Disaster Associated

Health Issues:
Emergency Health Services and
Communicable Diseases
 Cont………………..
 Identify the components involved in emergency
medicine.
 Describe a suitable infrastructure and procedures in
accessing emergency medicine services. .
 Identify the main communicable diseases common in
disaster situations.
 Discuss the risk factors that increase the likelihood of
an outbreak of communicable diseases.
 Identify ways of preventing/minimising outbreaks of
communicable diseases
 Terminology
 Acute Respiratory Infections (ARI):
 Severe adenovirus infection of the respiratory tract
characterized by fever, sore throat, and cough. such
as bronchitis.
 Agent:
 An infections disease agent is constantly searching
for opportunities to multiply since their genes can
transform rapidly, enabling it to be spread quickly to
new locations, and infecting more vulnerable
populations.
 Cont………..
 Communicable diseases:
 An illness that arises from transmission of an
infectious agent or its toxic product from an
infected person, animal, or reservoir to a
susceptible host, either directly or indirectly.
 These include acute respiratory infections,
diarrhoeal diseases, sexually transmitted
diseases and vaccine-preventable diseases that
can cause serious outbreaks.
 Cont…………..
 Diarrhoeal diseases:
 Occurs when the stool weight is above 300g
per day. This is mainly due to excess water,
which normally makes up 60–85% of faecal
matter.
 Cont……………
 In this way, true diarrhoea is distinguished
from diseases that cause only an increase in
the number of bowel movements
(hyperdefecation), or incontinence
(involuntary loss of bowel contents).
 Cont………………
 Diarrhoea is also classified by physicians into
acute, which lasts one to two weeks, and
chronic, which continues for longer than 23
weeks.
 Viral and bacterial infections are the most
common causes of acute diarrhoea, such as
cholera and dysentery.
 Cont………..
 Endemic diseases:
 Diseases that are prevalent in or peculiar to a
particular locality, region, or people
 Cont…………….
 Epidemic:
 The occurrence of cases of a particular disease in
excess of the expected. (Therefore, demanding
that emergency control measures be
implemented.)
 Vaccine-preventable diseases:

 Diseases such as measles, malaria and meningitis

are able to be prevented through vaccinations
 Emergency Health Services in
Disasters
 During the first few days following a disaster,
the priority is usually to treat casualties and the
sick or injured
 Cont……………
 Disasters like earthquakes often involve the
management of mass casualties which normally
requires the following activities:
 Search, rescue and first aid;
 Transport of health facilities and treatment;
 Triage;
 Tagging; and
 redistribution of patients between hospitals
when necessary.
 Cont…………
 The demand for curative care is highest during
the acute emergency stage, when the affected
population is most vulnerable to their new
environment and before basic public health
measures (e.g., water, sanitation and shelter)
have been implemented.
 Cont………..
 Thereafter, the priority should shift toward
preventive measures, which can dramatically
improve the overall health of the affected
population..
 Cont……………
 Otherwise, any prolonged interruption in
routine immunisations and other disease-
control measures may result in serious
outbreaks of measles, cholera etc
 Cont…………..
 Disasters call for a co-ordinated response
between curative and preventive health
services, including food supply, water and
sanitation, etc.
 Cont…………….
 In order to minimise mortality and morbidity it
is also necessary to organize the relief
response according to three levels of
preventive health measures;
 namely primary prevention,

 secondary prevention and

 tertiary prevention
 Infrastructure and procedures in
accessing emergency situations
 Managing a Mass Casualty Incident (MCI)
 A mass casualty incident (MCI) is any event
producing a large number of victims such
that the normal capacity of local health
services is disrupted.
 Common causes of an MCI include floods,
fires, explosions, industrial accidents, or
conflict situations.
 Cont…………..
 The response may be delayed after a MCI due
to poor communication.
 Valuable resources at the disaster site are used
up in attempts to save the most gravely injured
victims who cannot survive, while those who
are more likely to survive receive little
attention.
 Cont………..
 Inadequate transportation may decrease the
survival of victims in critical condition.
 Cont………….
 The following patients will frequently reach
the health facility first
 those nearest to the arriving ambulances;

 those who are first to be rescued; and

 those who are the most gravely injured.

 Cont………..
 If there is only one first referral health facility,
it may quickly become overwhelmed.
 Limited resources are used to care for victims
arriving first, even though most of them may
have minor injuries.
 Cont……………
 As a result, they tie up the personnel,
examining rooms, supplies, etc. increasing the
risk of death for critically ill victims whose
survival depends on receiving prompt medical
attention.
 Triage
 Triage is defined simply as sorting and
prioritising patients for medical attention
according to the degree of injury or illness and
expectations for survival.
 Cont…………..
 Triage is carried out to reduce the burden on
health facilities
 it is normally done by the most experienced
health worker assisted by competent staff on
the triage team.
 Triage is a continuous process that begins
when patients arrive at the medical post and
continues as their condition evolves until they
are evacuated to the hospital
 Cont………..

 The goal of managing a mass casualty incident is to

minimise the loss of life or disability of disaster
victims by first meeting the needs of those most likely
to benefit from services.
 This goal can be achieved by setting the following
priorities for triage:
 Priority for transportation to the hospital is based upon
referrals of priority needs of patients.
 Priorities for care in the field are often identified by
visible colour-coded tags that categorise patient needs.
 Cont…………….
 Countries with limited resources should focus
on the following:
 improving routine emergency services for
sudden-impact, small-scale incidents (e.g., car
accidents or accidents in the home). To avoid
confusion, the same procedures that are
necessary to save lives during an MCI should
be performed as routine emergency services;
 Cont………..
 co-ordinating activities that involve more than
an emergency medical unit (police, fire
fighters, ambulances, hospitals, etc.); and
 Cont……….
 ensuring a quick transition from routine
emergency services to mass casualty
management establishing standard procedures
for managing all incidents (small or large
scale) — search and rescue, first aid, triage,
transfer to hospital and hospital care
 A possible organisation of MCI
management centre is illustrated in the
following figure: