DISASTER MANAGEMENT

PLAN, RESOURCES, DRILL

MS. V. SHRIVIKA
MSC [N] II YEAR
 INTRODUCTION
Disaster is an occurrence arising with little
or no warning, which causes serious
disruption of life and perhaps death or
injury to large number of people. It is any
man made or natural event that causes
destruction and devastation which cannot
be relieved without assistance.
 TERMINOLOGIES
 Disaster – Any occurrence that causes damage ,
ecological disruption , loss of human life or deterioration
of health and health services on a scale sufficient to
warrant an extra-ordinary response from outside the
affected community or area.
 Preparedness – The pre-disaster stage in which
individuals and communities plan for and co-ordinate
their response efforts.
 Recovery – The stage of disaster when all involved
agencies and individuals pull together to restore
economic and civic life of a community.
 Response – Responsibilities assumed & activities that
occur as a result of a specific level of disaster.
 Mitigation – Actions or measures that can either prevent
the occurrence of a disaster or measures that can
reduce the severity if its effects.

 Bio-terrorism – Utilization of biological agents to cause

disease in a community.

 Casualty- A person affected in a disaster , who is in

need of emergency care.

 Triage – Deciding which victim needs immediate medical

care.
 MEANING
• It means a catastrophe, mishap, calamity or
grave occurrence, in any area, arising from
natural or man made causes or by accident or
negligence which results in substantial loss of
life or human suffering or damage to, and
destruction of property, or damage to, or
degradation of environment, and is of such a
nature of magnitude as to beyond the coping
capacity of community o affected area.
 DEFINITION

A disaster is an occurrence such as hurricane,

tornado, storm, flood, high water, wind-driven water,
tidal wave, earthquake, drought, blizzard,
pestilence, famine, fire, explosion, volcanic eruption,
building collapse, transportation wreck, or other
situation that causes human suffering or creates
human needs that the victims cannot alleviate
without assistance
- AMERICAN RED CROSS
• Any occurrence that causes damage, economic
disruption, loss of human life and deterioration in
health and health services on a scale sufficient
to warrant an extraordinary response from
outside the affected community or area
•
- WHO
Disaster Nursing– involves response to (and
preparedness for) natural or man-made events
that affect an entire community or communities.
(Usually) involve massive numbers of casualties
and extensive property damage.
• DISASTER’ alphabetically means:
D - Destructions
I - Incidents
S - Sufferings
A - Administrative, Financial Failures.
S - Sentiments
T - Tragedies
E - Eruption of Communicable diseases.
R - Research programme and its
implementation
• THE GLOBAL SCENARIO
Impact of natural disaster in the last 30 years.
Ø Death of 3 million people
Ø Economic loss increased due to disaster like flood
Ø In Indian scenario, 34jmijlion people affected per year
and 5116 death per year.
Ø In US, economic loss is 400 million dollar and 3 million
people died.
TYPES OF DISASTER

NATURAL

MAN MADE
 NATURAL DISASTER
Natural disaster is the effect of a natural hazard (e.g.
flood, tornado, hurricane, volcanic eruption,
earthquake, or landslide) that affects the
environment, and leads to financial, environmental
and/or human losses
Eg :
Earthquake Snow storms
Cyclones Ideal waves
Floods Severe air pollution
Tidal waves Heat waves
Land slides Famines
Volcanic eruption Epidemics
Fires Building collapse
Hurricanes Nuclear accident
Warfare
 MAN MADE
 Wars.
 Transportation accidents.
 Structural collapse.
 Explosions , bombing.
 Fires.
 Toxic chemical leak.
 Pollution.
 Civil unrest.
 Dam failures.
 Bioterrorism.
 TYPE OF DISASTER IN INDIA
• FLOOD AND DRAINAGE MANAGEMENT
• - Cyclones, tornadoes, hurricanes
• - heat, cold waves, snow avalanches, drought, thunder
lightening

• GEOLOGICALLY- RELATED DISASTER

• - Earthquakes, landslides & mud flow
• - dam failures, mine fires

• BIOLOGICALLY RELATED DISASTER

• - Biological disasters & Epidemics
• - pest attacks, cattle epidemics, food poisoning
• CHEMICAL, INDUSTRIAL & NUCLEAR RELATED
• Chemical, industrial disasters, nuclear disaster.

