GENERAL OBJECTIVES:

By the end of the class the group will be able to acquire knowledge about disaster nursing, improving the
skills in managing the clients in disaster situation.

SPECIFIC OBJECTIVES: By the end of the class the group will be able to

 define the Disaster

 define disaster nursing
 classify the disasters
 enlist the levels of disaster
 Describe the phases of disaster management
 emphasize the disaster cycle
 Illustrate the disaster management plans
 nurse’s role in community disaster management

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SPECIFIC TIME CONTENT TEACHING/ EVALUATION
OBJECTIVES LEARNING
ACTIVITY
DISASTER NURSING
Introduces the Teacher:
topic of disaster INTRODUCTION introduces
nursing topic with
 Disaster is an occurrence arising with little or no good example
warning, which causes serious disruption of life and Student:
Shows interest
perhaps death or injury to large number of people.
 It is may be a man made or natural event that causes
destruction and devastation which cannot be relieved
without assistance.

THE GOAL OF DISASTER NURSING is ensuring that

the highest achievable level of care is delivered through
identifying, advocating, and caring for all impacted
populations throughout all phases of a disaster event,
including active participation in all levels of disaster
planning and preparedness. Teacher:
define the What is the
Disaster Explain definition of
definition by disaster?

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DEFINITIONS: using OHP
transparencies
“DISASTER is any occurrence that causes damage, Students:
economic destruction, loss of human life and deterioration watches the
OHP listens
in health and health services on a scale sufficient to
carefully
warrant an extraordinary response from outside the
affected community or area”

WHO (2009)

“DISASTER is any human made or natural event

that causes destruction and devastation that cannot be
relieved without assistance”

Stanhope

“DISASTER is a sudden accident or natural event

that causes great damage or loss of life”

IGNOU BOOK

“A disaster can be defined as an occurrence either

nature or man made that causes human suffering and
creates human needs that victims cannot alleviate without
assistance”.
American Red Cross (ARC)

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 An occurrence of a severity and magnitude that normally
results in death, injuries and property damage that cannot
be managed through the routine procedure and resources
of government. What is the
define disaster
definition of
nursing FEMA (Federal Emergency Management Agency) Teacher: disaster
Explains
United Nations defines disaster is the occurrence of a nursing?
definition by
sudden or major misfortune which disrupts the basic fabric using OHP
and normal functioning of a society or community. transparencies
Students:
watches the
DISASTER NURSING OHP listens
carefully
1. “It can be defined as the adaptation of professional
nursing skills in recognizing and meeting the nursing,
physical and emotional needs resulting from a disaster”.
W.H.O
2. “Disaster Nursing is nursing practiced in a situation
where professional supplies, equipment, physical facilities
and utilities are limited or not available”.

classify the What is the

classification
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disasters ‘DISASTER’ alphabetically means: of disasters?
Teacher:
D - Destructions explains the
I - Incidents classification
by using power
S - Sufferings
point
A - Administrative, Financial Failures. presentation
S - Sentiments Students:
listening and
T - Tragedies observing the
E - Eruption of Communicable diseases. power point
R - Research programme and its implementation

CLASSIFICATION OF DISASTERS:

According to WHO:

Based on observations from the field suggest Disasters are

classified under the three broad classifications:

I. Natural Disasters
II. Human Made Disasters
III. Other Disasters
NATURAL DISASTERS:

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Disasters which occurs naturally are further divided into

 Acute Disaster
 Chronic Disaster
 Acute Disaster is sudden in onset. Eg:-
Earthquakes, cyclone, tsunami, floods, epidemics of
water, food, vector borne diseases, person-to-person
transmission of diseases.
 Chronic and slow Disasters: - Eg:- drought,
famine, deforestation, chronic exposure to toxic
substances.
HUMAN MADE DISASTERS:

The disasters which occurs with the interference of

humans.

Eg: - civil strive, war, industrial accidents, vehicular

accidents.

