2. DISASTER
• DISASTER is “Any occurrence that
causes damage, ecological
disruption, loss of human life or
deterioration of health & health
related services on a scale sufficient
to warrant an extraordinary
response from outside the affected
community area”
3. HAZARD
• “Any phenomenon that has the
potential to cause disruption or
damage to people & their
environment”
9. ACCIDENT RELATED
DISASTERS.
Forest fires, Urban fires, Mine
flooding, Oil spills, Major
building collapse, Serial bomb
blast, Festival related disasters,
Electrical disasters & fires, Air,
road & rail accidents, Boat
capsizing, village fire, Stampede.
11. RESULTS &CONSEQUENCES
OF DISASTER
1. Affect health & well being of
people.
2. Large number of people are
affected & displaced.
3. People are killed or injured.
16. I. DISASTER IMPACT &
RESPONSE
• Greatest need for emergency
care occurs in the first few hours.
17. • The management of mass
causalities can be further divided
into search & rescue, first aid,
triage & stabilization of victims,
hospital treatment & re
distribution of patients to other
hospitals if necessary.
18. SEARCH, RESCUE & FIRST
AID
FIELD CARE.
TRIAGE.
TAGGING.
IDENTIFICATION OF THE DEAD.
21. FIELD CARE
• Most injured persons converge
to the health care facility
spontaneously, using what ever
transport is available, regardless
of the facilities, operating status.
22. • This requires health care
resources be properly re directed
to this new priority.
• Moribund patients who require a
great deal of attention, with
questionable benefit, have the
lowest priority.
23. • Bed availability & surgical
services should be maximized.
• Provisions should be made for
food & shelter.
24. • A centre should be established
to respond to enquiries from
patient’s relatives & friends.
• Priority should be given to
victim’s identification &
adequate mortuary space should
be provided.
25.
26. TRIAGE
• The principle of “first come, first
treated” is not followed in mass
emergencies.
• A system of TRIAGE is followed.
27. • Triage should be carried out at
the site of disaster in order to
determine transportation
priority & admission to the
hospital or treatment center.
28. • A system of triage is followed
when the quantity & severity of
injuries overwhelm the
operative capacity of health
facilities.
29. • Triage consists of rapidly
classifying the injured on the
basis of the severity of their
injuries & the likely hood of their
survival with prompt medical
treatment.
30. • High priority is granted to victims
whose immediate or long term
prognosis can be dramatically
affected by simple intensive care.
31. • Triage is the only approach that
can provide maximum benefit to
the greatest number of injured in
a major disaster situation.
• The most often used triage
system is the four colour code
system.
32. NEED OF THE DISASTER
TRIAGE
1. Inadequate resource to meet
immediate needs
2. Infrastructure limitations
3. Inadequate hazard preparation
34. ADVANTAGES OF TRIAGE
1.Helps to bring order and
organization to a chaotic scene.
2.It identifies and provides care to
those who are in greatest need
35. 3. Helps make the difficult
decisions easier.
4. Assure that resources are used
in the most effective manner.
5. May take some of the
emotional burden away from
those doing triage.
37. SIMPLE TRIAGE
• Simple triage is used in a scene
of mass casualty, in order to sort
patients into those who need
critical attention and immediate
transport to the hospital and
those with less serious injuries.
38. • This step can be started before
transportation becomes available.
• The categorization of patients
based on the severity of their
injuries can be aided with the use
of printed triage tags or colored
flagging.
43. START
• S.T.A.R.T. (Simple Triage and
Rapid Treatment) is a simple
triage system that can be
performed by lightly trained lay
and emergency personnel in
emergencies.
44.
45. TRIAGE CLASSSIFIES INJURED
PERSONS INTO FOUR GROUPS
0 – The deceased who are
beyond help.
1 – The injured who can be
helped by immediate
transportation.
46. 2 – The injured whose transport
can be delayed.
3 – Those with minor injuries,
who need help less urgently.
