Introduction to Disaster Nursing Flashcards
Any community emergency that seriously affects people’s lives and property and exceeds the capacity of the community to respond effectively to the emergency
DISASTER
● A serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources
DISASTER
NDRRMC
National Disaster Risk Reduction and Management Council
● “Nurses, as the largest group of committed health personnel, often working in difficult situations with limited resources, play vital roles when disasters strike, serving (4)
first responders, triage officers, and care providers, coordinators of care and services, providers of information and counselors
Unforeseen or sudden occurrence, especially danger, demanding immediate action
Emergency
A dangerous phenomenon, substance, human activity or condition that may cause loss of life, Injury or other health impacts, property damage etc
Hazard
Epidemic limited to localized increase in the incidence of disease
Outbreak
Combination of probability of an event and its negative consequences
Risk
Refers to electricity, energy, water, sanitation, health and education
Basic Services
Combination of all the strengths and resources available within a community that can reduce the level of risk of a disaster (physical, institutional, social or economic means)
Capacity
Persons or groups of persons who have been forced or obliged to flee or leave their homes or places of habitual residence due to effects or consequences of disaster
Internally Displaced Population (IPD)
TYPES OF DISASTERS
Small Scale
Medium Scale
Large Scale
Disasters that have impacts limited to relatively small local areas
Small Scale
Disasters that are smaller than national geographic scales. Defined by a threshold of impacts causing reaction from multiple administrative regional authorities
Medium Scale
Disasters that require emergency response at a national or higher scale. Impacts cross administrative boundaries including international borders
Large Scale
bring back basic services like water and sanitation
Metropolitan Waterworks and Sewerage System
whole environment the whole disaster is going in = manmade also
Department of Environment and Natural Resources
rehabilitation and recovery
Department of Science and Technology
ITDS, evacuees
Department of Social Welfare and Development
NEDA
National Economic and Development Authority
PNP
Philippine National Police
ICN COMPETENCIES
Preparation and planning Communication Incident management systems Safety and Security Assessment Intervention Recovery Law and Ethics
actions taken apart from any specific emergency to increase readiness and confidence in actions to be taken during an event
1 Preparation and planning
approaches to conveying essential information within one’s place of work or emergency assignment and documenting decisions made
2 Communication
the structure of disaster/emergency response required by countries/organizations/institutions and actions to make them effective
3 Incident management systems
assuring that nurses, their colleagues and patients do not add to the burden of response by unsafe practices
4 Safety and Security
gathering RELEVANT data about assigned patients/families/communities on which to base subsequent nursing actions
5 Assessment
clinical or other actions taken in response to assessment of patients/families/communities within the incident management of the disaster event
6 Intervention
any steps taken to facilitate resumption of pre-event individual/family/community/ organization functioning or moving it to a higher level
7 Recovery
the legal and ethical framework for disaster/emergency nursing
8 Law and Ethics
Level I:
any nurse who has completed a programme of basic, generalised nursing education and is authorised to practice by the regulatory agency of his/her country.
GENERAL PROFESSIONAL NURSE
Examples of Level I
staff nurses in hospitals, clinics, public health centres; all nurse educators.
Level II:
any nurse who has achieved the Level I competencies and is or aspires to be a designated disaster responder within an institution, organisation or system.
ADVANCED OR SPECIALIZED NURSE
Examples of Level II
supervising or head nurses; nurses designated for leadership within an organization’s emergency plan; nurses representing the profession on an institution or agency emergency planning committee, preparedness/ response nurse educators.