OTHER DISASTERS:

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Such as the effects of loose polices which allow the

 Use of tobacco
 Sale of harmful drugs
 Uncontrolled use of pesticides and so on

TYPES OF DISASTERS:

There are many types of disasters such as

earthquakes, cyclones, floods, tidal waves, landslides,
volcanic eruptions, tornadoes, fires, snow, storms, severe
air pollution, famines, epidemics, heat waves, building
collapse, toxicological accidents (release of hazardous
substance) nuclear accidents and warfare.

EARTHQUAKE:

There is high level of mortality as a result of people

being crushed by following objectives:

 The risk is greater inside or near dwellings but is

very small in the open.
 Earthquake at night are more deadly. During the
night fractures of pelvis, thorax and spine are
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 common because earthquakes strike while people
are lying in bed.
 In daytime injuries to the arms and skull are
common
VOLCANIC ERUPTIONS:
Mortality is high in the case of mudslides (23,000
deaths in Colombia in 1985) and glowing clouds there
may be injuries, burns and suffocation.

FLOODS:
Mortality is high only in case of sudden flooding.
Eg:- flash floods, collapse of dams or tidal waves
fractures, injuries and bruises may occur, if whether is
cold, cases of accidental hypothermia may occur.

CYCLONE AND HURRICANES:

Mortality is not high unless tidal waves occur. The
combined affect of wind rain may cause houses to
What are

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 collapse. the levels of
A large number of objects may be lifted in the air disaster?
enlist the levels
of disaster and carried along with the wind. This may give risk to
injuries. Teacher:
explains the
DROUGHTS: levels of
Mortality may increase considerably in areas where disaster by
narration
drought cause famines in which case there may be protein-
students:
caloric malnutrition and vitamin deficiencies. Listens
FIRE ACCIDENTS: narration by
nodding their
We come across news of fires or even of victims of heads
devastating fires in hotels, shops, cluster “jhuggies”
offices and houses. These may be due to carelessness in
handling fire objects like throwing burning cigarettes or
bidies, hot ashes, bursting of gas cylinders, electric sparks. What are
Fire can also result from spontaneous conflagration in the phases
of disaster
forest or due to negligence of a man. managemen
Describe the BIOLOGICAL WARFARE: t?
phases of
It is a purposeful contamination of flood, drinking
disaster
management water and clothing is carried out by the enemies. Teacher:

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 This causes the suffering of both soldiers and the explains the
public with all kinds of phases by
using
Communicable diseases, malaria, food poisoning, other flashcards
water borne diseases like plaque, typhoid, paratyphoid, Students:
observes the
etc.. flashcards and
On the whole mortality which results from a disaster listens
carefully
situation can be classified into four types:
 Injuries
 Emotional Stress
 Epidemic of disease
 Increase in indigenous diseases

LEVELS OF DISASTER

 Level iii disaster – considered a minor disaster.

These are involves minimal level of damage
 Level ii disaster- considered a moderate disaster.
The local and community resources has to be
mobilized to manage this situation
 Level i disaster- considered a massive disaster- this

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 involves a massive level of damage with severe
impact.

Disaster mitigation

 Disaster mitigation refers to actions or measures that

can either prevent the occurrence of a disaster or reduce
the severity of its effects. (American Red Cross).
 Mitigation activities include awareness and education
and disaster prevention measures.

PHASES OF DISASTER MANAGEMENT

 Prevention phase
 Preparedness phase
 Response phase
 Recovery phase

Prevention phase

 Identify community risk factors and to develop and

implement programs to prevent disasters from
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 occurring.

