you to receive free Supercourse

CDs, just in time lecture, and annual prevention lectures

oNote: send this lecture to a friend button works from

PowerPoint slide show mode
mailto:putaddresses@here?subject=Nursing%20Supercourse


53/53

More information

This lecture is available at:

http://www.pitt.edu/~super1/lecture/lec35051/index.htm

Please fee free to e-mail at:

[email protected]
http://www.pitt.edu/~super1/lecture/lec35051/index.htmmailto:[email protected]:[email protected]://www.pitt.edu/~super1/lecture/lec35051/index.htmhttp://www.pitt.edu/~super1/lecture/lec35051/index.htmhttp://www.pitt.edu/~super1/lecture/lec35051/index.htmhttp://www.pitt.edu/~super1/lecture/lec35051/index.htmhttp://www.pitt.edu/~super1/lecture/lec35051/index.htm

ppt for emergency disaster nursing

Documents