47. ADVANCED TRIAGE
• In advanced triage, doctors may
decide that some seriously
injured people should not
receive advanced care because
they are unlikely to survive.
48. • Advanced care will be used on
patients with less severe injuries.
Because treatment is
intentionally withheld from
patients with certain injuries,
advanced triage has an ethical
implication.
49. PRINCIPLES OF ADVANCED
TRIAGE
• Do the greatest good for the
greatest number.
• Preservation of life takes
precedence over preservation of
limbs.
50. ADVANCED TRIAGE CATEGORIES
CLASS I
• (EMERGENT) RED IMMEDIATE
Victims with serious injuries that
are life threatening but has a
high probability of survival if
they received immediate care.
51. They require immediate surgery or
other life-saving intervention,
and have first priority for surgical
teams or transport to advanced
facilities; they “cannot wait” but
are likely to survive with
immediate treatment.
Critical; life threatening—
compromised airway, shock,
hemorrhage.
52. CLASS II
(URGENT) YELLOW DELAYED
• Victims who are seriously injured
and whose life is not
immediately threatened; and
can delay transport and
treatment for 2 hours.
53. Their condition is stable for the
moment but requires watching
by trained persons and frequent
re-triage, will need hospital care
(and would receive immediate
priority care under “normal”
circumstances).
Major illness or injury;—open
fracture, chest wound
54. CLASS III
(NONURGENT) GREEN MINIMAL
• “Walking wounded,” the
casualty requires medical
attention when all higher
priority patients have been
evacuated, and may not require
monitoring.
55. Patients/victims whose care and
transport may be delayed 2
hours or more.
“minor injuries; walking
wounded—closed fracture,
sprain, strain”
56. CLASS IV
(EXPECTANT) BLACK EXPECTANT
• They are so severely injured
that they will die of their
injuries, possibly in hours or
days (large-body burns, severe
trauma, lethal radiation dose),
57. • ……..or in life-threatening
medical crisis that they are
unlikely to survive given the care
available (cardiac arrest, septic
shock, severe head or chest
wounds)
58. They should be taken to a holding
area and given painkillers as
required to reduce suffering.
Dead or expected to die—massive
head injury, extensive full-
thickness burns.”
59. • Persons with minor or moderate
injuries should be treated at
their own homes to avoid social
dislocation & the added drain on
resources of transporting them
to central facilities.
60. • The seriously injured should be
transported to hospitals with
specialized treatment facilities.
65. TAGGING
• All victims should be identified
with tags stating their name, age,
place of origin, triage category,
diagnosis & initial treatment.
66.
67. • Taking care of the dead is an
essential part of the disaster
management.
• A large number of dead can
impede the efficiency of the
rescue operation.
70. Care of dead includes :
1. Removal of the dead from the
disaster scene.
2. Shifting to the mortuary.
3. Identification
71. 4.Reception of bereaved relatives
& proper respect of the dead. ( If
human bodies contaminate wells
or other water sources as in
floods, they may transmit
gastroenteritis or food poisoning
to survivors.
5.The dead bodies represent a
delicate social problem.
74. The type & quantity of
humanitarian relief supplies are
determined by two factors.
1.The type of disaster.
2.Type & quantity of supplies
available locally.
75. Disaster managers must be prepared
to receive large quantities of
donations.
There four components in managing
humanitarian supplies.
1.Acquisition of supplies.
2.Transportation.
3.Storage.
4.Distribution.
77. • Displacement of domestic & wild
animals, who carry with them
zoonoses that can be
transmitted to humans as well as
to other animals. (Leptospirosis).
78. • Provision of emergency food,
water & shelter in disaster
situation from different or new
source may itself be a source of
infectious disease.
80. • The pressure may be increased
by the press media & offer of
vaccines from abroad.
• Routine vaccination
programme may be organized
with camps with a large number
of children population.
81. NUTRITION
• A natural disaster may affect the
nutritional status of the
population by affecting one or
more components of food chain
depending on the type, duration
& the extent of the disaster.
