Chapter 29 Natural and Manmade Disasters Flashcards by Kelsey Klipfel

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

National incident management system (NIMS)

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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

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

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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:

Disaster definitions

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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

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

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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)

Casualties can be classified as:

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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

Types of disasters

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

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

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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

Manmade disasters - Types of disasters

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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

Weapon of mass destruction - Types of disasters

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

Characteristics used to describe/of disasters

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how often a disaster likely to occur/occurs

Frequency

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

Predictability

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

Preventability/mitigation

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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

Imminence

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

Scope and number of casualties

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

Intensity

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Primary prevention
Secondary prevention
Tertiary prevention

Levels of prevention

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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:

Primary prevention

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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

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

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)

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

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

Secondary prevention

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

Tertiary prevention

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

Disaster management

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

Developing an effective disaster plan - Disaster management

Prevention Stage Preparedness and Planning Stage Response Stage Recovery Stage

Disaster management stages

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

Prevention Stage - Disaster management stages

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

Preparedness and Planning Stage - Disaster management stages

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

Response Stage - Disaster management stages

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

Recovery Stage - Disaster management stages

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

Disaster triage

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

Triage - Disaster triage

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

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

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

4 Classifications - Disaster triage

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

Psychological triage

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

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

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

Governmental responsibilities

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

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

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

Public Health System - Other partnerships in disasters

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

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

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

Classic 4 phases: Community responses to a disaster

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

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

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

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

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

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

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

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

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

Nurses should…

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

Need to know - Nurses should…