Level I Preparation and Planning
- preparedness plan
- drills/exercises
- up-to-date knowledge
- describe approaches to accommodate vulnerable population
Level II Preparation and Planning
- drills/exercises at least annually
- nursing improvement actions
- roles and responsibilities
- actions to vulnerable
- Level I
Level I Communication
- disaster terminology correctly
- priority information
- communication skills
- multilingual resources
- documentation
Level II Communication
- communication systems
- communication expectations
- leadership teams
- critical documentation
Level I Incident Management
- national structure
- specific disaster plan
- observations and experiences post event eval
- professional practice
Level II Incident Management
- organisational incident plan
- participates in post-event evaluation
- improvement in nursing practice based on event assessment
- emergency planning guidance
Level I Safety and Security
- maintain safety
- basic infection control
- regular assessment
- PPE
- reports possible risk
Level II Safety and Security
- materials supporting nursing decision making
- timely alternative infection control
- access to medical and mental health treatment
- explains PPE
- eliminate risk
Level I - Assessment
I.5.I Reports symptoms or events
I.5.2. Performs rapid physical and mental health assessment
I.5.3. Maintains ongoing assessment
Level II- Assessment
II.5.1 up-to-date information on potential emergency events and the process for reporting them
II.5.2 Develops event-specific guidance on rapid physical and mental health assessment
II.5.3. Includes principles of disaster/emergency triage
II.5.4. Identifies event-specific vulnerable population (s) and actions needed to protect them
Level I - Intervention
I.6.1. basic first aid
I.6.2. Isolates individuals/families/clusters
I.6.3. contamination assessment or decontamination of individuals
I.6.4. Engages patients, their family members or assigned volunteers, within their abilities
I.6.5. priority needs and available resources
I.6.6 surge capacity activities as assigned (e.g. mass immunization)
I.6.7 management of large numbers of deceased in respectful manner
Level II - Intervention
II.6.1. emergency plans and institutional policy include the expectation that basic first aid
II.6.2. organizationally specific guidance on implementation of isolation
II.6.3. range of CBRNE exposures and the exposure-related decontamination methods
II.6.4. expanded patient, patient’s family or volunteer participation
II.6.5. nursing reassignments
II.6.6 Guides nursing participation in surge activities
Level I - Recovery
I.7.1 maintain or resume functioning during and post event
I.7.2 assists assigned patients/families/communities
I.7.3 referrals for ongoing physical and mental health needs
I.7.4. transition de-briefing
Level II - Recovery
II.7.1 nursing roles, responsibilities and needs to leadership
II.7.2 up-to-date referral resource lists
Level I - Law and Ethics
I.8.1. emergency-specific laws, policies and procedures
I.8.2 institutional or national disaster ethical framework
I.8.3. utilitarian principles
Level II - Law and Ethics
II.8.1. development of emergency-specific policy and procedure guidance
II.8.2 development of disaster/emergency frameworks for allocation of resources
II.8.3. develops guidance and support for nurses expected to apply utilitarian principles
ISDR
International Strategy to Disaster Reduction
• Result of an ecological disruption or threat that exceeds the adjustment capacity of the affected community
NATURAL DISASTERS
• Direct and adverse effect of major industrial accidents, unplanned release of nuclear energy, fires or explosions from hazardous materials
TECHNOLOGICAL DISASTERS
cause disruption of normal hospital function due to injuries or deaths of hospital personnel or damage to the facility itself, as with a hospital fire, power failure, or chemical spill
• Internal disasters
those that do not affect the hospital infrastructure but tax hospital resources due to numbers of patients or types of injuries
• External disasters
an intense low pressure system which is characterized by strong spiral winds towards the center, called the “Eye”
CYCLONES
● In a counter-clockwise flow in the
northern hemisphere.
maximum winds from 35 kph to 63 kph
○ Tropical Depression
maximum winds from 64 kph to 118 kph
○ Tropical Storm
maximum winds exceeding 118 kph.
○ Typhoons
● Large, powerful and violent tropical cyclone.
● It is a low pressure area rotating counterclockwise and containing rising warm air that forms over warm water in the Western Pacific Ocean.
TYPHOONS
Atlantic Ocean
○ Hurricane
Indian Ocean
○ Cyclone
● Described as a violently rotating column of air extending from a thunderstorm to the ground.
TORNADO
develop from severe thunderstorms in warm, unstable air along and ahead of cold fronts.
