HESI Page 18-21

Disaster Nursing

The role of the nurse takes place at all three levels of disaster
management:
o Disaster preparedness
o Disaster response
o Disaster recovery
To achieve effective disaster management:
o Organization is the key
o All personnel must be trained
o All personnel must know their roles
Levels of Prevention in Disaster Management

Primary prevention
o Participate in the development of a disaster plan
o Train rescue workers in triage and basic first aid
o Educate personnel about shelter management
o Educate the public about the disaster plan and personal
preparation for disaster
Secondary prevention
o Triage
o Treatment of injuries
o Treatment of other conditions, including mental health
o Shelter supervision
Tertiary prevention
o Follow-up care for injuries
o Follow-up care for psychological problems
o Recovery assistance
o Prevention of future disasters and their consequences
Triage

A French word Meaning to sort or categorize

Goal: maximize the number of survivors by sorting the injured
according to treatable and untreatable victims
Primary criteria used
o Potential for survival
o Availability of resources

Nursing interventions and roles in triage

Triage duties using a systematic approach such as the START method

Treatment of injuries
1

HESI Page 18-21

o Render first aid for injuries

o Provide additional treatment as needed in definitive care areas
Treatment of other conditions, including mental health
o Determine health needs other than injury
o Refer for medical treatment as required
o Provide treatment for other conditions based on medically
approved protocols

Shelter Supervision

Coordinate activities of shelter workers

Oversee records of victims admitted and discharged from shelter
Promote effective interpersonal and group interactions among victims
in shelter
Promote independence and involvement of victims housed in the
shelter

Bioterrorism

Learn the symptoms of illnesses that are associated with exposure to

likely biologic and chemical agents
Understand that they could appear days or weeks after exposure
Nurses and other health care providers would be the first responders
when victims seek medical evaluation after symptoms manifest. First
responders are critical in identifying an outbreak, determining cause of
outbreak, identifying risk factors, and implementing measures to
control and minimize the outbreak.
Possible agents
o Biological agents
Anthrax
Pneumonic plague
Botulism
Smallpox
Inhalation tularemia
Viral hemorrhagic fever
o Chemical agents
Biotoxin agents: ricin
Nerve agents: sarin
o Radiation

Nursing Assessment

Community-disaster risk assessment

Measures to mitigate disaster effect
Exposure symptom identification
2

HESI Page 18-21

Analysis (Nursing Diagnosis)

Deficient knowledge (specify) related to

Risk for poisoning related to
Risk for trauma related to
Anxiety related to
Fear related to
Ineffective community coping related to
Risk for post-trauma syndrome related to

Nursing Plans and Interventions

Participate in development of disaster plan

Educate the public on disaster plan and personal preparation for
disaster
Train rescue workers in triage and basic first aid
Educate personnel for shelter management
Practice triage
Treat injuries and illness
Treat other conditions, including mental health
Supervise shelters
Arrange for follow-up care for injuries
Arrange for follow-up care for psychological problems
Assist in recovery
Work to prevent future disasters and their consequences