DISASTER MANAGEMENT

Submitted to - Mrs. Bindu Submitted by - Jagwinder Singh Sekhon Roll no. - 37

The Phases of Disaster management

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

Mitigation
Includes any activities that prevent a disaster, reduce the chances of a disaster happening, or reduce the damaging effects of unavoidable disasters (FEMA,1986)

Mitigation
Activities that reduce or eliminate a hazard
Prevention Risk reduction

Examples
Immunization programs Public education Improved building codes

Role Of Nurse In Mitigation

Role of Nurse in Mitigation

Nurses have key role in disaster mitigation by working with local, state and federal agencies in identifying disaster risks and developing disaster prevention strategies through extensive public education in disaster prevention and readiness. The nurse needs to have knowledge about community assessment information, community resources (e.g., hospitals, clinics), community health personnel (e.g., nurses, doctors, emergency medical teams), community govt. officials and local industry.

Preparedness
Includes plan and preparation made to save lives and help rescue operations (FEMA 1986)

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

Preparedness
Public education to reduce the impact of dangerous situations in certain areas that are prone to disaster situations. Community health nurses may be involved in such efforts, which may include instruction regarding proper safety precautions, storage of emergency supplies, and first aid courses to prepare the public to care for injuries in the event of an actual emergency.

 Members of a community have the most to loss from being vulnerable to disasters and the most to gain from an effective and appropriate emergency preparedness program. 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. Resources are most easily pooled at the community level and every community possesses capabilities. Failure to exploit these capabilities is poor resource management. Sustained development is best achieved by allowing emergency affected communities to design, manage and implement internal and external assistance program.

The reasons of community preparedness

 Plan for rescue, evacuation, caring for disaster victims, training disaster response personnel. Gathering resources, equipment and materials necessary for coping with disaster. Making anticipatory provision for food, water, clothing, shelter and medicine.

Planning

Following strategies could be considered for developing preparedness plan.

Convening meeting for the purpose of sharing knowledge. Holding disaster drills, rehearsals and stimulations. Developing techniques for training, information transfer and hazard assessment. Understanding public educational activities. Establishing informal lines and ties between relevant groups. Anticipating and communication about future dangers and hazards. Drawing up organizational disaster plans and integrating them in overall community disaster plan.

Are nurses prepared??

Role of nurse
Community health nurse have skills in crises intervention and are involved in acute care, first aid, rescue and evacuation procedures, recognizing and preventing communicable illnesses. To establish an effective public communication system.

 Planning should be a continuous process. It should reduce the unknown in problematic situation. It must evoke appropriate action. It should foresee what is likely to happen. It should be based on valid knowledge. It should focus on general principles. It should serve as an educational activity. It should overcome resistance. The plan must be tested. Adjust planning to people rather than expecting people to change their behavior in order to confirm with the planning.

Principles of disaster plan

Response
Activities a hospital, healthcare system, or public health agency take immediately before, during, and after a disaster or emergency occurs.

Response
How these goals are achieved will vary with the type of disaster and the type of rescue worker. Police officers and firefighters will have an entirely different focus than health care workers. Preplanning mandates the designation of a command center and coordinated interactions among various response personnel. In the event of a disaster situation, the emergency operation center (EOC) becomes operational. The EOC includes health personnel from the local emergency medical system (EMS). These personnel will be included in treating people at the scene of the disaster as well as at other designated location, including local hospitals.

Response
The management of mass casualties can be further divided into;
Search and rescue. Field care/ first aid Triage and stabilization of victims. Hospital treatment and redistribution of patients to other hospitals, if necessary.

Response
Tagging
All patients should be identified with tags stating their name, age, place of origin, triage category, diagnosis and initial treatment.

Identification of dead Removal of dead from the disaster scene. Shifting to mortuary Reception of bereaved relatives.

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

Recovery
The reconstruction of the victims life begins with initial care and continues until the victim has recovered. This may take few days , months, or years. Victim and disaster workers must receive adequate psychological counseling and emotional support to be able to effectively return to normal living.

Relief phase
Begins when assistance from outside starts to reach the disaster area. Following the initial emergency phase, needed supplies will include; food, blankets, clothing, shelter, sanitary engineering equipment and construction material. Principal components in managing humanitarian supplies;
Acquisition of supplies. Transportation. Storage. Distribution.

Care of disaster victims

The goal is to provide the greatest chance of survival to the largest number of the disaster victims through a system of attending the most sick and seriously injured victims first, then others who are less serious and could wait for sometime to get medical attention(Triage).

Disaster triage
To determine the priorities of care, victims are classified into several groups. Classification according to treatment need;
Minimal treatment; Persons who may assist others after treatment is given. Immediate treatment; persons who will benefit most by treatment. Delayed treatment; Persons who will not die if treatment is delayed. Expectant treatment; critically injured persons who will receive treatment if time permits.

