Chapter 29 Natural and Manmade Disasters

Question 1

U.S. Department of Homeland Security (DHS) established in March 2003 by President George W. Bush - put into place NIMS; have levels on what at
National Incident Management System (NIMS) established the following year (2004)
Local Citizens Corp Councils have been established to give volunteers an opportunity to support local fire, law enforcement, emergency medical services, and community public health efforts - certain amounts of training; vary depending on disaster/city
Efforts to prepare for disaster have been enhanced at the state level - start recruit to volunteer to be called up to respond to disasters; need tell fams and employers - take priority at employer

Answer 1

National incident management system (NIMS)

Question 2

Provides a systematic, proactive way for all levels of governmental and nongovernmental agencies to work together to respond to disasters; prevent, protect against, respond to, recover from, and prevent the effects of disasters

Answer 2

National Incident Management System (NIMS) established the following year (2004)

Question 3

A disaster is any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources
A multiple casualty event is one more than 2 but fewer than 100 individuals are involved
A mass casualty event is one in which 100 or more individuals are involved - not dead; many levels of people affected; direct person, families, work in area, HCP
Casualties can be classified as:

Answer 3

Disaster definitions

Question 4

Does not have to result in death; injury, economic/infrastructure damage
Immediate community overwhelmed and not have resources to respond
Community responding - fams, those around - help neighbors
Emergencies differ from disasters, in that agencies, communities, families, or individuals can manage emergencies using their own resources
A disaster level event may be beyond the ability of the community to respond and recover from the incident using its own resources; situations may require assistance from outside the immediate community, both for management of resulting issues and for recovery

Answer 4

A disaster is any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources

Question 5

Direct victim (immediately affected; happened to), indirect victim (friend, fam member of victim or first responder; not involved but is their fam member), displaced person (house taken now move), refugee (usually moving across borders - commonly country borders)

Answer 5

Casualties can be classified as:

Question 6

Natural disasters - weather/earth related; tend handle better; not under control
Manmade disasters
Disasters are identified as natural, manmade, or a combination of both
Terrorism
Weapon of mass destruction

Answer 6

Types of disasters

Question 7

Avalanches
Blizzards
Communicable disease epidemics
Droughts, wildfires
Earthquakes, tsunamis
Hailstorms
Heat waves
Hurricanes
Tornadoes, cyclones
Volcanic eruptions

Answer 7

Natural disasters - weather/earth related; tend handle better; not under control - Types of disasters

Question 8

Terrorism
Civil unrest (riots)
Explosions, bombings
Fires
Structural collapse (bridges)
Floods, mudslides - determine infrastructure; then by default more likely; need ways to mitigate damage
Toxic or hazardous spills
Mass transit accidents
Pollution
Wars
Fires

Answer 8

Manmade disasters - Types of disasters

Question 9

Any weapon that is designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals, or their precursors - gases
Any weapon involving a disease organism (biological agents)
Any weapon that is designed to release radiation or radioactivity at a level dangerous to human life (chemical agents)
Dangerous to human life

Answer 9

Weapon of mass destruction - Types of disasters

Question 10

Frequency
Predictability
Preventability/mitigation
Imminence
Scope and number of casualties
Intensity

Answer 10

Characteristics used to describe/of disasters

Question 11

how often a disaster likely to occur/occurs

Answer 11

Frequency

Question 12

refers to the ability to determine when and whether a disaster event will occur; approx what going to happen

Answer 12

Predictability

Question 13

refers to actions taken to reduce loss of life and property by lessening the impact of disasters (taking action now before the next disaster)

Answer 13

Preventability/mitigation

Question 14

the speed of onset of an impending and relates to the extent of forewarning possible and the anticipated duration of the incident - how much forewarning possible

Answer 14

Imminence

Question 15

geographic area involved (small town/large city) and the number of individuals affected, injured, or killed

Answer 15

Scope and number of casualties

Question 16

characteristic describing the level of destruction and devastation of the disaster event

Answer 16

Intensity

Question 17

Primary prevention
Secondary prevention
Tertiary prevention

Answer 17

Levels of prevention

Question 18

Aimed at preventing the occurrence of a disaster or limiting the consequences when the event itself cannot be prevented (mitigation)
prevent/prepare before they happen
Need plan ahead of time; cannot prevent something but mitigate damage
Nondisaster stage: period before a disaster occurs (disaster management begins before a disaster occurs); preventative actions include: before thinking disaster is imminent - all what ifs before an isse
Predisaster stage: time when a disaster is imminent; preventative actions include:

Answer 18

Primary prevention

Question 19

Assessing communities to determine potential disaster hazards - resources, where go, buildings withstand damage
Developing disaster plans at local, state, and federal levels
Conducting drills to test the plan
Training volunteers and health care providers - know what do; done frequently
Providing educational programs of all kinds to gen community - found and plan - how respond
Risk maps and resource maps are developed to aid in planning

