Disaster nursing

PRESENTED BY
SANDEEP YADAV
MSc nursing1st year

INTRODUCTION• Disaster as “any occurrence that causes
damage ecological disruption, loss of human
life, deterioration of health and health services.
• Disaster are not confined to a particular part of
the world; they can occur any where and any
time

Disaster nursing
Disaster nursing can be defined as ''a
adaptation of professional nursing skills in
recognizing and meeting the nursing physical
and emotional needs resulting from the disaster.''

TYPES OF DISASTER
1. Natural Disaster – tornados, hailstorms,
tsunami, floods, Earthquakes,
communicable disease etc.
2. Man-Made Disaster- fires, explosions,
toxic materials, pollution, terrorist attack,
transportation accidents etc.

Goals of the Disaster Nursing
• To meet the immediate basic survival needs of
populations affected by disasters.
• To identify the potential for a secondary
disaster.
• To appraise both risks and resources in the
environment.
• To correct inequalities in access to health care
or appropriate resources.

Contd..
• To empower survivors to participate in and advocate
for their own health and well being.
• To respect cultural, lingual, and religious diversity
in individuals and families and to apply this
principle in all health promotion activities.
• To promote the highest achievable quality of life for
survivors.

Principles of Disaster Nursing
• Rapid assessment of the situation and of nursing care needs.
• Triage and initiation of life-saving measures first.
• The selected use of essential nursing interventions and the
elimination of nonessential nursing activities.

Contd..
• Evaluation of the environment and the
mitigation or removal of any health hazards.
• Prevention of further injury or illness.
• Leadership in coordinating patient triage,
care, and transport during times of crisis.

Contd..
• The teaching, supervision, and utilization of
auxiliary medical personnel and volunteers.
• Provision of understanding, compassion and
emotional support to all victims and their
families.

Health Effects of Disasters
• Disasters may cause premature deaths, illnesses, and
injuries.
• Disasters may destroy the local health care
infrastructure.
• Disasters may affect the psychological, emotional,
and social well being of the population.

Contd…
• Disasters may cause shortages of food and cause
severe nutritional deficiencies.
• Disasters may create large population movements.
• Disasters may create environmental imbalances.

Phases of a Disaster
• Pre-impact phase
• Impact phase
• Post-impact phase

PRE-IMPACT PHASE
• It is the initial phase of disaster, prior to the actual
occurrence. A warning is given at the sign of the first
possible danger to a community with the aid of weather
networks and satellite many meteorological disasters can be
predicted.
• The role of the nurse during this warning phase is to assist
in preparing shelters and emergency aid stations and
establishing contact with other emergency service group.

IMPACT PHASE
• The impact phase occurs when the disaster actually
happens. It is a time of enduring hardship or injury end of
trying to survive.
• This is the time when the emergency operation center is
established and put in operation. It serves as the center for
communication and other government agencies of health
tears care healthcare providers to staff shelters. Every
shelter has a nurse as a member of disaster action team. The
nurse is responsible for psychological support to victims in
the shelter.

POST – IMPACT PHASE
• Recovery begins during the emergency phase ends with the
return of normal community order and functioning. The
victims of disaster in go through four stages of emotional
response.
• 1. Denial – during the stage the victims may deny the
magnitude of the problem or have not fully registered.
• 2. Strong Emotional Response – in the second stage,
the person is aware of the problem but regards it as
overwhelming and unbearable.

Contd..
3. Acceptance – During the third stage, the
victim begins to accept the problems caused
by the disaster and makes a concentrated effect
to solve them.
4. Recovery – The fourth stage represent a
recovery from the crisis reaction. Victims feel
that they are back to normal.

RESPONSE
The response phase is the actual implementation of the
disaster plan. response activities need to be
continually monitored and adjusted to the changing
situation.
• A hospital, healthcare system, or public health
agency take immediately during, and after a disaster or
emergency occurs.

RECOVERY
Once the incident is over, the organization and staff needs to
recover. Invariably, services have been disrupted and it takes
time to return to routines.
• 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

Evaluation/ Development
Often this phase of disaster planning and response receives
the least attention. After a disaster, employees and the
community are anxious to return to usual operations. It is
essential that a formal evaluation be done to determine what
went well (what really worked) and what problems were
identified. A specific individual should be charged with the
evaluation and follow-through activities.