82. Specially if vulnerable population
is more. (Pregnant mothers,
children)
Measures for an effective food
relief programme are :
1. Assessing the food supplies
after a disaster.
83. 2.Gauging the nutritional needs of
the affected population.
3.Calculated food rations & need
for large population groups.
4.Monitoring the nutritional
status of the affected
population.
84. REHABILITATION
• The final phase in a disaster
should lead to restoration of the
pre disaster conditions.
• Rehabilitation starts from the
very first day of disaster.
85. • Services should be reorganized &
re structured.
• Priorities will shift from health
care towards environmental
health measures, as follows.
86. WATER SUPPLY
• A survey of all water supply
should be made.
• This includes water source &
distribution system.
87. • It is important to determine
physical integrity of system
components, the remaining
capacities & bacteriological &
chemical quality of water
supplied.
88. • The main public safety aspect of
water quality is microbial
contamination.
• The first priority of ensuring
water quality in emergency
situations is chlorination.
90. • It is the best way of disinfecting
the water.
• It is advisable to increase
residual chlorine level to about
0.2 – 0.5 mg /litre.
91. • Low water pressure increases
the risk of infiltration of
pollutants into water mains.
• Repaired mains, reservoirs &
other units require cleaning &
disinfection.
92. • Chemical contamination &
toxicity are a second concern in
water quality & potential
chemical contaminations have to
be identified & analyzed.
• The existing & new water sources
require the following protection
measures :
94. 1.Restrict access to people &
animals, if possible, erect a fence
& appoint a guard.
2.Ensure adequate excreta
disposal at a safe distance from
water source.
96. • 3.Prohibit bathing, washing &
animal husbandry, upstream if
intake points in rivers & streams.
• 4.Upgrade wells to ensure that
they are protected from
contamination.
97. 5.Estimate the maximum yield of
wells & if necessary, ration the
water supply. In many emergency
situations, water has to be
trucked to disaster site of camps.
6.All water tankers should be
inspected for fitness & be cleaned
& disinfected before transporting
water.
99. FOOD SAFETY
• Poor hygiene is a major cause of
food – borne disease in disaster
situations.
• Kitchen sanitation is important
in the feeding camps.
101. BASIC SANITATION & FOOD
HYGIENE
• Many diseases spread through
fecal contamination of water &
food.
• Hence every effort should be
made to ensure the sanitary
disposal of excreta.
102. • Emergency latrines should be
made available to the displaced
where toilet facilities have been
destroyed.
• Washing, cleaning & bathing
facilities should be made
available for the displaced
persons.
103. VECTOR CONTROL
• Control programme for vector
borne diseases should be
intensified in the emergency &
rehabilitation period.
• Of special concern are malaria,
dengue fever, leptospirosis, plague.
106. III RESPONSE PHASE
1. Implementing plans.
2. Implementing disaster
legislation or declarations.
3. Issuing warnings
107. 4. Mobilizing resources.
5. Notifying public authorities.
6. Providing medical assistance.
7. Providing immediate relief.
8. Search and rescue.
108. IV RECOVERY PHASE
1. Myth that “things
go back to
normal in a couple
of weeks.”
-Psychological
effects may last a
lifetime
109. 2. Cost of recovery means loss of
opportunity for development.
3. Most need for financial and
material assistance is the
months after a disaster…but
forgotten by then ….
114. PREPAREDNESS: Planning
• Failure to plan is planning to fail”.
• Planning provides the
opportunity to network and
engage participants prior to the
event.
124. 1. Disaster management is the
responsibility of all spheres of
government.
2. Disaster management should
use resources that exist for a
day-to-day purpose.
125. 3. Organizations should function
as an extension of their core
business.
4. Individuals are responsible for
their own safety.
126. 5. Disaster management planning
should focus on large-scale
events.
6. Disaster management planning
should recognize the
difference between incidents
and disasters.