• ACCIDENT RELATED DISASTER

• Forest fire, urban fire, oil spill, village fire, electrical
disaster, air, road, rail accidents.
 EARTH QUAKE
An earthquake (also known as a quake, tremor, temblor
or seismic activity) is the result of a sudden release of
energy in the Earth's crust that creates seismic waves.

Earthquakes are measured with a seismometer; a device

which also records is known as a seismograph
Developed in 1935 by Charles Richter in partnership with
Beno Gutenberg, both of the California Institute of
Technology,
• EARTHQUAKES
What to do beforehand

- Build in accordance with urban planning regulations for

risk areas.
- Ensure that all electrical and gas appliances in houses,
together with all pipes connected to them, are firmly
fixed.
- Avoid storing heavy objects and materials in high
positions.
- Hold family evacuation drills and ensure that the whole
family knows what to do in case of an earthquake.
- Prepare a family emergency kit.
• During an earthquake
- Keep calm, do no panic.
- People who are indoors should stay there but move to the
central part of the building.
- Keep away from the stairs, which might collapse suddenly.
- People who are outside should stay there, keeping away
from buildings to avoid collapsing walls and away from
electric cables.
- Anyone in a vehicle should park it, keeping away from
bridges and buildings.
• After an earthquake
- Obey the authorities instructions.
- Do not go back into damaged buildings since tremors may start
again at any moment.
- Give first aid to the injured and alen the emergency services in
case of fire, burst pipes, etc.
- Do not go simply to look at the stricken areas: this will hamper
rescue work.
- Keep emergency packages and a radio near at hand.
- Make sure that water is safe to drink and food stored at home is
fit to eat (in case of electricity cuts affecting refrigerators and
freezers).
 CYCLONES

Cyclones are huge revolving storms caused by winds

blowing around a central area of low atmospheric
pressure. In the northern hemisphere, cyclones are
called hurricanes or typhoons and their winds blow in an
anti-clockwise circle. In the southern hemisphere, these
tropical storms are known as cyclones, whose winds
blow in a clockwise circle
CYCLONE
4.2.1 Indian Meteorological Department (IMD) has a developed
detailed procedure for Four Stage Warning of Cyclone
1. Pre-Cyclone Watch
Pre-cyclone watch is an early warning issued about 72 hrs. in
advance of the commencement of bad weather. This is issued
by the IMD HQrs. to all designated authorities including the
Cabinet Secretary and other senior officers of Govt. of India
and the Chief Secretaries of concerned Maritime States, media
and all Cyclone Warning Centres (CWS) of IMD.
2. Cyclone Alert
Cyclone Alert is issued to all designated authorities/Agencies
as far as possible, 48 hours before the expected
commencement of adverse weather.
3. Cyclone Warning
Cyclone warning are issued to all designated
Authorities/Agencies including the Chief Secretaries of the
maritime States and the District Magistrates/Collectors of the
coastal districts and the immediate interior districts expected to
be affected by the cyclone.
Cyclone Warning is also issued to the designated railway
officials and defence personnel.
After initial warning , cyclone warning are issued to above
officials twice a day by high priority telegrams based on 0830
IST and 1730 IST charts till the weather improves.

4. Post Landfall Outlook

Post landfall outlook is issued at least 12 hours in advance of
the landfall by concerned CWCs. On the basis of this outlook,
the concerned Meteorological Centre will also issue cyclone
warnings for the interior areas.
Cyclone Warning Dissemination System (CWDS)
4.2.2 250 Cyclone Warning Dissemination System (CWDS)
receivers have been established in vulnerable coastal areas
using INSAT/METSAT. The system is being used extensively
on operational basis during cyclone.
The cyclone warning message is originated from Advanced
Cyclone Warning Centres (ACWC) Chennai, Kolkata and
Mumbai whenever a storm is observed. Warning messages
are received in local languages directly by CWDS receivers
located in areas likely to be affected by the cyclone.