● Tornadoes
● 69% of all tornadoes
● less than 5% of tornado deaths
● lifetime 1-10+ minutes
● winds less than 110 mph
Weak Tornadoes
● 29% of all tornadoes
● nearly 30% of all tornado deaths
● may last 20 minutes
● winds 110-205 mph
Strong Tornadoes
● only 2% of all tornadoes
● 70% of all tornado deaths
● lifetime can exceed 1 hour
● winds greater than 205 mph
Violent Tornadoes
in Asian countries is rare. These destructive forces are found most frequently in the United States.
tornadoes
● A weather condition that produces lightning and thunder heavy rainfall from cumulonimbus cloud and possibly a tornado
THUNDERSTORMS
Occur most frequently in the _ (some localities have as many as 200 a year) and seldom in the polar regions.
equatorial zone
● Referred as inundation of land areas which are not normally covered by water.
FLOOD
● A massive outward and downward movement of slope-forming materials.
LANDSLIDES
direct impact of global warming
● Climate change
cause changes to weather patterns
● Climate change
● A quasiperiodic climate pattern that occurs across the tropical Pacific Ocean roughly every five years.
EL NINO/ LA NINA SOUTHERN OSCILLATION (ENSO)
● A prolonged period of excessively hot and sometimes also humid weather relative to the normal climate pattern of a certain region.
● In extreme heat and high humidity, evaporation is slowed and the body must work extra hard to maintain a normal temperature.
HEAT WAVES
● An event involving shaking of the ground caused by sudden slippage of rock masses below or at the surface of the earth
● It is a wave like movement of the earth’s surface
EARTHQUAKE
Measures energy waves emitted by earthquake
THE RICHTER SCALE
can be detected only by seismograph
- 0-1.9
hanging objects may swing
- 2-2.9 -
comparable to the vibrations of a passing truck
- 3-3.9 -
may break windows, cause small or unstable objects to fall
- 4-4.9
furniture moves, chunks of plaster may falls from walls
- 5-5.9
damage to well-built structures, severe damage to poorly built ones
- 6-6.9
buildings displaced from foundational; cracks in the earth; underground pipes broken
- 7-7.9
bridges destroyed, few structures left standing
- 8-8.9
near-total destruction, waves moving through the earth visible with naked eye
- 9 and over
Measures the strength of shaking produced by the earthquake at a certain location. Determined from effects on people, human structures and the natural environment.
INTENSITY
Is a seismic scale used for measuring the intensity of an earthquake
MERCALLI INTENSITY SCALE
imperceptible to people
- Intensity 0
imperceptible to people
- Intensity 0
some people in the building feel it
- Intensity 1
many people in the building feel it, some people awaken, if the quake strikes at night
- Intensity 2
- felt by most people in the building, some people are frightened
- Intensity 3
many people are frightened, some people try to escape from danger. Most people awaken, if the quake strikes at night
- Intensity 4 -
most people try to escape from danger, some people find it difficult to move
- Intensity 5 lower
many people are very frightened and find it difficult to move
- Intensity 5 upper
difficulty to keep standing
- Intensity 6 lower
impossible to keep standing and to move without crawling
- Intensity 6 upper -
- thrown around by the shaking, impossible to move as well.
- Intensity 7
● Referred to as giant sea waves generated by earthquakes and volcanic eruptions under the seabed
● Tsunamis can only occur when the earthquake is strong enough (M7.0+) to displace the seabed, creating pressures in the water above it.
● The large waves of a tsunami are preceded by initial lowering of the water level ven beyond the lowest tidal levels and sometimes being falsely called “tidal waves”
● Tsunamis generated in distant locations will generally give people enough time to move to higher ground
● For locally-generated tsunamis, where you might feel the ground shake, you may only have a few minutes to move to higher ground
TSUNAMI
● Volcanic eruption is a process wherein volcanic materials such as molten or hot fragmented rocks or gaseous materials are ejected from a volcano.
VOLCANIC ERUPTION
● Hazards from volcanoes may be of different nature. These hazards includes
○ Fast-moving lava
○ Volcanic ash
○ Volcanic bombs
○ Lahar
Top 10 provinces at risk to Volcanic Eruptions are:
- Camiguin
- Sulu
- Biliran
- Albay
- Bataan
- Sorsogon
- South Cotabato
- Laguna
- Camarines Sur
- Batanes
- Suffering and devastation caused by war, civil strife, and other political conflicts.
