DISASTER

NURSING
Maria Flordeliza U.
Donato,RN,MSN

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

TYPES OF DISASTER
1.Natural Disaster flood,
windstorm, earthquake,
volcanic eruption
2.Man made unintentional
disaster fire, explosion,
accidents of train, aircraft,
ships
3.Man made intentional

CHARACTERISTIC OF DISASTER

Predictability
Controllability
Speed of onset
Length of
forewarning
Duration of impact
Scope and
intensity of impact

PHASES OF DISASTER
Preimpact
phase
Impact
phase
Postimpact
phase

Elements of Disaster Risk

Management framework

Pre Disaster phase

Risk assessment Diagnostic process

to identify the risks that a community
faces
Prevention - Activities to avoid the
adverse impact of hazards
Mitigation Structural/non-structural
measures undertaken to limit the
adverse impact
Preparedness - Activities and
measures taken in advance to ensure
effective response
Early warning - Provision of timely and
effective information to avoid or reduce

Elements of Disaster Risk

Management framework
During disaster

Evacuation - temporary mass departure of

people and property from threatened
locations
Saving people and livelihoods
Protection of people and livelihoods during
emergency
Immediate assistance Provision of
assistance during or immediately after
disaster
Assessing damage and loss
Information about impact on assets and
loss to production

Elements of Disaster Risk

Management framework
Post disaster

Ongoing assistance Continued

assistance until a certain level of recovery
Recovery - Actions taken after a disaster
with a view to restoring infrastructure and
services
Reconstruction - Actions taken after a
disaster to ensure resettlement/relocation
Ongoing development activities
Continued actions of development
programmes

ROLES AND RESPONSIBILITIES OF

A DISASTER NURSE

daptation of nursing skills

to

situation.

C ontinuous awareness
T each auxillary
personnel

ROLES AND RESPONSIBILITIES OF

A DISASTER NURSE
N urse plan should be
coordinated and integrated
along with the other health
team.
U pdate physical and
psychological preparedness
R esponsible for organizing,
supervising and teaching
S timulate community

SECURITY TEAM: protects restricted areas

limiting any further danger from the
disaster and to provide crowd control in
order to ensure the safety of respondents
and victims.
SEARCH AND RESCUE TEAMS priority is
to locate and evacuate victims from the
impact zone and transfer them to the
medical post after assessing their status.
MEDICAL POST: should be established as
close as possible to the impact zone while
again maintaining a safe distance.

TRIAGE TEAM: under the leadership of

the Triage officers, tags, treats and
releases patients from the medical
post according to their health
conditions.
EVACUATION TEAM: is responsible for
the safe transfer of stabilized victims
to a health care facility using the most
appropriate transport and escorts
available definitive care.

THE SEVEN SECTOR IN THE

IMS
1. Mobile Command Sector considered
the headquarters or command post
for incident management.
2. Supply Sector responsible for
distributing the medical materials and
equipment necessary to render care.
3. Extrication Sector responsible for
freeing patients from wreckage and
managing them at the incident site.

ADVANTAGE OF INCIDENT
MANAGEMENT SYSTEM:

1.Prevents chaos
2.Prevents individualism
3.Prevents injury and
further damage
4.Prevents prolongation of
the incident.

TRIAGE

the greatest good for th

eatest number of injure

 RED:

Ventilation present only

after positioning the airway; OR
respirations over 30 per minute;
OR radial pulse not present and/or
perfusion greater than 2 seconds;
OR patient fails to follow simple
commands.

YELLOW:

Any patient who

does not fit either the immediate
or minor categories.
26

 GREEN:

These patients are

separated from the general group at the
start of triage by ordering, "Anyone
who can walk...," followed by an area
assignment for the patients to walk to.
These patients are ambulatory and can
move out of the triage area into an
assigned treatment area or they can
even be asked to assist medical
personnel.

BLACK:

No ventilation present even

after attempting to position the airway
twice.
27

Contaminated Patients
Patients with exposure (potential or real)
to contaminants should be tagged as

BLUE
This category will continue to stay until
patient is adequately decontaminated then
follow START as usual
Some recommend a double tagging
with blue and the standard START color

Reverse Triage / Inverted Triage

Situations

Reverse Triage or
Inverted Triage may play
a vital role in treating the
most viable victims first that
would otherwise be sorted
less effectively.
29

Reverse Triage
1.Used in mass-casualty
lightning injuries
2.The dead are treated first
3.High potential for
respiratory arrest
4.Potential for resuscitative
success

START

(Simple Triage and Rapid

Treatment )

DISASTER MANAGEMENT
Remember the principle:

Do not further
harm

Principles of Disaster
Management
1.
2.
3.
4.
5.
6.
7.
8.

Prevent the disaster

Minimize casualties
Prevent further casualties
Rescue the victims
First aid
Evacuate
Medical care
Reconstruction
36

Prevention Levels in Disaster Management

Primary Prevention - means keeping

the crisis from occurring

Secondary Prevention - focuses on

reducing the intensity and duration of
the crisis during the crisis itself

Tertiary Prevention - involves the

reduction of the amount and degree of
disability, injury, and damage following
a crisis
37

If there is FIRE
1. Exit the building as quickly as
possible.
2. Crawl low in a smoke.
3. Use a water cloth to cover your nose
and mouth.
4. Use the back of your hand to feel the
lower, middle and upper parts of the
closed doors.
5. If the door is hot, brace yourself
against the door and open it slowly.

If there is FIRE
6. Do not open the door if it is hot.
Look for another way out.
7. Use appropriate fire exits, not
elevators.
8. If you catch fire do not run.
9. STOP, DROP and ROLL.
10.If you are at home,go to previously
meeting.
11.Account your family members.
12.Do not go back

If there is FIRE
If you are TRAPPED IN A DEBRIS:
1. If possible use flashlight to signal
your location.
2. Avoid unnecessary movement so
that you can kick up the dust.
3. Cover your mouth and nose.
4. Tap on a pipe or wall so that
rescuer can hear you. Use a
whistle if available.

When protective equipment is not

available:
1. Close your eyes and control breathing.
2. Get under cover
3. If cover is not available, and it is only
vapor contamination, lie flat on the
ground as the toxic cloud generally
forms 30 cms above surface.
4. A blanket should be hung as a curtain
to act as air lock.
5. One should immediately wet cloth or
towel on his face covering eyes and
41

DUCK

what to do as soon as the

shaking stops:
1. Be alert.
2. Listen to teachers instructions.
3. Walk out of the classroom in an
orderly manner.
4. While walking along the corridors to
the nearest exit of the building, be
alert and look out for falling debris.
5. DONTRun, DONT Push,
6. DONT Talk, DONT Return,

what to do as soon as the

shaking stops:
7. DONT bring your things
8. Quietly but quickly proceed to the
designated evacuation area for the class
and wait for further instructions from the
teacher.
9. NEVER go back to the building once you
are outside. Buildings should be inspected
by engineers for possible damage after an
earthquake. Students should stay in the
open area and wait for their
parents/guardians to pick them up.