4.2.3 In addition Cyclone Warning is disseminated through the

following means:
(i) Police Wireless
(ii) Warnings through All India Radio (AIR) Bulletins
(iii) Doordrashan News
(iv) Press Bulletins
(v) Aviation Warning
 FLOOD

A flood is an overflow of an expanse of water that

submerges land. The EU Floods directive defines a
flood as a temporary covering by water of land not
normally covered by water.
 FLOOD
•
What to do beforehand
While town planning is a government responsibility,
individuals should find out about risks in the area where
they live.
• For example, people who live in areas downstream from a
dam should know the special signals (such as foghorns)
used when a cam threatens to break. Small floods can be
foreseen by watching the water level after heavy rains and
regularly listening to the weather forecasts.
Forecasting of floods or tidal waves is very difficult, but
hurricanes and cyclones often occur at the same time of
year, when particular vigilance must be exercised. They are
often announced several hours or days before they arrive.
• During a flood
- Turn off the electricity to reduce the risk of electrocution.
- Protect people and property:
- as soon as the flood begins, take any vulnerable people
(children, the old, the sick, and the disabled) to an upper
floor;
•
- whenever possible, move personal belonging upstairs or
go to raised shelters provided for use in floods.
•
- Beware of water contamination - if the taste, colour, or
smell of the water is suspicious, it is vital to use some
means of purification.
•
- Evacuate danger zones as ordered by the local authorities
• After a flood

- wait until the water is declared safe before drinking any

that is untreated;
•
- clean and disinfect any room that has been flooded;
- sterilize or wash with boiling water all dishes and kitchen
utensils;
•
- get rid of any food that has been in or near the water,
including canned foods and any food kept in refrigerators
and freezers;
•
- get rid of all consumables (drinks, medicines, cosmetics,
etc.).
 TIDAL WAVES

A wave that moves up to 200 MPH and is up

to 1,000 feet high
 LANDSLIDE

A landslide or landslip is a geological

phenomenon which includes a wide range of
ground movement, such as rock falls, deep failure
of slopes and shallow debris flows, which can
occur in offshore, coastal and onshore
environments
LANDSLIDE
4.5.1 Geological Survey of India issues alerts and warnings to
all designated authorities and agencies of the Central
Government and State Governments/ district Administration
for landslides in the following categories.

Category IV: Landslides of small dimensions that occur away

from habitations and do not affect either humans or
their possessions.

Category III: Landslides which are fairly large and affect

infrastructural installations like strategic and important
highways and roads, rail routes and other civil installations
like various appurtenant structures of hydroelectric and
irrigation projects.
Category II: The landslides that may occur on the fringes of
inhabited areas and result in limited loss of life and
property.

Category I: Landslides of large dimensions that are located

over or in close vicinity of inhabited areas like urban
settlements or fairly large rural settlements. Activity on these
slides can result in loss of human lives, dwellings on large
scale.
 VOLCANO

A volcano is an opening, or rupture, in a planet's

surface or crust, which allows hot magma, ash and
gases to escape from below the surface. The word
volcano is derived from the name of Vulcano island
off Sicily which in turn, was named after Vulcan, the
Roman god of fire.[1]
 HURRICANE

Hurricane is a powerful, spiraling storm that begins

over a warm sea, near the equator. When a hurricane
hits land, it can do great damage through its fierce
winds, torrential rains, inland flooding, and huge
waves crashing ashore.

A powerful hurricane can kill more people and destroy

more property than any other natural disaster.
• STORMS, HURRICANES AND TORNADOES
What to do beforehand

- choose a shelter in advance, before the emergency

occurs - a cellar, a basement, or an alcove may be
perfectly suitable;
•
- minimize the effects of the storm - fell dead trees,
prune tree branches, regularly check the state of roofs,
the state of the ground, and the drainage around houses
• ;
- take measures against flooding;
•
- prepare a family emergency kit.
• During an emergency
- Listen to the information and advice provided by the
authorities.
- Do not go out in a car or a boat once the storm has
been announced.
- Evacuate houses if the authorities request this, taking
the family emergency package.
•
- If possible, tie down any object liable to be blown away
by the wind;
- If caught outside in a storm, take refuge as quickly as
possible in a shelter; if there is no shelter, lie down flat in
a ditch.
•
- In a thunderstorm keep away from doors, windows, and
electrical conductors, unplug electrical appliances and
television aerials. Do not use any electrical appliances
- Anyone who is outside should:
- look for shelter in a building (never under a tree);
- if out in a boat, get back to the shore;
- keep away from fences and electric cables;. .- -
kneel down rather than remain standing.
After an emergency
After the storm has subsided:
- follow the instructions given by the authorities;
- stay indoors and do not go to the stricken areas;
- give the alert as quickly as possible;
- give first aid to the injured;
- make sure the water is safe to drink and check the contents of
refrigerators and freezers;
- check the exterior of dwellings and call for assistance if there
is a risk of falling objects (tiles, guttering, etc.).
 SNOWSTORM