128. 8. Disaster management planning
must take account of the type of
physical environment and the
structure of the population.
9. Disaster management
arrangements must recognize the
involvement and potential role of
non-government agencies.
130. • Disaster nursing can be defined
as “the adaptation of
professional nursing knowledge,
skills and attitude in recognizing
and meeting the nursing, health
and emotional needs of disaster
victims.”
131. PRINCIPLES OF
DISASTER NURSING
• The basic principles of nursing
during special (events)
circumstances and disaster
conditions include:
132. 1. Rapid assessment of the
situation and of nursing care
needs.
2.Triage and initiation of life-
saving measures first.
133. 3. The selected use of essential
nursing interventions and the
elimination of nonessential
nursing activities.
4. Evaluation of the environment
and the mitigation or removal
of any health hazards.
134. 5. Adaptation of necessary
nursing skills to disaster and
other emergency situations.
The nurse must use
imagination and
resourcefulness in dealing
with a lack of supplies,
equipment, and personnel.
135. 6. Prevention of further injury or
illness.
7. Leadership in coordinating
patient triage, care, and
transport during times of crisis.
136. 8. The teaching, supervision, and
utilization of auxiliary medical
personnel and volunteers.
9. Provision of understanding,
compassion, and emotional
support to all victims and their
families.
137. CHARATERISTICS OF A
GOOD DISASTER
INTERVENTION….
• IT MUST FOCUS ON KEY ISSUES
• Taking care of the most
vulnerable first
138. 1. Foster a culture of prevention.
2. Integration into development
Equity.
3. It must ensure community
involvement
139. 4. It must be driven in all spheres
of government.
5. It must be transparent and
inclusive.
6. It must accommodate local
conditions
140. 7. It must have legitimacy
8. It must be flexible and
adaptable.
9. It must be efficient and
effective.
141. 10.It must be affordable and
sustainable.
11.It must be needs-oriented and
prioritized.
12. It must be based on a multi-
disciplinary and integrated
approach
142. GOALS OF THE DISASTER
NURSING
• The overall goal of disaster
nursing is to achieve the best
possible level of health for the
people and the community
involved in the disaster.
• Other goals of disaster nursing
are the following:
143. 1.To meet the immediate basic
survival needs of
populations affected by
disasters (water, food, shelter,
and security).
2 To identify the potential for a
secondary disaster.
144. 3. To appraise both risks and
resources in the environment.
4.To correct inequalities in access
to health care or appropriate
resources.
145. 5. To empower survivors to
participate in and advocate for
their own health and well-
being.
146. 6. To respect cultural, lingual, and
religious diversity in
individuals and families and to
apply this principle in all
health promotion activities.
147. ROLE OF A NURSE
N- ursing Plans should be
integrated and coordinated.
U- pdate physical
and Psychological
preaparedness
149. D- isseminate information on the
prevention and control
of environmental Hazards.
I- nterpret health laws and
regulations.
S- erve yourself of self-survival.
150. S- election of Essential Care.
A- ccepts directions and take
orders from an organized
authority.
A- daptation of Skills to Situation
151. S- erve the best of the MOST.
T- each AUXILLARY personnel.
T- each the meaning of warning
signals
155. DISASTER MITIGATION TOOL
1. Health kit.
2. First Aid Medicine Kit.
3. School Kit.
4. Kit for Kids.
5. Domestic Kit.
6. Sewing Kit.
7. Cleaning & Utensils.
8. Individual Items for Disaster
mitigation.
156. HEALTH KIT
1 Hand towel.
2.1 Wash cloth.
3.1.Hair comb.
4.1 Nail clipper.
5.1 Bathing Soap.
6.Tooth brush, tooth paste.
7.Band aids.
8.Cloth line/Tie.
157. FIRST AID MEDICINE KIT
1. Sterile Gauze Pads (4x4) 50 pads.
2. Adhesive tape 6 rolls, ½” or 1x10 yds.
3. Triple antibiotic topical ointment 4
tubes.
