DISASTER MANAGEMENT

DEFINITIONS OF DISASTER

A disaster can be defined as any occurrence that cause damage, ecological disruption, loss of human life, deterioration of health and health services on a scale, sufficient to warrant an extraordinary response from outside the affected community or area. (W.H.O.)

A disaster can be defined as an occurrence either nature or manmade that causes human suffering and creates human needs that victims cannot alleviate without assistance. American Red Cross (ARC)

DISASTER NURSING
It

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

TYPES OF DISASTER
Water related and climate related disasters Geologically related disasters

Chemical, industrial and nuclear related disasters

Accidents related disasters

Floods and drainage.

Landslides

Nuclear disasters Chemical disasters

Fires

Cyclones

Earthquakes

Oil spill

Tornadoes

Dam failures

Serial bomb blasts

Rail accidents

Droughts

Mine fires

TYPES OF DISASTER
Biological related disasters
Biological disasters and epidemic

Food poisoning

DISASTER AND HEALTH:

Injuries from the event. Environmental exposure after the event (no shelter) Emotional stress. Epidemic of disease. Increase in indigenous diseases. Malnutrition after the event. Mental health (disaster syndrome) Flooded sewer systems. The destruction of the health care infrastructure. The interruption of the health services geared towards communicable diseases

LEVELS OF DISASTER:
LEVEL 3 DISASTER - Considered a minor disaster. These are involves minimal level of damage.

LEVEL 2 DISASTER - Considered a moderate disaster. The local and community resources has to be mobilized to manage this situation.

LEVEL 1 DISASTER Considered a massive disasterthis involves a massive level of damage with severe impact.

GOALS OF DISASTER REDUCTION

Creating public awareness about safety from disasters. Amending legislation from safety from disasters. Planning development area with safety from disasters. Protection of habitants from adverse disaster impacts. Constructing new building safe from disasters. Retrofitting existing buildings for improving disaster resistance

PHASES OF DISASTER MANAGEMENT

Disaster Mitigation Disaster Preparedness

Disaster Response
Disaster Recovery

Disaster mitigation

This involves lessening the likely effects of emergencies. These include depending upon the disaster, protection of vulnerable population and structure.

Activities that reduce or eliminate a hazard. (1) Prevention (2) Risk reduction Example: Immunization programs, Public education

For examples, improving structural qualities of schools, houses and such other buildings so that medical causalities can be minimized. Similarly ensuring the safety of health facilities and public health services including water supply and sewerage system to reduce the cost of rehabilitation and reconstruction. This mitigation compliments the disaster preparedness and disaster response activities.

Disaster preparedness
Disaster preparedness is an ongoing multisectoral activities that are taken to built capacity and identify resources that may be used Objective: To ensure that appropriate system, procedures and resources are in place to provide prompt effective assistance to disaster victim. The states are responsible for relief activities ,central government also takes measures for suffering people on natural calamities and provides physical and financial resources. Central government response depends on the factors like. 1. The gravity of a natural calamity. 2. 2.the scale of the relief operation necessary. 3. 3.the requirements of central assistance for financial resources at the disposal of the state government.

Preparedness should be in the form of money, manpower and materials Evaluation from past experiences about risk Location of disaster prone areas Organization of communication, information and warning system Ensuring co-ordination and response mechanisms Development of public education programme Co-ordination with media National & international relations Keeping stock of foods, drug and other essential commodities.

Types of Preparedness
It is of two types:Personal preparedness: Professional preparedness Personal preparedness: Making people aware of what is expected of them in case of an emergency. 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 media so as to be informed of development. Carry out the official instructions given by the radio and loudspeaker. Keep a family emergency kit ready.

Floods
During a flood: Turn off the electricity to reduce the risk of electrocution. Protect peoples and property. Beware of water contamination. Evacuate danger zones as ordered by the local authorities. After a flood: When flood is over it is important that people do not return home until told to do so by the local authorities. Wait until water is declared safe before drinking. Clean and disinfect any room that has been flooded. Sterilize or wash with boiling water all dishes and utensils. Get rid of any food that has been in or near the water.