A storm with widespread snowfall accompanied

by strong winds
AVALANCHE
AVALANCHES
4.6.1 Snow and Avalanche Study Establishment (SASE) of
the Defence Research and Development Organisation
(DRDO) Chandigarh is responsible for issuing alerts and
warnings to all designated authorities and agencies of
the Central Government and State Governments/ district
Administration for avalanches in the following category:

Low: Generally favourable condition. Triggering is possible

only with high additional loads and on very few extreme
slopes. Valley movement is safe. Movement on slopes with
care.
Medium: Partly unfavourable condition. Triggering is possible
on most avalanche prone slopes with low additional loads
and may reach the valley in medium size. Movement on
slopes with extreme care. Valley movements with caution.
Avoid steep slopes. Routes should be selected with care.
High: Unfavorable condition. Triggering possible from
all avalanche prone slopes even with low additional
loads and reach the valley in large size. Suspend all
movement.
Airborne avalanches likely.

All Round: Very unfavorable condition. Numerous large

avalanches are likely from all possible avalanche
slopes even on moderately steep terrain. Suspend all
movements.
Airborne avalanches likely.
 EPIDEMIC

Occurs when new cases of a certain disease, in a

given human population, and during a given
period, substantially exceed what is "expected,"
based on recent experience

(the number of new cases in the population

during a specified period of time is called the
"incidence rate").
 HEAT WAVES

Heat wave is a prolonged period of excessively hot

weather, which may be accompanied by high humidity.
SEVERE AIR POLLUTION
FAMINES
BUILDING COLLAPSE
TSUNAMI
TSUNAMI
4.3.1 In the aftermath of the Indian Ocean Tsunami of 26
December 2004, the Ministry of Earth Sciences has set up
an Indian Tsunami Early Warning Center at the Indian
National Centre for Ocean Information Services (INCOIS)
Hyderabad.
The Center is mandated to provide advance warnings on
Tsunamis likely to affect the coastal areas of the country.
INCOIS has developed a detailed protocol for issuing
Tsunami Watch, Alerts and Warnings.

Earthquake Information Bulletin contains information about

origin time, latitude and longitude of the epicenter, name of
geographical area, magnitude and depth of an earthquake.
This message also contains preliminary evaluation of
tsunami potential based on the magnitude. No immediate
action is required.
Tsunami Warning (RED) contains information about the
earthquake and a tsunami evaluation message indicating that
tsunami is expected.
This is the highest level wherein immediate actions are
required to move public to higher grounds. Message also
contains information on the travel times and tsunami grade
(based on run-up estimates) at various coastal locations.

Tsunami Alert (ORANGE) contains information about the

earthquake and a tsunami evaluation message indicating that
tsunami is expected. This is the second highest level wherein
immediate public evacuation is not required.
Public should avoid beaches since strong current are
expected. Local officials should be prepared for evacuation if it
is upgraded to warning status. Message also contains
information on the travel times and tsunami grade at various
coastal locations
Tsunami Watch (YELLOW) contains information about the
earthquake and a tsunami evaluation message indicating that
tsunami is expected. This is the third highest level wherein
immediate public evacuation is not required, Local officials
should be prepared for evacuation if it is upgraded to warning
status. Message also contains information on the travel times
and tsunami grade at various coastal locations.

Tsunami cancellation (GREEN) will be issued if the tsunami

warning was issued on the basis of erroneous data or if the
warning center determines from subsequent information that
only an insignificant wave has been generated. In addition,
tsunami warning may be cancelled on a selective basis when a
significant wave that has been generated clearly poses no threat
to one or more of the areas the warning center warns, either
because of intervening continents or islands which screen them
or because the orientation of the generating area causes the
tsunami to be directed away from these areas.
Tsunami All Clear (GREEN) bulletin indicates
that the ‘Tsunami Threat’ is passed and no
more dangerous waves are expected.
WARS
ACCIDENTS
NUCLEAR WARFARE
TERRORISM
TOXIC FUMES
• CLOUDS OF TOXIC FUMES
What to do beforehand
People in a risk area should:
- find out about evacuation plans and facilities;
- familiarize themselves with the alarm signals used in
case of emergency;
- equip doors and windows with the tightest possible
fastenings;
- prepare family emergency kits.
• During an emergency
- Do not use the telephone; leave lines free for rescue
services.
- Listen to the messages given by radio and other media.
- Carry out the instructions transmitted by radio or
loudspeaker.
- Close doors and windows.
- Stop up air intakes.
- Seal any cracks or gaps around windows and doors with
adhesive tape.
- Organize a reserve of water (by filling wash basins, baths,
etc.).
- Turn off ventilators and air conditioners.