- TERRORISM (political unrest) AND WARFARE
COMPLEX EMERGENCIES
- Results of combination of forces like famine, drought, epidemics, and political unrest
- TRANSITIONAL HUMAN SHELTERS
DISASTERS THAT OCCUR IN HUMAN SETTLEMENTS
4 PRIORITIES FOR ACTION TO PREVENT NEW AND REDUCE EXISTING DISASTER RISKS:
(i) Understanding disaster risk;
(ii) Strengthening disaster risk governance to manage disaster risk;
(iii) Investing in disaster reduction for resilience and;
(iv) Enhancing disaster preparedness for effective response, and to “Build Back Better” in recovery, rehabilitation and reconstruction.
To enable communities to become resilient to disasters saving lives as well as social, economic and environmental assets
INTERNATIONAL STRATEGY FOR DISASTER REDUCTION:
● Long term Goal:
● Government is requested to establish or strengthen national platforms or focal points for disaster reduction with a multisectoral and interdisciplinary approach with the support of two international mechanism
- Inter Agency Secretariat, Geneva Switzerland
- Inter Agency Task Force on Disaster Reduction, that represents 25 agencies and organizations from UN, regional bodies and civil society.
● A comprehensive, action -oriented response to international concern about the growing impacts of disasters on individuals, communities and national development
HYOGO FRAMEWORK
● A comprehensive, action -oriented response to international concern about the growing impacts of disasters on individuals, communities and national development
HYOGO FRAMEWORK
● Provides guide on the timeline of a disaster
DISASTER CONTINUUM
● Also known as Emergency management cycle
● Cyclical process
● Composed of phases, often taking place concurrently, indicative of specific actions, along with the nature and scope of the plan.
● Aims to reduce the negative impact or consequences of adverse events
DISASTER PLANNING
● All actions taken before a disaster to reduce its impacts, including preparedness and long-term risk reduction measures.
PHASE 1: MITIGATION AND PREVENTION
■ Activities or Projects which aims to reduce economic and societal impacts
○ Structural Mitigation
■ policies and practices which raise awareness of hazards or encourage developments to reduce the impact of disasters
○ Non-Structural Mitigation
■ Utilizes the results of the hazard identification and vulnerability analysis.
■ Determines the probability of a specified outcome from a given hazard that affects a community with known vulnerabilities.
○ Risk Assessment
a function of the hazards to which a community is exposed and the vulnerabilities of that community. However, that risk is modified by the level of the local preparedness of the community at risk.
■ Risk
■ Risk Assessment Benefits
● Prevention or removal of hazards
● Removal of at-risk populations from hazards
● Provision of public information and education
● Establishment of early warning systems
● Reduction of risk posed by some hazards
● Enhancement of a local community’s capacity to respond during disasters
● Hazard = Potential danger or disaster
■ Industrial chemicals
■ Transportation elements
■ Collections of people in areas with limited access
■ Environmental and meteorological hazards
■ Explosions and terrorism
(4 Ways) Methods by which planners identify which events are most likely to affect a community:
■ Understand the nature of the threat
■ Identify variations of threats in between locations
■ Frequency of occurrence of events/threats
■ Identify possible risk factors
○ Vulnerability - Is the extent to which a community’s structure, services or environment is likely to be damaged or disrupted by the impact of a hazard.
○ Vulnerability -
● People - lives, health, security, living conditions
● Property - services, physical property loss, loss of use
● Economy - loss of products and production, income
● Environment - water, soil, air, vegetation, wildlife
Tangible/Material (easy to see; value easily determined)
● Social structures - family and community relationships
● Cultural practices - religious and agricultural
● Cohesion - disruption of normal life
● Motivation- will to recover; government response
Intangible/Abstract (difficult to see; value difficult to determine
○ Methods used to determine:
■ Who is most likely to be affected.
■ What property is most likely to be damaged or destroyed.
■ What is the capability of the community to deal with the effects of the disaster
● Plant crops that are resistant to locations prone to calamities
Adjusting normal development programs to reduce losses
● Introduce other economic activities that are less vulnerable when the primary source of income is threatened
Economic diversification
● Match the type of economic enterprise to the placement location considering the presence of hazards.