Storms, Hurricanes and Tornadoes:

Take optimum preventive measures such as:

Choose a shelter in advance, before the emergency occurs.

Minimize the effects of storm. Take measures against flooding. Prepare a family emergency kit. During an emergency: Listen to the information and advice provided by the authorities. Do not go out once storm has been declared. Tie down the object liable to be blown away by the wind. In a thunderstorm keep away from doors, windows, and electrical conductors. After an emergency: Follow the instructions given by the authorities. Stay indoors. Give the alert as quickly as possible. Give first aid to the injured..

Earthquakes:
Before Earthquake:

Build in accordance with urban planning regulations. Ensure that all electrical and gas appliances are firmly fixed. Avoid storing heavy objects in high positions. Hold family evacuation drills. Prepare a family emergency kit. Keep calm, do not panic. People who are indoors should move to the central part of building. Keep away from the stairs, which might collapse. People who are outside should stay. Follow the instructions given by the authorities. Do not go back into damaged buildings. Give first aid to the injured. Make sure the water is safe to drink and food stored at home is fit to eat.

During earthquake:

After earthquake:

Professional preparedness
Key organizations and professional in disaster management. Health care community

Hospitals Health professionals Pharmacies Public Health departments

Rescue personnel

Non Health Care community

Fire fighters

Municipal or government officials

Media Medical examiners Medical supply manufacturers

Police

E.g.: Indian Meteorological department (IMD)

plays a key role in forewarning the disaster of cyclone-storms by detection tracing. It has 5 centres in Kolkata, Bhubaneswar, Vishakapatanam, Chennai & Mumbai. In addition there are 31 special observation posts setup a long the east coast of India.

The International Agencies which provides humanitarian assistance to the disaster strike areas are United Nation agencies. Office for the co-ordination of Humanitarian Affair (OCHA) World Health Organization (WHO) UNICEF World Food Programme (WFP) Food & Agricultural Organisation (FAD)

E.g.: Non Governmental Organizations

Co-Operative American Relief Every where (CARE) International committee of Red cross International committee of Red cross

Disaster response

(1)

Rescue and first aid: After a major disaster, the need for search rescue and first aid is likely to be so great that organized reliefs services will be able to meet only a small fraction of the demand.

(2) Triage: French verb Trier means to sort. Assign priorities when resources limited. Disaster Triage needed when:Inadequate resources to meet immediate needs. Infrastructure limitations. Inadequate hazard preparation. Limited transport capabilities. Multiple agencies responding.

Triage

Golden hour Immediate or high priority: Delayed or medium priority: Minor or minimal or ambulatory patients: Expectant or least priority: Colour code:

Relief phase
This phase begins when assistance from outside starts to reach the disaster area. Relief supply usually determine by two main factors. (1) The type of disaster (2) The type and quantity of supplies available locally.

Epidemiologic surveillance and disease control Vaccination Nutrition

Recovery phase
During this phase action are taken to repair, rebuilt or reallocate damaged homes and businesses and restore health and economic vitality of the community Water supply Food safety Basic sanitation and personal hygiene Vector control

DISASTER MANAGEMENT CYCLE

DISASTER-EFFECTS
Deaths Disability Increase in communicable disease Psychological problems Food shortage Socioeconomic losses Shortage of drugs and medical supplies. Environmental disruption

DISASTER DRILL
A disaster drill is an exercise in which people simulate the circumstances of a disaster so that they have an opportunity to practice their responses.