4. Ferrous sulphate tab 500 tab -325mg.
158. 5. Children’s MVT with iron
chewable tab 500.
6. Adult MVT with iron-500 tabs.
7. Children’s acetaminophen
chewable tabs 300.
8. Asprin 325mg tabs.
183. NATIONAL DISASTER MANAGEMENT AUTHORITY
HEADED BY PM
STATE DISASTER MANAGEMENT AUTHORITY HEADED
BY CM
DISTRICT DISASTER MANAGEMENT AUTHORITY
HEADED BY COLLECTOR
BLOCK DISASTER MANAGEMENT COMMITTEE
HEADED BY BDO & NGO
VILLAGE COMMITTEE FOR DISASTER
MANAGEMENT-PANCHAYAT RAJ & COMMITTEE
184.
185. AGENCIES/MINISTRIES &
DISASTER MANAGEMENT
DISASTER AGENCY MINISTRY
Heat wave/Cold
wave/Cyclone
/Earthquake
Indian
Meteorological
Dept (IMD)
Earth Sciences
Tsunami Indian National
centre for
Oceanic
Information
System (INCOIS)
Earth Sciences
188. LEGISLATION IN INDIA
• National cyclone mitigation
project.
• National Disaster Response Force.
(2005).
• National Earthquake Risk
Mitigation Project.
189. National Executive Committee Act
(2005).
State Disaster Management
Authority.
National Policy on Disaster
Management (2009).
190. ROLE OF NMDA IN
DISASTER PREPAREDNESS
Specialist Response Teams.
Setting up of Search and Rescue
Teams in States.
197. INTERVENTIONS-NMDA
• Human Resources Development –
organising/sponsoring programmes
to enhance the awareness/skill of
Government functionaries at
Central, State and district level as
well as NGOs, CBOs, Panchayat
leaders for successful
implementation of disaster
reduction programmes.
198. • Research and Consultancy
Services.
• Documentation of major events
of Natural Calamities.
• Vulnerability assessment
projects.
199. • Establishment of National Centre
of Disaster Management.
• Creation of natural disaster
management faculties in the
State Level Training Institutes.
200. • Public Education and community
awareness programmes.
• Regional cooperation.
201. DISASTER WARNING
SYSTEM IN INDIA
Early Warning System : Cyclone
Forecasting
Indian Meteorological
Department (IMD) is mandated
to monitor and give warning.
203. FLOOD FORCASTING
The Flood Forecasting involves the
following four main activities :-
(i) Observation and collection of
hydrological and hydro-
meteorological
data;
204. (ii) Transmission of Data to
Forecasting Centres.
(iii) Analysis of data and
formulation of forecast;
and.
(iv) Dissemination of forecast.
205. BEFORE FLOOD
Avoid building in a flood prone
area unless you elevate and
reinforce your home.
Elevate the furnace, water
heater, and electric panel if
susceptible to flooding.
206. Install "check valves" in sewer
traps to prevent floodwater from
backing up into the drains of your
home.
Contact community officials to find
out if they are planning to
construct barriers. (levees, beams,
floodwalls) to stop floodwater from
entering the homes in your area.
207. Seal the walls in your basement
with waterproofing compounds
to avoid seepage
208. DURING A FLOOD
Listen to the radio or television for
information.
Be aware that flash flooding can
occur. If there is any possibility of a
flash flood, move immediately to
higher ground. Do not wait for
instructions to move.
209. • Be aware of streams, drainage
channels, canyons, and other
areas known to flood suddenly.
Flash floods can occur in these
areas with or without such
typical warnings as rain, cloud or
heavy rain.
211. DISASTER’ alphabetically
means:
D - Destructions
I - Incidents
S - Sufferings
A - Administrative, Financial Failures.
S - Sentiments
T - Tragedies
E - Eruption of Communicable diseases.
R - Research programme and its
implementation