Answer 19

Nondisaster stage: period before a disaster occurs (disaster management begins before a disaster occurs); preventative actions include: before thinking disaster is imminent - all what ifs before an isse- Primary prevention

Question 20

Know disaster coming
Notifying the appropriate officials - start plan for aftermath
Warning the population - tell plan and evac route - when leave by; consequences of staying
Advising what response to take (voluntary or mandatory evacuation - officials decided EMS not responding if calls for help because HCP at risk)

Answer 20

Predisaster stage: time when a disaster is imminent; preventative actions include: - Primary prevention

Question 21

Post disaster
Implemented once the disaster occurs
Actions Aimed at preventing further injury or destruction - moving away to safer spot
“Safety before search and rescue” - first priority is your safety; not safe do not go in - limited resources and people do not create situation where hard to respond

Answer 21

Secondary prevention

Question 22

Post disaster
Focuses on recovery and restoring the community to previous levels of functioning and its residents to their maximum functioning
Revise plan; what need consider from now on
Aimed at preventing a recurrence or minimizing the effects of future disasters through debriefing meetings to identify problems with the plan and making revisions

Answer 22

Tertiary prevention

Question 23

Requires an interdisciplinary, collaborative team effort and involves a network of agencies and individuals to develop a disaster plan to respond - variety people responding
Key: network people who can respond, get together ahead of time for planning so know role
Developing an effective disaster plan

Answer 23

Disaster management

Question 24

Communities can respond more quickly, more effectively, and with less confusion if the efforts needed in the event of a disaster have been anticipated, and plans for meeting them identified
Ensures that resources are available
Delineates roles and responsibilities of all personnel and agencies, both official and unofficial
More lives saved and less injuries

Answer 24

Developing an effective disaster plan - Disaster management

Question 25

Prevention Stage
Preparedness and Planning Stage
Response Stage
Recovery Stage

Answer 25

Disaster management stages

Question 26

occurs before a disaster is imminent; also known as nondisaster stage; know disaster coming and plan for those

Answer 26

Prevention Stage - Disaster management stages

Question 27

continuous process, the plan changes with circumstances or when gaps are identified during drills or from actual disaster incidents; more likely to occur; what areas going to occur

Answer 27

Preparedness and Planning Stage - Disaster management stages

Question 28

begins immediately after the disaster incident occurs; includes shelter in place, evacuation, search and rescue, staging area (start making an on-site incident command station), and disaster triage; often first neighbor helping neighbor; not all go there; figure out resources and need consider victims; command station assigns according to credential; always start command then told where to go

Answer 28

Response Stage - Disaster management stages

Question 29

begins when the danger from the disaster has passed and all local, state, and federal agencies are present in the area to help victims rebuild their lives and the community restore public services; afterward; need money to pay people

Answer 29

Recovery Stage - Disaster management stages

Question 30

Triage
START triage system – means “simple triage and rapid treatment”
4 Classifications

Answer 30

Disaster triage

Question 31

identifying and separating individuals into diff grps quickly according to injury severity and treatment needed; disaster triage focuses on sorting the greatest number of people as fast as possible; focus: “do the greatest good, for the greatest number, in the shortest time”; what resources needed: resources like care, meds, transfusions

Answer 31

Triage - Disaster triage

Question 32

Stablilizing enough to where can transport them
Used in multicasualty or mass casualty incident
Triage of injured person should occur in less than 1 minute based on respirations, perfusion, and mental status - ABCs; bleeding - obvious/internal; respirations - breathing/not, and type; circ - color, temp, cap refill
Describes how to use people with minor injuries to help
Status made: Person is tagged with a colored triage tag
Following triage, victims are moved to the treatment area
Consider whole pic with tags

Answer 32

START triage system – means “simple triage and rapid treatment” - Disaster triage

Question 33

Green = MINOR - walking wounded; minor injuries; status unlikely to deteriorate over days; can wait
Yellow = DELAYED - transport can be delayed; includes serious and potentially life-threatening injuries, but status not expected to deteriorate significantly over several hours; fractures - need treatment but if have wait not hurt more than now
Red = IMMEDIATE – can be helped by immediate intervention and transport; requires medical attention within minutes for survival (up to 60); includes compromises to patient’s airway, breathing, circulation; highest priority people; can make it and will if transport them right now to hospital
Black = EXPECTANT – victim unlikely to survive given severity of injuries, level of available care, or both
Respirations, circ, bleeding and where from
Hazmat tag = contaminated - radiation

Answer 33

4 Classifications - Disaster triage

Question 34

Four keys to gauging mental health impact: - any 2 cause lasting effect
In addition, panic during the disaster, horror, separation from family, and relocation or displacement may play a part