Preparedness phase
What are
 Personal preparedness phases of
disaster
 Professional preparedness cycle?
emphasize the
disaster cycle
Key organizations and professionals in disaster
management
Teacher:
Health care community explains
disaster cycle
 Hospitals by using leaflet
Students:
 Health professionals
Observes
 Pharmacies leaflet and
 Public health departments listens
carefully
 Rescue personnel

Non-health care community

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  Fire fighters
 Municipal or government officials
 Media
 Medical examiners
 Medical supply manufactures
 Police

Community preparedness

 The level of community preparedness for a disaster

is only as high as the people and organization in the
community make it.
 Community must have adequate warning system
and a back up evaluation plan to remove people
from the area of danger

Response phase
What are
Illustrate the The level of disaster varies and the management plans essential in
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disaster disaster
management mainly based on the severity or extent of the disaster. managemen
plans t plans?
Recovery phase

Teacher:
 During this phase actions are taken to repair, rebuilt,
explains
or reallocate damaged homes and businesses and disaster plans
restore health and economic vitality to the by using
pamphlets
community. Student:
 Psychological recovery must be addressed. Both observes
phamphlet and
victims and relief workers should be offered mental listens
health activities and services. carefully

DISASTER CYCLE
1. Non disaster or inter disaster phase
2. Pre disaster or warning phase
3. Impact phase
4. Emergency or Relief phase
5. Reconstruction or Rehabilitation phase
1. Non disaster or inter disaster phase: mapping,
analysis, assessing resources, planning

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 a. Preventive
b. Preparedness
c. Mitigation
d. Conducting education and training.
2. Pre disaster phase:
a. Issuing warning
b. Implementing protective measures
3. Impact phase:
a. Disaster occurs and community experiences
effects
4. Emergency phase:
a. Search and rescue
b. First aid
c. Emergency medical assistance
d. Restoration of Emergency communication
and transport network
e. Public health surveillance
f. Evacuation from areas still vulnerable to the
hazard

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 5. Reconstruction or Rehabilitation phase:
a. Restoration
b. Reconstitution
c. Mitigation

Disaster management cycle

Prevention                     ------>        preparedness

         I                                                         v

                                          
Recovery                <---------            response                       

Disaster management plans

Aims of disaster plans

 to provide prompt and effective medical care to the

maximum possible in order to minimize morbidity
and mortality

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Objectives

 To optimally prepare the staff and institutional 

resources for effective performance in disaster
situation
 To make the community aware of the sequential
steps that could be taken at individual and
organizational levels

Disaster management committee

The following members would comprise the disaster

management committee under the chairmanship of
medical superintendent/ director

 Medical superintendent/ director

 Additional medical superintendent
 Nursing superintendent/ chief nursing officer
 Chief medical officer (casualty)

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  Head of departments- surgery, medicine,
orthopedics, radiology, anesthesiology,
neurosurgery
 Blood bank in charge
 Security officers
 Transport officer
 Sanitary personnel

Disaster control room

 the existing casualty may be referred as the disaster

control room.

Rapid response team

 The medical superintendent will identify various

specialists, nurses and pharmacological staff to
respond within a short notice depending up on the
time and type of disaster.
 The list of members and their telephone numbers
should be displayed in the disaster control room.

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 What is the
Information and communication nurse’s role
in disaster
 the disaster control team would be responsible for managemen
t?
nurse’s role in collecting, coordinating and disseminating the
community
information about the disaster situation to the all
disaster
management concerned.
Teacher:
Disaster beds explains role of
nurse by using
 Requirement of beds depends up on the magnitude chart
Student:
of the disaster.
observes chart
 Utilization of vacant beds, day care beds, and pre- and listens
operative beds carefully

 Convalescing patients, elective surgical cases and

patients who can have domiciliary care or OPD
management should be discharged
 Utility areas to be converted in to temporary wards
such as wards with side rooms, corridors, seminar
rooms etc.
 Creating additional bed capacity by using trolleys,

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 folding beds and floor beds

Logistic support system

 Resuscitation equipments
 Iv sets, iv fluids,
 Disposable needles, syringes and gloves
 Dressing and suturing materials and splints
 Oxygen masks, nasal catheters, suction machine and
suction catheters
 ECG monitors, defibrillators, ventilators
 Cut down sets, tracheostomy sets and lumbar
puncture sets
 Linen and blankets
 Keys of these cupboards should be readily available
at the time of disaster

Training and drills

 Mock exercise and drills at regular intervals are

conducted to ensure that all the staff in the general

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 and those associated with management of causalities
are fully prepared and aware of their
responsibilities. 