 Priority one; Emergency; Persons who need immediate attention to save their lives. Priority two; Urgent; Persons who need attention within a few hours; If they do not receive attention, may suffer serious consequences. Priority three; Non-urgent; Persons who can tolerate a delay in receiving attention. Victims in this group can be attended in order of arrival and will need assurance that they have not been forgotten about. Priority four; Non-acute; Persons who do not require the services from rescuing/emergency department but can be examined by the medical staff as a regular or routine case.

Classification according to priority of care

Displacement of disaster victims

Mass casualty management

Do the best for the most promptly within the prevailing resources. Triage. Grade the care of casualties.
First aid Life saving measures Preparation for evacuation Primary surgery

Limit the first aid activities at the disaster site for maintaining and restoring vital functions. Transport the victims. Work with confidence and in co-ordination with other members of the rescue team.

Disaster scene
Each locality has its own standard operating procedures for disaster operations. But in general following procedures can help; A command post is established in a safe area. Communication is to be established with hospitals, medical facilities, dispatchers and other emergency units. Hazard control must begin as soon as possible. There must be close co-ordination between rescue personnel, fire fighters and law enforcement officers. Emergency medical first aider on the first ambulance to arrive automatically become triage officer, such as a physician from nearby hospital.

 Extrication may be difficult or delayed. Those doing the extrication must work closely with first aiders so that triage can begin along with first aid and patients are not injured during disentanglement operation. When possible patients are removed according to the severity of their injuries but this is not always practical. A triage point should be set up in safe area in such a way so that all patients are funneled through triage before they are taken to ambulance for transport. All ambulance drivers stay with their vehicles. First aider should report to triage officer along with equipments. The command post should determine the hospital to which a particular ambulance should go.

 A special care area should be set up to receive relatives and friends of disaster victims. Person in charge of this area must make certain that only reliable information is passed on to friends and relatives. Emergency care should be available at the information centre. Since dead bodies may not be removed from the scene until all the injured patients have been transported, a temporary morgue should be established out of site and source one should guard to prevent unauthorized persons from disturbing the bodies.

Shifting of patients
First aider should be mentally prepared to give first aid to the casualty. The ambulance
The driver of the ambulance should be active so that he can inspect the need of first aid needed by any person. The first aider should be alert. The driver should keep ready his ambulance. He should check;
Wheels and tires daily Doors and windows Fuel tank Facilities i.e. equipments should be ready and in a working condition. The warning devices i.e. check the siren, horn, visual warning signals, to be sure in working order. Lights should be alright like test the high/low head lights, turn signals, brake lights, back up lights, etc. The driver should have knowledge about the priority tag and he should have tags according to the need.

 There are number of ways in which dispatchers collect and disseminate information. A trained dispatcher should ask from the caller;
Disclose your identity and from where you are speaking. What is the nature of emergency. What is the exact location of accident. (the exact location of sick or injured is critical. Dispatcher should ask the building number, street name and direction, etc.) How many people are involved in accident. Note down the number of caller, if any.

Information obtained by dispatcher

Driving the ambulance to the scene

The driver should know about the emergency driving. He should avoid accidents. The driver should know about the law. Emergency vehicles are granted certain privileges with respect to speed, parking passage through traffic signals and direction of them but then also driver must be conscious about the law, because law never forgive anybody.

Driver must be well educated. He must know about road laws. He must be a licensed driver. He must be active and punctual. He should not take any medicine like narcotics, tranquilizers or anti-allergic which cause the sedation. He is not allowed to drink at the time of duty to prevent accident. He should not overuse the warning devices, Use siren when needed. Be prepared for the erratic maneuvers of other drivers. Some people become panic when they listen siren. Never use the siren indiscriminately and never use it to scare someone. Equip ambulance with simple horn, not in a tuning. The driver should be cautious about the animals or the people on the road. He should slow down his speed while watching them from far away.

Tips for disaster rescuer

Be professional; to stay alert to detect the victims problems and needs. Have a presence of mind; Be prompt in any action what normally a prudent person would do. Talk with victims; Acknowledge their individual existence, fears, questions and needs. Listen to victims; Reassurance often comes from having someone listening especially for victims who are near panic, argumentative or overly active. Provide needed care; Both physical and emotional needs of the victim must be considered. Provide food and drink; This will have a calming effect, provide assurance. Design tasks for the victims; Those who are injury free should be kept engaged by simple tasks, i.e. feeding, giving water to helpless. Keep victims together; To think that he is not alone or a stranger during disaster.

Personal protection in different types of emergencies

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 loud speaker. Keep a family emergency kit ready. In all the different types of emergencies, 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.

Disaster prevention
The measures designed to prevent natural phenomenon from causing or resulting in disaster or other emergency situations. It include;
Formulation and implementation of long range policies and programs to prevent or eliminate the occurrence of disaster. Enactment of legislation and regulatory measures pertaining to physical and urban planning, public works and building.

THANKS