Developing disaster resistant economic activities
● A continuous and integrated process
● Involves a wide range of activities and resources taken before the onset of a disaster from multi-sectoral sources.
● Enables successful discharge of emergency management programs, by which disaster relief is coordinated and mobilized from governmental and nongovernmental organizations to helpless victims of a disaster.
Disaster Preparedness
Disaster Preparedness Goals:
● To achieve a satisfactory level of readiness to respond to any emergency situation.
● Develop programs that will strengthen the technical and managerial capacity of governments, organizations, and communities.
● Build response mechanisms and procedures, rehearsals, developing long-term and short-term strategies, public education and building early warning systems.
Disaster Preparedness Measures:
● Preparedness plans ● Emergency exercises/training ● Warning systems ● Emergency communications systems ● Evacuations plans and training ● Resource inventories ● Emergency personnel/contact lists ● Mutual aid agreements ● Public information/education
● Physical measures to reduce the vulnerability and exposure of infrastructure to natural hazards as well and to provide coping and adaptive infrastructure in case of a disaster event (IFRCRCS, 2005).
● Forms the pillar of disaster preparedness
Disaster Risk Reduction (DRR)
Disaster Risk Reduction Recommendations:
● Policy, planning and capacity building in disaster management
● Physical prevention; example, building sea-walls against storm surge or flood shelters during flood events.
● Capacity building at institutional and systemic level in disaster preparedness.
● Act of putting preparedness plans into action
● Measures taken to save lives and prevent further damage in a disaster or emergency situation.
PHASE 3: RESPONSE
Disaster Response
Re-establish self-sufficiency and essential services as quickly as possible, with special attention to those whose needs are greatest: the most vulnerable and underprivileged
Provide immediate assistance
Ensure the survival of the maximum possible number of victims, keeping them in the best possible health in the circumstances
Maintain life
In situations of civil or international conflict, ensure protection and assistance the civilian population
Support morale
Provide adequate supply of basic needs. Ensure reduction of health-related threats in relocation sites
Improve health
■ Refers to information concerning the nature of the danger and imminent disaster threats.
■ Action: rapidly disseminate warnings to government officials, institutions and the population at large in the areas at immediate risk (national to barangay)
- Warning
■ Involves the relocation of a population from zones at risk of an imminent disaster to a safer location.
■ Primary concern: protection of life, immediate treatment of injuries.
- Evacuation and Migration
■ the process of identifying the location of disaster victims that may be trapped or isolated and bringing them to safety and medical attention.
- Search and Rescue (SAR)
■ The primary objectives:
➢ provide a clear, concise picture of the post disaster situation
➢ to identify relief needs
➢ to develop strategies for recovery
■ It determines options for humanitarian assistance, how best to utilize existing resources, or to develop requests for further assistance.
- Post-disaster Assessment
■ Should take place immediately
■ There should be no delays.
■ Contingency plans should be constructed. (Plan A,B,C)
■ Relief - is the provision on a humanitarian basis of material aid and emergency medical care necessary to save and preserve human lives.
- Response and Relief
➢ Communication Equipments
○ Radios, telephones, Wireless devices
○ Supporting systems: satellites, transmission lines (first to destroy)
➢ Information Management System
○ Protocol of communication
○ Information dissemination and interpretation (most common complication: different interpretation)
- Communication and Information Management
■ Assess victims for existing social coping mechanism
■ Provide social services to victims with special needs to help them adjust with the trauma and disruption caused by the disaster. – rapport
■ Active Participation of Victims = Healthy Recovery
- Survivor Response and Coping
■ Not always a priority issue after a sudden onset of disasters.
■ Civil defense or police departments should ensure the protection of the human rights and safety of displaced populations or refugees.
- Security
■ Policies and procedures that set out the scope of activities required for community preparedness and response.
■ Allows the community to respond to threats and engages responders in the short-term recovery.
■ Must be flexible (adjustable in real and potential emergencies).
○ Rehabilitation
○ Reconstruction
- Emergency Operations Management
● Emergency Operations Plan (EOP)
■ Actions taken in the aftermath of disaster to.
