MGT
Disasters
Objectives
Identify disaster types, planning and nursing participation.
Describe the public health response throughout the phases of an emergency response.
….Nurses at their Best
https://www.youtube.com/watch?v=JPSbDq2NjDg (13 mins)
Disasters
“A disaster is an event that causes human suffering and demands more resources than are available in the community. A disaster can be naturally occurring, man-made (accidental or terrorism types), or a combination of both, such as a natural disaster causing technological failures.” ATI p. 65
Phases:
Pre-impact
Impact
Post-Impact
Disaster Management Cycle
Effective emergency management includes a functional approach to all emergencies, cooperative planning, appropriate use of resources, and shared responsibilities among the three levels of government.
Personal disaster preparedness is the first and most effective intervention to reduce the impact of disasters.
Levels of DM mitigation= prevention
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Disaster Prevention/Mitigation
Increased surveillance
Improved inspections at airports and other points of entry
Strengthening immunizations, isolation & quarantine
Strengthening flood barriers
Teaching methods of preventing communicable disease transmission
Assessment of the community’s threats, vulnerabilities, strengths
Levels of Prevention and Disasters: Potential Roles for CPH Nurses
Level 1
1
Education in homes, work and schools
Serving on teams to develop disaster plans
Working with vulnerable populations (ex., “shelter-in-place”)
Participate in disaster training, including disaster drills
Immunizations
Level 2
2
Work on immediate response teams
Level 3
3
Work on teams to limit damage and disability (ex., mental health services)
Roles of Community Health Nurses Risk Assessment
Populations at risk
History of prior disasters and responses
What is the community disaster plan?
What is the community warning system?
What response teams are already in place?
What other resources are already in place?
What type of evacuation measures will be needed?
What type of environmental dangers can be involved?
Disaster Preparedness: Development of a Community Emergency Plan
Occurs at the national, state, and local levels
Individuals, families and professionals should be prepared
Preparations should be based on thorough assessment
A communication protocol is imperative to reach:
Red Cross
State and federal governmental agencies
Federal Emergency Management Agency (FEMA)
CDC
US Department of Homeland Security
Office of Emergency Management
Disaster drills are needed to rehearse responsiveness
https://www.youtube.com/watch?v=wTWOgBTuOoE (2 mins)
Disaster Preparedness: Family Emergency Plan
Personal Disaster Preparedness
Prep for individuals and families should include:
Action plan
Communication alternatives/options
Evacuation routes
Local and remote meeting places
Disaster kit or “go bag”
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Roles of Community Health Nurses: Disaster Planning
Develop a plan based on the most likely disaster
Identify communication options: warning system, communication center, chain of command
Identify first responders plan
List agencies that are available (local, state, federal)
Define nursing roles in first-, second- and third-level triage
Locate necessary supplies
Check equipment function
Disaster Response
Activate Disaster Plan
Immediate need for organization and management at the scene
Incident Command Center (ICS)
Activate NIMS
Based on initial and follow-up assessments of:
How many people are affected?
How many people are injured or dead?
How much fresh water and food is available?
What are the areas of risk, including sanitation problems?
Mobilization is multidisciplinary, starting w/ law enforcement, fire and ambulance services.
Must restore communication and transportation early
TRIAGE
Communicate with potential responding agencies
Disaster Response
Classified according to type, level and scope. If federal emergency is declared, National Response Framework (NRF) is activated.
Federal level agencies involved:
Fed. Emergency Management Agency (FEMA)
CDC
U.S. Department of Homeland Security
American Red Cross (ARC)
Office of Emergency Management
Public Health System
FEMA
“FEMA’s mission is to support our citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards.” The Federal Emergency Management Agency.
Response: Incident Command System
National Incident Management System (NIMS) - Federal Level
Provides framework for local incident command structure
The Incident Command System (ICS) is a standardized approach to the command, control, and coordination of emergency response providing a common hierarchy within which responders from multiple agencies can be effective.
Nurses’ Duty to Respond to a Disaster
Are we ethically and legally bound to respond?
Class Activity: Read, Think Pair, Share
Mass Casualty Responses & Triage
Community trained pros triage @ ~ 6 min in
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Simple triage and rapid treatment (START) is a triage method used by first responders to quickly classify victims during a mass casualty incident (MCI) based on the severity of their injury.
Stop, look, listen, think
Voice triage for walking wounded
Immediate care: difficulty breathing, bleeding, shock
START Triage Model
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START Field/ Pre-Hospital Triage Model
Triage based on
Ambulation
Respirations
Circulation
Mental status
Tags
Green—Minor injury(ies)
Yellow—Delayed (walking wounded; ill but stable)
Red—Immediate (unstable based on signs of shock)
Black--Deceased
Other Triage Tags
Immediate Care
Open airway—head tilt, chin lift
Control bleeding—pressure, elevation
Treat for shock
Re-establish blood volume
Give oxygen
Protect from complications
Disaster Recovery
Stabilization and Rebuilding phase
Lasts until the economic and civil life of the community are restored
At an individual level, it’s the time it takes to become functional again in the community
Communicable disease threats are controlled through sanitation, etc.
PTSD and other stress-related disorders are common
Phases of Emotional Reactions During Recovery:
Heroic-excitement and concern for survival
Honeymoon-affected people bond and relive experiences
Disillusionment-depression and disillusionment
Reconstruction-adjustment to a new reality; rebuilding of the area; hope.
Roles of Community Health Nurses: Disaster Recovery
Re-assess population needs
Make home visits
Provide and coordinate care in shelters
Provide stress counseling and assess for PTSD
Make referrals prn
Evaluate disaster responses
Make surveillance reports
Evaluation of Disaster Response
Evaluate area, effect and level of disaster
Create ongoing assessments and surveillance reports
Evaluate efficiency of response teams
Estimate the length of time for recovery
Bahamas: Hurricane Dorian Recovery
https://www.supplychaindive.com/news/navigating-logistics-recovery-hurricane-dorian/563224/
Main Causes of Disaster
Tornadoes https://www.ready.gov/tornadoes
Floods https://www.ready.gov/floods
Fires https://www.ready.gov/home-fires
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Are YOU Prepared?
These slides were created as a collaborative effort between members of the Community Health team at Resurrection University 9/2019
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