Disaster Nursing

Christina Barrick

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 Objectives
• Describe examples of natural and manmade
disasters. attack.
• Describe the different phases of a disaster.
• Discuss the nurse’s role in managing the disaster
victim.
• Compare the reactions of children and the elderly.
• Discuss the role of the nurse in primary, secondary,
and tertiary care.
• Apply principles of triage to select situations.
• Describe the principles of disaster management.
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What is a Disaster?

• Forces overwhelm a community.

• Services are compromised.
• Outside assistance is required.

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 Characteristics of Disaster Agents

• Predictability
• Frequency
• Controllability/Mitigation
• Time: speed, duration
• Scope
• Intensity
• Community Implications
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Manmade Disasters: Terrorism
• D.O.D estimates that as many as 26
nations possess chemical or biological
agents.
• 10 countries are believed to possess
biological agents as weapons
• Attack can take many forms
• Aerosolized agents
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Nuclear Attack

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Nuclear and Radiological Attack

• “Dirty Bomb”
• Appeal to terrorists
• Availability

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Natural Disaster: Tsunami

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Phases of a Disaster

• Pre-disaster
• Warning
• Impact
• Emergency
• isolation
• rescue
• remedy
• Recovery
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Immediate Physical Management of the
Disaster Victim

• Validate what you hear

• Perform a thorough assessment
• Assess for other injuries/illnesses
even when symptoms are absent
• Is the condition life-threatening
• What is past medical history?
• Do not ignore patient fears or
complaints
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Management of the Psychosocial Aspects of
a Disaster Victim

• Pre-disaster Preparations and Warning

Phase
• reactions: apathy to panic
• interventions: mock drills, leadership
• important goal
• interventions: mental health services

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Management of the Psychosocial Aspects of
a Disaster Victim

• Impact and Emergency Phase

• reaction: “disaster syndrome”
• Interventions: prevent isolation, rumor control

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Management of the Psychosocial
Aspects of a Disaster Victim
• Recovery Phase
• reaction
• interventions

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Reactions of Children to a Disaster

• Developments level
• Family’s reactions
• Separation anxiety
• School refusals
• Enuresis
• Guilt

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Reactions of Children to a Disaster

• Interventions
• Research
• www.fema.gov/kids

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Elderly Reactions

• Generally cope better

• Prob. related to chronic illness/resources
• Fear loss of independence
• Interventions
• assistance with clean up
• financial, legal, and tax info.
• refer to a support team
• refer to appropriate comm. agencies

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Caregivers Reactions

• Same as Victim
• Role Strain
• Concerns over Personal Safety & Family
• Possessiveness towards victims
• Nurse - parent identification with
pediatric victims
• Interventions
• clear disaster plans & disaster exercises

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Criteria for Post Traumatic Stress Disorder

• The trauma is universally recognized

• Re-experience the trauma
• Demonstrate either emotional numbing
or decrease in normal events

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Three Tier Triage System

• First Priority
• Second Priority
• Third Priority

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Three Tier Triage System

• Special Cases:
• pregnancies
• injured disaster personnel
• family of rescue worker
• agitated of violent patients

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Role of the Nurse at the Disaster Site

• Insure safety
• First Aid
• Emergency care

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Role of the Nurse in a Shelter

• Objective: temporary means of caring

• Assessment
• Planing:
• 24/7 nursing and ancillary coverage
• Supplies
• Implementation
• Evaluation

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Role of the CHN in a Community Setting
After a Disaster

• Goal: Achieve the best possible level of

health for persons in a community after a
disaster
• Primary Prevention
• Secondary Prevention
• Tertiary Prevention

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Prevention Levels in Disaster Management

• Primary Prevention
• Secondary Prevention
• Tertiary Prevention

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Principles of Disaster Management

• Prevent the disaster

• Minimize casualties
• Prevent further casualties
• Rescue the victims
• First aid
• Evacuate
• Medical care
• Reconstruction
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