■ Resumption of basic services.
■ Assist victims in repair of dwellings and community facilities.
■ Facilitate revival of economic activities.
- Rehabilitation
Traditional Responses To Disaster:
- Provision In-Kind
a. Far flung places like Mindanao and Sulu - Provision in Cash
a. Red Cross Flood Rescue Donation
c. ABS-CBN Foundation Inc. - Local Partnership
- Civil Services
a. Government
- Reconstruction
● Actions taken to return the community to normal following a disaster- NEW NORMAL
● There is no distinct point at which immediate relief changes into recovery
● Continues until all systems return to normal or better
PHASE 4: RECOVERY/ REHABILITATION
Disaster Recovery
○ Short Term - Immediate measures conducted that tend to overlap with Response. Some activities last for weeks
● Recovery Activities
○ Short term recovery (activities)
- Restores interrupted utility services
- Clear Roads
- Fix or demolish severely damaged building
- Provide food and shelter to displaced victims
- Designed to spell out major steps for managing successful recovery
- Involves designation of key partners for each steps including their roles and instruction for mobilization
● Recovery Plan
● Recovery Plan
Gathering basic information ↓ Organizing recovery ↓ Mobilizing resources for recovery ↓ Administering recovery ↓ Regulating recovery ↓ Coordinating recovery activities ↓ Evaluating recovery
● Purposes:
○ Evaluate the disaster response plan for effectiveness and completeness
○ Assess the comprehension of key personnel expected to execute the plan and their ability to perform the assigned duties.
○ Ensure availability and functionality of equipment to be called in during disaster events.
DISASTER PLAN EVALUATION
● Best method to evaluate disaster plans for effectiveness
● Staging of full scale or small segment of disaster response
Disaster Drills
● Assessment Technique
○ Table top academic exercises
○ Mock patients
○ Computer simulations
○ Seminar sessions focused on key personnel or aspects of disaster
Essentials of Effective Disaster Drill Implementation:
● Goals and objectives should be clearly communicated
● The more realistic the exercise, the more likely it is to be useful in assessing the strength and weakness of both the disaster plan and the responders.
● Include all individuals and agencies likely to be involved in a disaster response, and critique, during debriefing of the participants
Key points to Disaster Plan Evaluation
● Any modifications made to a disaster plan or response procedure must be communicated to all groups involved.
● Evaluate personnel to ensure their familiarity with their roles in disaster situations.
● Accommodate changes in population demographics, regional emergency response operations, hospital renovations, and other variables.
● At a minimum, disaster drills should take place once every 12 months in the community, and more frequently in hospitals. Twice a year.
Good Practices of Disaster Risk Reduction
- Aims to provide policies, plans, and programs to deal with disasters
- Principle guide to DRRM
- Safer, adaptive and disaster resilient Filipino communities toward sustainable development
The concepts of Thematic areas are not mutually exclusive
- They mutually reinforce each other
- They do not, should not, and cannot stand alone
- They have no clear starting and ending points
● The outcomes of the activities could be focused as a part of the whole plan
● Avoid hazards and mitigate their potential impacts by reducing vulnerabilities and exposure and enhancing capacities of communities
● Reduce vulnerabilities and exposure of communities to health hazards (monitoring, funding)
Disaster Prevention and Mitigation
Department of Science and Technology
● Establish and strengthen to anticipate, cope, recover from the negative impacts of emergency occurrences
● Increase level of awareness of the community
● Equip the community with skills to cope with the negative impacts of disaster
● Increase the capacity of a community
● Develop and implement disaster preparedness policies and plans
Disaster Preparedness
Department of Interior and Local Government
● Provide life preservation and meet the basic subsistence needs of affected population based on acceptable standards
● Decrease the number of preventable death and injuries
● Provide basic subsistence needs of the affected population
Disaster Response
Department of Social Welfare and Development
● Restore people’s means of livelihood and continuity of economic activities
● Restore shelter and other installations
● Reconstruct infrastructure and other public utilities
● Assist in the physical and psychological rehabilitation of people who suffered from the effects of disaster
Rehabilitation and Recovery
National Economic and Development Authority