Answer 34

Psychological triage

Question 35

Extreme and widespread property damage - in survival mode only
Serious and ongoing financial problems - whole lives wiped out
High prevalence of trauma in the form of injuries, threat to life, and loss of life
Worse When human intent caused the disaster - sig damage psychologically

Answer 35

Four keys to gauging mental health impact: - any 2 cause lasting effect - Psychological triage

Question 36

Local government (first responders: incident management) – responsible for the safety and welfare of its citizens; foreseeing, preparing, and responding as best can; when resources gone call in state and once those gone use fed; if likelihood huge event can preemptively declare state of emergency call on fed govt; if call after the fact, harder get money
State government (Office of Emergency Management) – involved when a disaster overwhelms the local community’s resources
Federal government (Department of Homeland Security - DHS) – a single department focusing on protecting the American people and their homeland

Answer 36

Governmental responsibilities

Question 37

Federal Emergency Management Agency (FEMA) is part of DHS - mission is to support citizens and first responders to ensure that, as a nation, everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards; main entity FEMA - support first responders and citizens to prepare, protect, recover
Centers for Disease Control and Prevention (CDC) – after survivors have been rescued, conducts surveillance to ensure that clean drinking water, food, shelter, and medical care are available for those affected - whether CDC’s involvement is necessary depends on the type of disaster

Answer 37

Federal government (Department of Homeland Security - DHS) – a single department focusing on protecting the American people and their homeland - Governmental responsibilities

Question 38

Broad term used to describe all of the governmental and nongovernmental organizations and agencies that contribute to the improvement of the health of populations
Primary agencies for the health and medical responses to disaster incidents and are part of the initial response activities

Answer 38

Public Health System - Other partnerships in disasters

Question 39

Seen responding all time
Not a governmental agency but is chartered by Congress to provide disaster relief
Receives federal money and voluntary contributions
Works in partnership with other agencies - FEMA, DHS, the CDC, and other local, state, and federal agencies to provide and manage needed services; disaster plans, where take, funds/resources, then distribute appropriately
Primarily a volunteer organization with chapters in all 50 states, but has some paid staff - lots diff areas; reg full-time staff salary paid - communicating frequently to know protocols nationwide/state
Efforts focus on meeting the immediate disaster-related needs of affected people and providing support services to the emergency rescue and recovery workers
Disaster response functions are to provide health services, mental health services, family services, and mass care (involves feeding, sheltering, providing basic first aid, bulk distribution, and a Disaster Welfare Information system) and to inquire about family well-being

Answer 39

American Red Cross (ARC or Red Cross) - Other partnerships in disasters

Question 40

Heroic Phase –
Honeymoon Phase –
Disillusionment Phase –
Reconstruction Phase –

Answer 40

Classic 4 phases: Community responses to a disaster

Question 41

everyone feels the need to rush to help people survive the disaster
Went through all of it together

Answer 41

Heroic Phase - Classic 4 phases: Community responses to a disaster

Question 42

individuals who have survived the disaster gather together with others who have simultaneously experienced the same event
Tell stories, supporting each other and sharing stories, and review what occurred
If responses not going well, vent together to figure out resources necessary to get what needed
Bonds formed and gratitude expressed for being alive

Answer 42

Honeymoon Phase - Classic 4 phases: Community responses to a disaster

Question 43

when time has elapsed and a delay in receiving help or failure to receive the promised aid has not occurred, feelings of despair arise - first responders; realize not way ever be again; not given what should have been given; as in pub feel forgotten
Happens every time

Answer 43

Disillusionment Phase - Classic 4 phases: Community responses to a disaster

Question 44

once the community has restored some of the buildings, homes, and services, and some sense of normality is returning, feelings of despair subside; people begin to look to the future
Start to Rebuild and some sense of normality; figure out how make it better later

Answer 44

Reconstruction Phase - Classic 4 phases: Community responses to a disaster

Question 45

Be involved in all stages of prevention and related activities to respond effectively
Need to know
Prepared to Educate others about disasters and how to prepare for and respond to them; see what missing and needed
Think ahead of time of personal plan of disaster; if expected to respond work out ahead of time - not request: cannot be effective if worried; figure out what do and how get care and that plan put in place - not figure out on fly; do not rely on phone lines
Keep up to date on latest recommendations and advances in life-saving measures

Answer 45

Nurses should…

Question 46

What kind of disasters threaten their communities; communities: natural disasters most common in that area
What injuries to likely expect from different disaster scenarios - what probably dealing with in hospitals/disaster sites
Evacuation routes - for selves and direct other people
Locations of shelters
Warning systems in place

Answer 46

Need to know - Nurses should…