After an emergency
- Comply with the authorities' instructions and do not go out
until there is no longer any risk.
- Carry out necessary decontamination measures.
 MINISTRY RESPONSIBLE FOR
VARIOUS CATEGORIES OF DISASTER
• Natural disaster mgt – MINISTRY OF HOME AFFAIRS
Drought & Drought relief – MINISTRY OF AGRICULTURE
• Air accidents – MINISTRY OF AVIATION
• Railways accident – MINISTRY OF RAILWAYS
• Chemical disasters – MINISRTY OF ENVIRONMENT &
• FORESTS
• Biological disaster – MINISTRY OF HEALTH
• Nuclear disasters – DEPARTMENT OF ATOMIC

ENERGY
 What to assess

• Total population affected

• Number of displaced
• Number of deaths
• Number of houses damaged
• Number of temporary camps and their
location
• Number of persons hospitalized
 GENERAL EFFECTS OF DISASTER
• - loss of life
• - injury
• - damage of property
• - damage of cash
• - loss of livelihood
• - disruption of lifestyle
• - disruption of essential services
• - loss / disruption of infrastructure
• - National / State economic loss
• - sociological / psychological after effects.
 COMMON RXN TO DISASTER
 Adults:
 Extreme sense of urgency.
 Panic & fear.
 Disbelief.
 Disorientation & numbing.
 Reluctance to abandon property.
 Difficulty in making decisions.
 Anger and blaming.
 Delayed reactions.
 Insomnia.
 Apathy & depression.
 Irritable.

 Children:
◦ Regressive behaviors.
◦ Fantasies that disasters have never occurred.
◦ Nightmares.
◦ School-related problems.
 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 involves a massive level of damage with
severe impact.
 PHASES OF A DISASTER
• Pre impact phase:
• Initial phase prior to occurrence.
• Sometimes warning is given by the government.
• Impact phase:
• When disaster actually occurs.
• Hardship & injury occur.
• Individuals help neighbors and families at the scene.
• Post impact phase:
• Begins with emergency till the return to the normal
community functioning.
 Heroic phase:
 At the time of disaster.
 People work together with excitement.
 Honeymoon phase:
 Short period when the victims are completely supported by
external agencies.
 Optimism is high and plans are made.
 Disillusionment phase:
 Unexpected delays & failures.
 Frustration & confusion.
 Victims function individually.
 Reconstruction phase:
 Lasts for years.
 Co-ordinated individual community effort to rebuild the
community.
 Environmental health problems are solved.
 AGENCIES INVOLVED
 United nations office for coordination of
humanitarian affairs.{OCHA}.
 World health organization.
 UNICEF.
 World food program {WFP}.
 Food & agriculture organisation {FAO}.
 European community humanitarian office {ECHO}.
 International committee of the red cross {ICRC}.
 International council of voluntary agencies.
 International federation of the red cross and red
crescent {IFRC}.
STAGES OF DISASTER MANAGEMENT

PREVENTION

PREPAREDNESS

RESPONSE

RECOVERY
 PREVENTION LEVELS IN
DISASTER
• Primary prevention:
• Participate in developing a disaster plan for the
community.
• Secondary prevention:
• Assess the disaster victims and triage for care.
• Tertiary prevention:
– Participate in home visits to uncover dangers that
may cause additional injuries or cause other
problems.
 PREVENTION STAGE

The task during this phase is to identify community risk

factors and to develop and implement programs to
prevent disasters from occurring.

Programs developed during this phase may also focus

on strategies to mitigate the effects of disaster that
cannot be prevented such as earth quakes, cyclones etc.