Mitigation
These are steps that are taken to lessen the
impact of a disaster should one occur and can be
considered as prevention and risk reduction measures.
Examples of mitigation activities include installing
and maintaining backup generator power to mitigate
the effects of a power failure or cross training staff to
perform other tasks to maintain services during a

Preparedness/Risk assessment
Evaluate the facility’s vulnerabilities or propensity for
disasters. Issues to consider include: weather patterns;
geographic location; expectations related to public events
and gatherings; age, condition, and location of the facility;
and industries in close proximity to the hospital (e.g.,
nuclear power plant or chemical factory)

ADVANCED TRIAGE CATEGORIES
CLASS I (EMERGENT) RED IMMEDIATE
– Victims with serious injuries that are life threatening but has a high probability of survival if they received immediate care.
– They require immediate surgery or other life-saving intervention, and have first priority for surgical teams or transport to advanced
facilities; they “cannot wait” but are likely to survive with immediate treatment.
“Critical; life threatening—compromised airway, shock, hemorrhage”
CLASS II (URGENT) YELLOW DELAYED
– Victims who are seriously injured and whose life is not immediately threatened; and can delay transport and treatment for 2 hours.
– Their condition is stable for the moment but requires watching by trained persons and frequent re-triage, will need hospital care
(and would receive immediate priority care under “normal” circumstances).
“Major illness or injury;—open fracture, chest wound”
CLASS III (NON-URGENT) GREEN MINIMAL
– “Walking wounded,” the casualty requires medical attention when all higher priority patients have been evacuated, and may not
require monitoring.
– Patients/victims whose care and transport may be delayed 2 hours or more.
“minor injuries; walking wounded—closed fracture, sprain, strain”
CLASS IV (EXPECTANT) BLACK EXPECTANT
They are so severely injured that they will die of their injuries, possibly in hours or days (large-body burns, severe trauma, lethal
radiation dose), or in life-threatening medical crisis that they are unlikely to survive given the care available (cardiac arrest, septic
shock, severe head or chest wounds);
They should be taken to a holding area and given painkillers as required to reduce suffering.
“Dead or expected to die—massive head injury, extensive full-thickness burns”

Organizing an effective
Disaster System
The nurse must be familiar with the
personnel at the disaster scene and their roles and
functions. A disaster scene is usually broken up
into three zones-

Contd..
1. Disaster zone
2. Treatment zone
3. Transport zone

1.Disaster zone:
• It is the actual location of the incident
from where patient are to be removed as
soon as possible. Majority of disaster
personnel are sent to this zone initially.

2.Treatment zone:
Nurses spend most of their time in their
zone during a disaster, where equipment
and personnel to carry out patient care are
concentrated. Activities carried out in this
zone includes.
- Assessment of each patient
- Treatment of injuries
- Preparation for transport.

3.Transportation zone:
• It should be situated directly next to the
treatment zone so that ambulances and
other vehicles can load patient and leave
for hospitals. delivering appropriate
patient care:

Triage area must be equipped
with the following
• Wheelchairs
• Stretchers
• Backboards
• IV poles
• Splints, bandages
• Emesis basins
• Disaster tags
• Pens
• Adhesive tape
• Oral airway
• Scissors
• Blankets
• Stethoscope
• Emergency trolley
with equipment

MAJOR ROLES OF NURSE IN
DISASTER
1. Define health needs of the affected groups
2. Establish priorities and objectives
3. Identify actual and potential public health
problems

Contd..
5. Determine resources needed to respond to the
needs identified
6. Collaborate with other professional
disciplines, governmental and non-governmental
agencies
7. Maintain a unified chain of command

CONCLUSION
Hardly a day now passes without news about a
major or complex emergency happening in
some part of the world. Disasters continue to
strike and cause destruction in developing and
developed countries about their vulnerability
to occurrences that can gravely affect their day
to day life and their future. Nurses in any
location will be on the frontline as care giver
and managers in the event of damaging
disaster.

Contd..
• So they need to have adequate knowledge and
framing to work in such a unique, chaotic
stressful situations and to identify and meet the
complex, multifarious health needs of victims
of disaster.

SUMMARY/EVALUATION
• Define the term Disaster and Disaster
Nursing.
• Explain the type of disaster.
• Enlist the goals of disaster nursing.
• List down the principles of disaster nursing.
• Explain about phases of disaster.
• Explain disaster Management cycle and
how to organize an effective disaster
system
• Discuss about major roles of nurse in
disaster.

Disaster nursing

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