Elements of disaster plan

A disaster plan should have the following elements

 Chain of authority
 Lines of communication
 Routes and modes of transport
 Mobilization
 Warning
 Evacuation
 Rescue and recovery
 Triage
 Treatment
 Support of victims and families
 Care of dead bodies

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  Disaster worker rehabilitation

Activation of disaster management plans

 Standard operating procedures (SOPs)

 Reception area
 Triage
o Priority one- needing immediate
resuscitation, after emergency treatment
shifted to intensive care unit
o Priority two- immediate surgery, transferred
immediately to operation theatre.
o Priority three- needing first aid and possible
surgery- give first aid and admit if bed is
available or shift to hospital
o Priority four- needing only first aid-discharge
after first aid.
 Documentation

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  Public relations.
 Essential services.
 Crowd management/ security arrangement.

Disaster management- nurse’s role in community

Assess the community

 Assessment - the local climate conducive for disaster

occurrence, past history of disasters in the community,
available community disaster plans and resources,
personnel available in the community for the disaster
plans and management, local agencies and
organizations involved in the disaster management
activities, availability of health care facilities in the
community etc.

Diagnose community disaster threats

 Determine the actual and potential disaster threats (eg;

explosions, mass accidents, tornados, floods,
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 earthquakes etc).

Community disaster planning

 Develop a disaster plan to prevent or deal with

identified disaster threats
 Identify local community communication system
 Identify disaster personnel, including private and
professional volunteers, local emergency personnel,
agencies and resources
 Identify regional back up agencies and personnel
 Identify specific responsibilities for various
personnel involved in the disaster plans
 Set up an emergency medical system and chain for
activation
 Identify location and accessibility of equipment and
supplies
 Check proper functioning of emergency equipments

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  Identify outdated supplies and replenish for
appropriate use.

Implement disaster plans

 Focus on primary prevention activities to prevent

occurrence of manmade disasters
 Practice community disaster plans with all personnel
carrying out their previously identified responsibilities
(eg: emergency triage , providing supplies such as
food, water, medicine, crises and grief counseling)
 Practice using equipment; obtaining and distributing
supplies

Evaluate effectiveness of disaster plan

 Critically evaluate all aspects of disaster plans and

practice drills for speed, effectiveness, gaps and
revisions.
 Evaluate the disaster impact on community and
surrounding regions

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  Evaluate the response of personnel involved in disaster
relief efforts.

SUMMARY:
Disasters are of different types which can happen any time ,any where, in the world causing tremendous after
effects such as loss of human life ,economical imbalances, food scarecity epidemics , forced relocation of
population etc. Disasters usually affect the developing countries comparing with the developed countries. While
deserting the matter we could come to the conclusion that the adverse effects of natural disasters can be minimized
by proper preventive measures alert technologies at high risk areas, proper mobilization of resources, decreased
corruption in the field and also the mock training programmes in the community

Conclusion

Disaster is an emergency situation, therefore coordination of actions and various departments is an essential
requisite for efficient management of mass casualties.

BIBLIOGRAPHY:

 Allender j a, spradly bw. Community health nursing- promoting and practicing the public’s health. 6th edn.
Lippincott williams and wilkins. London. 2005

 Clemenstone s, mcguire sl, eigsti dg. Comprehensive community health nursing- family aggregate and
community practice. 6th edn. Mosby publishers. St louis. 2002

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 Stanhope m, lancaster j. Community and public health nursing. 6th edn. Mosby publishers. London. 2004.

 Lewis sl, heitkemper mm. Medical surgical nursing- assessment and management of problems. Mosby
publishers. Philadelphia. 2007.

LESSON PLAN
On
Disaster nursing
PREPARED BY,
K.SAGAR,
ASSISTANT PROFESSOR,
INDIRA GANDHI SCHOOL & COLLEGE OF NURSING

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