Disaster management plans

Aims of disaster plans to provide prompt and effective medical care to the maximum possible in order to minimize morbidity and mortality

Objectives To optimally prepare the staff and institutional resources for effective performance in disaster situation To make the community aware of the sequential steps that could be taken at individual and organizational levels

Disaster management committee

Medical superintendent/ director Additional medical superintendent Nursing superintendent/ chief nursing officer Chief medical officer (casualty) Head of departments- surgery, medicine, orthopedics, radiology, anesthesiology, neurosurgery Blood bank in charge Security officers Transport officer Sanitary personnel

Disaster control room the existing casualty may be referred as the disaster control room. Rapid response team The medical superintendent will identify various specialists, nurses and pharmacological staff to respond within a short notice depending up on the time and type of disaster. The list of members and their telephone numbers should be displayed in the disaster control room. Information and communication the disaster control team would be responsible for collecting, coordinating and disseminating the information about the disaster situation to the all concerned.

Disaster beds Requirement of beds depends up on the magnitude of the disaster. Utility areas to be converted in to temporary wards such as wards with side rooms, corridors, seminar rooms etc. Creating additional bed capacity by using trolleys, folding beds and floor beds Logistic support system Resuscitation equipments Iv sets, iv fluids, Disposable needles, syringes and gloves Dressing and suturing materials and splints Oxygen masks, nasal catheters, suction machine and suction catheters Ecg monitors, defibrillators, ventilators Cut down sets, tracheostomy sets and lumbar puncture sets Linen and blankets Keys of these cupboards should be readily available at the time of disaster

Elements of disaster plan A disaster plan should have the following elements Chain of authority Lines of communication Routes and modes of transport Mobilization Warning Evacuation Rescue and recovery Triage Treatment Support of victims and families Care of dead bodies Disaster worker rehabilitation

Activation of disaster management plans Standard operating procedures (SOPs) Reception area Triage
Priority one- needing immediate resuscitation, after emergency treatment shifted to intensive care unit Priority two- immediate surgery, transferred immediately to operation theatre. Priority three- needing first aid and possible surgerygive first aid and admit if bed is available or shift to hospital Priority four- needing only first aid-discharge after first aid.

Documentation Public relations. Essential services. Crowd management/ security arrangement.

ROLE OF NURSE IN DISASTER MANAGEMENT

DISASTER PREPAREDNESS To facilitate preparation with community To provide updated record of vulnerable populations within community Nurse leads a preparedness effort Nurse play multiroles in community Nurse should have understanding of community resources Disaster Nurse must be involved in community organization

DISASTER RESPONSE
Nurse must involve in community assessment Once rescue workers begin to arrive at the scene, immediate plans for triage should begin Nurse work a member of assessment team To be involved in ongoing surveillance

DISASTER RECOVERY
Successful Recovery Preparation Be vigilant in Health teaching Psychological support Referrals to hospital as needed Remain alert for environmental health Nurse must be attentive to the danger

Summary
Disaster is a result of vast ecological breakdown in the relation between humans and their environment, as serious or sudden event on such that the stricken community needs extraordinary efforts to cope with outside help or international aid. Disaster Plan are required to optimally prepare the staff and institutional resources for effective performance in disaster situation Nursess has vital role in disaster management. They need to assess the community and Determine the actual and potential disaster threats

Conclusion
Disaster is an emergency situation, therefore coordination of actions and various departments is an essential requisite for efficient management of mass casualties. It is a result of vast ecological breakdown in the relation between humans and their environment, as serious or sudden event on such that the stricken community needs extraordinary efforts to cope with outside help or international aid. Except natural disaster all other disasters can be prevented. Natural disaster can be predicted and its impact can be reduced significantly. Therefore Disaster can be reduced by creating public awareness about safety from disasters and Planning development area with safety from disasters.

There are four phases of disaster management.(1)Mitigation to Lessen the impact of a disaster before it strikes,(2) Preparedness activities undertaken to handle a disaster when it strikes, (3) Response to search and rescue, clearing debris, and feeding and sheltering victims,(4) Recovery in Getting a community back to its pre disaster status. Disaster Plan are required to optimally prepare the staff and institutional resources for effective performance in disaster situation and to make the community aware of the sequential steps that could be taken at individual and organizational levels