Task force includes are local and national government,

social service providers, police & fire department, major
industries, local medias etc.
EARLY WARNING
Nodal Agencies for Early Warning
4.1.1 Following are the Nodal agencies in the Government of India
mandated for early warning of different natural hazards:
Disasters Agencies
Cyclone Indian Meteorological Department
Tsunami Indian National Centre for Oceanic Information Services
Floods Central Water Commission
Landslides Geological Survey of India
Avalanches Snow and Avalanche Study Establishment
Heat & Cold Waves Indian Meteorological Department

4.1.2 These agencies shall be responsible for keeping track of

developments in respect of specific hazards assigned to them and inform
the designated authorities/agencies at National, State and District levels
about the impending disasters. All these agencies have developed
guidelines for early warning of disasters.
 PREPAREDNESS

PERSONAL PROFESSIONAL COMMUNITY

PERSONAL PREPAREDNESS:

Health care professionals with client responsibilities can

also become disaster victims. Conflicts arise between
client related and work related responsibilities. Personal
and family preparation can help to ease of some of the
conflicts.
 PERSONAL PREPAREDNESS

• STEP ONE: Get A Kit

• STEP TWO: Make a Plan

• STEP THREE: Be Informed

• STEP ONE: Get A Kit
• At a minimum, have the basic supplies listed below.
• Keep supplies in an easy-to-carry emergency preparedness
kit that you can use at home or take with you in case you
must evacuate.
• Water—one gallon per person, per day (3-day supply for
evacuation, 2-week supply for home)
• Food—non-perishable, easy-to-prepare items (3-day supply
for evacuation, 2-week supply for home)
• Flashlight
• Battery-powered or hand-crank radio (NOAA Weather
Radio, if possible)
• Extra batteries
• First aid kit
• Medications (7-day supply) and medical items
• Multipurpose tool
• Sanitation and personal hygiene items
• Copies of personal documents (medication list and
pertinent medical information, proof of address, deed/lease
to home, passports, birth certificates, insurance policies)
• Cell phone with chargers
• Family and emergency contact information
• Extra cash
• Emergency blanket
• Map(s) of the area
• Consider the needs of all family members and add
supplies to your kit.
• Suggested items to help meet additional needs are:
• Medical supplies (hearing aids with extra batteries,
glasses, contact lenses, syringes, cane)
• Baby supplies (bottles, formula, baby food, diapers)
• Games and activities for children
• Pet supplies (collar, leash, ID, food, carrier, bowl)
• Two-way radios
• Extra set of car keys and house keys
• Manual can opener
• Additional supplies to keep at home or in your kit based
on the types of disasters common to your area:
• Whistle
• N95 or surgical masks
• Matches
• Rain gear
• Towels
• Work gloves
• Tools/supplies for securing your home
• Extra clothing, hat and sturdy shoes
• Plastic sheeting
• Duct tape
• Scissors
• Household liquid bleach
• Entertainment items
• Blankets or sleeping bags
• STEP TWO: Make a Plan
• Meet with your family or household members.
• Discuss how to prepare and respond to emergencies
that are most likely to happen where you live, learn, work
and play.
• Identify responsibilities for each member of your
household and plan to work together as a team.
• If a family member is in the military, plan how you would
respond if they were deployed.
• Plan what to do in case you are separated during an
emergency.
• Choose two places to meet:
• Right outside your home in case of a sudden emergency,
such as a fire Outside your neighborhood, in case you
cannot return home or are asked to evacuate
• Choose an out-of-area emergency contact person. It may
be easier to text or call long distance if local phone lines
are overloaded or out of service.
• Everyone should have emergency contact information in
writing or programmed into their cell phones.
• Plan what to do if you have to evacuate.
• Decide where you would go and what route you would
take to get there. You may choose to go to a hotel/motel,
stay with friends or relatives in a safe location or go to an
evacuation shelter if necessary.
• Practice evacuating your home twice a year. Drive your
planned evacuation route and plot alternate routes on
your map in case roads are impassable.
• Plan ahead for your pets. Keep a phone list of pet-
friendly hotels/motels and animal shelters that are along
your evacuation routes.
• Plan for pandemic influenza:
• During a flu pandemic you may be asked to stay home
for an extended period of time, even if you are not sick.
Schools and workplaces may close, and public
gatherings such as sporting events or worship services
may close temporarily. Mass transportation such as
subways, buses, trains and air travel may be limited.
You, your family and friends may need to rely on each
other when you cannot depend on the services you
normally use.
• Plan ahead of time by:
• Talking with family members and loved ones about how
they would be cared for if they got sick.
• Finding out your employer's plans to keep the business
open if key staff can't come to work.
• Asking your child's school or day care if there are plans
to encourage children who are sick to stay home to
reduce the spread of the disease.
• Identifying how you can get information, whether through
local radio, TV, Internet or other sources. Click here for
more information on how to prepare for a flu pandemic
• STEP THREE: Be Informed
• Learn what disasters or emergencies may occur in
your area.
• These events can range from those affecting only you
and your family, like a home fire or medical emergency,
to those affecting your entire community, like an
earthquake or flood.
• Identify how local authorities will notify you during a
disaster and how you will get information, whether
through local radio, TV or NOAA Weather Radio stations
or channels. Know the difference between different
weather alerts such as watches and warnings and what
actions to take in each.
• Know what actions to take to protect yourself during
disasters that may occur in areas where you travel or
have moved recently. For example, if you travel to a
place where earthquakes are common and you are not
familiar with them, make sure you know what to do to
protect yourself should one occur.
• When a major disaster occurs, your community can
change in an instant. Loved ones may be hurt and
emergency response is likely to be delayed. Make sure
that at least one member of your household is trained in
first aid and CPR and knows how to use an automated
external defibrillator (AED). This training is useful in
many emergency situations.
• Share what you have learned with your family,
household and neighbors and encourage them to be
informed.
• Emergency Contact Cards for All Household
Members
• Get your Emergency Contact Cards online here.
• Print one card for each family member.
• Write the contact information for each household
member, such as work, school and cell phone numbers.
• Fold the card so it fits in your pocket, wallet or purse.
• Carry the card with you so it is available in the event of a
disaster or other emergency.
•  
PROFESSIONAL PREPAREDNESS :

