Disaster Management in Nursing

Disaster & Emergency
Nursing
GROUP 4
1. Identify potential issues, requirements, decisions and potential planning. What should be the
immediate reaction of the authorities? What are the priorities? What notifications should be
made?
Notify the fireman central station, police central station, ambulance service, hospital emergency
department and local committee for disaster situation.
Assess in scene security and safety.
Assess for hazards.
 Triage and treatment
 Vacate the area. Starting with those who need non emergent care and will not cause life
threatening events.
2. How will you coordinate simultaneous mass casualty incidents?
 Transfer is organized according to different principles such as strict control of the rate and
destination of evacuation to avoid overwhelming of the health care facilities
1. Stop spontaneous evacuation from by-standers of unstable victims or minimal injured
patients
2. Victims should not be removed from the medical post to health care facility before:
- They are in the most stable condition possible
- They adequately equipped for the transfer
- the receiving health care facility is correctly informed and ready to received pt.
- the most appropriate escort and vehicle are available
2. How will you coordinate simultaneous mass casualty incidents?
 The Noria Principle

- Patient movement must be in a one way direction and without back-tracking.
Impact zone  collecting point
Collecting point  Advanced medical post entrance
and subsequently to areas of treatment, evacuations and hospital care
3. How will you deal with the medical surge of critical care patients?
 Clearly established treatment areas in the hospital and provide necessary staffing
 Treatment area designation should reflect triage levels, e.g. red treatment area for victims
triaged in the red category.
 Emergency medicine physician and anesthesiologist should be in-charged
 Victims triage as yellow should be re-evaluated or observed as needed if their conditions
worsens transfer them to the red treatment area
 Victims with no hope of survival should be kept in a separate ward and have an area for the
deceased victims if the hospital morgue is overwhelm
4. What measures will you take to expand critical care beds in hospitals?
 Discharge all patients that can be cared for out-patient basis

 Adding hallway beds or opening up hospital clinics can help with search capacity
 All arriving victims whether or not they’ve been previously triaged, should be retriaged upon
arrival
 On-scene command post, that advanced medical post and the hospital command post should all
be in communication continuously, providing updates on number, severity of injured victims,
transport time and current hospital capacity
5. What resources are anticipated?
fireman central station

 police central station
 ambulance service
hospital emergency department
 local committee for disaster situation.
6. What information and expected actions are shared with health care partners?
 Patient referral information should be provided from the site of the incident command and from
there to the intervening agencies and the nearest hospitals. Essential information includes:
- number of victims
- number of persons need to be transferred to a hospital
- when and how they will be transported
- relevant lesions care of victims
7. How will you support the field and overwhelmed hospitals?
 Nurses may be among the first responders and coordinate rapid-needs assessments.
Provide immediate assistance to maintain life, improve health and support the morale of the
affected population.
Focus lies on meeting the basic needs of those who are affected by immediate emergency issues
then conducting repairs and restoring utilities in the overwhelmed hospital
8. In these incidents, it is especially important that notifications are made swiftly and repeatedly to
key decision-makers, senior officials, executive boards and department heads. How would you ensure
that notifications are made quickly and efficiently? Who notifies who?
 Incident commander  Fireman Station Head  Assistant Head  Staff

 Incident Commander  Police Central Station Head  Chief Officer  Assistant Chief Officer 
Staff
 Incident Commander  Hospital Emergency Department Head  Medical Director  Manager
 Nursing Chief  Staff
 Incident Commander  Local Committee for Disaster Situations  Committee Chairman
9. As nurses, how will you participate in this scenario?
Nurses perform proper assessment, prioritize injuries, communicate effectively, and collaborate
with other providers.
Reassess and observes patient properly.
10. Discuss the triaging data you received from the field. Present the needs of victims according to
their triage classifications.
130 persons injured; Triage ratings: 50 – GREEN, 35 –YELLOW, 45 – RED and 10 – BLACK
 RED – Needs immediate care for survival but minimal intervention, if treatment is delayed
progresses rapidly to expectant
 YELLOW – delayed. Required medical care but can wait for few hours without a treat to life
 GREEN – minimal injuries. Care can be delayed for few hours or days. Individual of this group can
be moved away from the main triage
 BLACK – expectant. Injuries are extensive, survival rate are unlikely.

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Disaster & Emergency

 The Noria Principle

 Discharge all patients that can be cared for out-patient basis

fireman central station

 Incident commander  Fireman Station Head  Assistant Head  Staff

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