Reymon Jan B. Rodado III-DN Term paper #4 Disaster Nursing I.

Introduction In response to disasters, natural and man-made, a specialty within the area of critical care nursing has emerged. Disaster nursing involves readiness and preparedness in responding to immediate community needs during and after a catastrophic event. Catastrophic events are extremely overwhelming to any community. It's not just the high mortality rate. Damage to roads, buildings and electrical services profoundly limit a region's capacity to respond. Paramedics and police, fire and hospital emergency departments become overburdened. Government organizations are quickly inundated with requests for aid and other immediate relief. The role of the critical care nurse during these kinds of situations can cover a wide area of responsibility: medical history and physical assessment, psychosocial assessment and referral to mental health services. In addition to giving medical treatment, disaster nurses also provides emotional support to families, children and the elderly, and assists with rumor control. They make quick decisions about who will get treatment first. They often must decide who will receive care when supplies are low or have run out. However, their first priority is always to treat the walking wounded. Then they are able to be of some assistance to the nurses and other medical staff as needed. The historical background of disaster nursing is based in military nursing. Throughout most of history, nurses have been present in wartime, offering support and solstice to those bloodied in battle. During the Crimean War, Florence Nightengale assembled a staff of 38 volunteer nurses to care for wounded soldiers. They were receiving poor care due to the overburdened medical staff. Supplies were short and infection rampant. With the help of the nurses, mortality decreased, as did instances of infection. Many of the protocols that were implemented later became prominent health care models later on. Because of events such as earthquakes, hurricanes, tornadoes, fires and terrorist attacks, it is important for nursing personnel to be adequately prepared. Disaster nursing education is now

provided at practically every level, whether it be offered as part of a LVN/PN course, or RN program. It may also be given in the format of continuing education courses for ongoing updating or refreshing, both traditional and online. Courses are comprised of, but not limited to: theory in basic preparedness for catastrophic events, how to evaluate and prioritize patient care, and moving and evacuation protocols. The courses also cover the details of caring for pregnant women and children, treating the victims of severe trauma, and all of the hazards of certain disasters that are biological or chemical in nature

Helping nurses become formally trained for disaster equips them with a universal code or method for them to adhere to, no matter the environment (hospital, clinic, war zone or nursing care facility). It also gives them much more confidence in their ability to lead and organize large groups of people in frantic situations and times. As part of the first-response front, by being more adequately readied, nurses are then better able to effectively assist and ease overwhelmed medical teams. So in essence, it can save many lives.

The issue of being culturally sensitive is becoming more essential, especially regarding health care. Nurses come in contact with many people of varying nationalities, traditions and ethnicities, all possessing their own understanding of sickness. It is for this reason that nurses, specifically those who are dealing with people experiencing a disastrous event, must be trained about the importance of sensitivity to those from cultures different from their own. This increases the likelihood of acceptance of medical treatment, helps the patient return to health quicker, and establishes rapport as well.

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 involves a massive level of damage with severe impact. D is ast er mit igat io n

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.

Phas es o f d isa st er ma nage me nt

y y y y

Prevention phase Preparedness phase Response phase Recovery phase

Prevention phase
y

Identify community risk factors and to develop and implement programs to prevent disasters from occurring.

Preparedness phase
y y

Personal preparedness Professional preparedness

Community preparedness
y

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 The level of disaster varies and the management plans mainly based on the severity or extent of the disaster. Recovery phase

During this phase actions are taken to repair, rebuilt, or reallocate damaged homes and businesses and restore health and economic vitality to the community.

Psychological recovery must be addressed.Both victims and relief workers should be offered mental health activities and services.

D is ast er ma nage me nt cyc le Prevention I ------> preparedness v

Recovery

<---------

response

D is ast er ma nage me nt pla ns Aims of disaster plans

y

to provide prompt and effective medical care to the maximum possible in order to minimize morbidity and mortality

Objectives
y

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 control room

y

the existing casualty may be referred as the disaster control room.

Rapid response team

y

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.

Information and communication

y

The disaster control team would be responsible for collecting, coordinating and disseminating the information about the disaster situation to the all concerned.

Disaster beds
y y y

Requirement of beds depends up on the magnitude of the disaster. Utilization of vacant beds, day care beds, and pre-operative beds 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, folding beds and floor beds

D is ast er ma nage me nt - nurses ro le in co mmu nit y Assess the community

y

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

y

Determine the actual and potential disaster threats (eg; explosions, mass accidents, tornados, floods, earthquakes etc).

Community disaster planning

y y y

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

y y y y y y

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 Identify outdated supplies and replenish for appropriate use.

Implement disaster plans

y y

Focus on primary prevention activities to prevent occurrence of manmade disasters Practice community disaster plans with all personnel carrying out their previously identified responsibilities (e.g.: 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

y

Critically evaluate all aspects of disaster plans and practice drills for speed, effectiveness, gaps and revisions.

y y

Evaluate the disaster impact on community and surrounding regions Evaluate the response of personnel involved in disaster relief efforts.

Act ivat io n o f d isa st er ma nage me nt pla ns

y y y

Standard operating procedures (SOPs) Reception area Triage

o

Priority one- needing immediate resuscitation, after emergency treatment shifted to intensive care unit

o o

Priority two- immediate surgery, transferred immediately to operation theatre. Priority three- needing first aid and possible surgery- give first aid and admit if bed is available or shift to hospital

o y

Priority four- needing only first aid-discharge after first aid.

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

y y y

Training and drills

y

Mock exercise and drills at regular intervals are conducted to ensure that all the staff in the general and those associated with management of causalities are fully prepared and aware of their responsibilities.

II. Discussion Giving help and support for those people who are in a calamaties is the most important thing. Proper triage should be initiate immediately to secure the people safety and nurses should

be aware that not only physical help is needed by the people because they under gone horrible trauma and they are physiologically unstable. Medical team should act in a proper plan during these critical times. There is no space for errors because it can affect the clients in many ways. If we are talking disaster and natural calamities Philippines is just a hot spot. Volcanic eruption, earthquake, tropical typhoon, tsunami, landslide, flashflood the medical team should undergone special trainings in this situation to minimize casualties and deaths. Proper use of emergency paraphernalia should be observed because demands are greater in these emergency situations. Cooperation in different health sector should be provided immediately. Prevention is also important because infection is primary killer in a disaster, preventing further infection and spread of it is a important consideration. Nurses should help patients how to cope in the situation.

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

as well as initial work conducted to examine components of deployment readiness, were incorporated into a proposed model for military disaster nursing that requires ongoing research and evaluation. Disasters of the future will be broad in scope and intense in terms of mass casualties. Additional research is needed to determine the model's usefulness in both military and civilian care environments.

REFERENCES http://www.scribd.com/doc/17471550/Nursing-Care-Plan-for-Disaster-Considerations

http://www.wadem.org/documents/int_disaster_nursing_chapter_1.pdf