Professional preparedness requires that health

care professionals become aware of and
understand the disaster plans at their work place
and community. Adequately prepared
professionals can function as leaders in the
disaster management areas.

Personal items that are recommended for a

professional to keep for the disaster
management are- copy of professional license,
personal equipments such as stethoscope, flash
light and extra batteries, cellular phone, warm
clothing or heavy jackets, protective shoes,
pocket sized reference
 PROFESSIONAL PREPAREDNESS

• Nurses should understand and be aware

of the disaster plans in their workplace and
community.
• Involve with interest & participate in mock
drills.
• Well prepared nurses can lead during
disasters.
• Keep personal items prepared.
• Train yourself in first aid & CPR.
• Register in a relief organization.
KEY ORGANIZATION AND PROFESSIONAL IN
DISASTER MANAGEMENT
Health care community-
  hospitals
 Mental health professionals
 Pharmacies
 Public health departments
 Rescue personnel
Non health care community
 Clergy
 Fire fighters
 Municipal or government officials
 Media
 Medical examiners
 Medical supply manufactures
 Police
 COMMUNITY PREPAREDNESS
• Communities should have written disaster
plans applicable to their location.
• All the members should be aware of it.
• Conduct annual mock drills.
• The government also provides this.
• Nurses can work together with the
community and be prepared.
 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, such as holding community

meetings on disaster preparedness

Disaster prevention-such as building a retaining wall

to prevent flood water from the residences

Advocacy such as supporting actions and efforts for

effective building codes or proper land use.
DISASTER MANAGEMENT PLANS

Although no disaster management plans can

be made to fit every emergency but protocols
and chronological action plans to prove to deal
emergency situation efficiently if executed in
coordinated manner.
AIMS OF DISASTER PLANS
To provide prompt and effective medical care to the
maximum possible in order to minimize morbidity and
mortality

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
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
Disaster worker rehabilitation
CONSTITUTION OF 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)
Head of departments- surgery, medicine, orthopedics,
radiology, anesthesiology, neurosurgery
Blood bank in charge
Security officers
Dietitian
Transport officer
Sanitary personnel
The disaster management committee is overall
responsible for managing the disaster situation, take
administrative decisions, review the disaster plans
and inform authorities
National Disaster Mitigation Resource Centres (NDMRCs)

3.2.4 The NDMRCs will be co-located with the NDRF

battalions. These will also serve as repositories for
NDMR bricks of relief stores for thedisaster affected
people, in each of the eight NDRF locations. These will
cater to the emergent requirements especially for the
first 72-96 hours.
These stores will supplement the reserves maintained by
the respective states/UTs.
In addition, these centres will assist in running mock
drills and capacity development programmes. During
disasters, they will act as facilitators to the states/UTs in
deployment of central resources and provide much
needed additional link to the centre
TRAINING AND DRILLS

Mock exercise and drills at regular intervals to ensure

that all the staff in the general and those associated
with management of causalities are fully prepared
and aware of their responsibilities. 
 MOCK DRILLS
They are conducted in a desktop manner or in realistic
scenarios. The objectives are to:
 Promote confidence.
 Develop skills.
 Co-ordinate activities.
 Co-ordinate the participants.

The drill leader needs special skills in

disaster management and the ability to co-ordinate the
activities. The participants can evaluate the rescue
plan and make further recommendations.
Training and Equipping of SDRF
Each SAR Team will be trained for search, rescue and
evacuation in collapsed structure and medical first
response. Some units of the select SAR Teams will also be
trained and equipped for deep-water rescue, slithering
and industrial accidents. The Teams will also have dog
squads and appropriate measures will be taken for
procurement and training of dogs and dog handlers.

3.2.9 Besides the SAR Teams, the Police/ Armed

Police/Forest Protection Force will also be imparted
general training in search and rescue at the time of
induction and as a part of refresher training. This will
cover gazetted officers, subordinate officers and other
ranks.
State Disaster Mitigation Resource Centres
(SDRMCs)

State Government shall also set up Resource Centres

based on their requirements to pre-position essential
supplies.

The States shall be responsible to constantly evaluate

their own capabilities to handle that situation and
project the anticipated requirements for the central
resources well in time.

Memorandum of Understanding may be entered into by

the neighboring States for assisting each other during
natural calamity. Inter-State assistance and cooperation
shall be encouraged.
FIRE & EMERGENCY SERVICES
3.3.1 The Fire Services in the States/ UTs will be
strengthened and will be made multi-hazard response
units. These will be appropriately equipped depending
upon their location and area of operation.

ARMED FORCES
3.4.3 Establishment of NDRF should progressively reduce
deployment of the Armed Forces. Armed Forces would be
deployed only when the situation is beyond the coping
capacity of State Government and NDRF.
CIVIL DEFENCE
3.4.1 Civil Defence volunteers will be enrolled
for voluntary services in accordance with the
provisions of the Civil Defence Act.

The services of CD volunteers should be

utilized during response to natural disasters
.
3.4.2 Civil Defence training institutions at the
National and State levels will be set
up/upgraded to cater to the training of Civil
Defence volunteers in relevant areas of
disaster response
MEDICAL PREPAREDNESS
3.8.1 The State Governments will identify the hospitals,
team of doctors and para-medics including mental health
and psycho-social service provider at sub-divisional and
district levels, who will be deployed at short notice.

Their names, addresses, telephone numbers, mobile

available to the district and State control rooms.

The list will be updated annually.

The stock of medicines, accessories and equipment for
each of identified teams at the district and sub-divisions
will be decided in advance as per needs
ANIMAL CARE
3.9.1 Animals both domestic as well as wild are exposed to
the effects of natural and man-made disasters.

It is necessary to devise appropriate measures to protect

animals and find means to shelter and feed them during
disasters and their aftermath, through a community effort, to
the extent possible.

It is pertinent to note that many communities have shown

compassion to animals during disasters, and these efforts
need to be formalized in the preparedness plans of the
Departments of Animal Husbandry at the Centre and the
States.
DISTRICT LEVEL PREPAREDNESS FOR RESPONSE
Vulnerability assessment
3.10.1 Each district will make its vulnerability assessment
and identify potential hazards. While making such
assessment, the risk involved and capacity to respond
will be taken into account.

3.10.2 The local community will be informed about their

vulnerability to potential hazard/disasters through the
representatives of Panchayati Raj Institutions/Local Self-
Government and NGOs
Contact Details
3.10.3 A comprehensive directory of officers involved in disaster
management at various levels will be prepared for National and State
levels giving their names, addresses, telephone numbers, mobile
numbers, email address, Fax numbers. Such directory will be widely
circulated and updated annually.

Review
3.10.4 Annual review of the preparedness measures will be done at the
National, State, District and sub-Divisional levels.

Annual review will ensure that all loose ends are tied up so that response
during natural disasters is efficient, effective and timely.
The review will also include prearrangements for essential commodities
required for response and relief and emergent basis.

3.10.5 The decentralization of authority is an important feature of good

management of natural disasters. As such, the States will also review in
their annual meeting, the present levels of delegation of powers to the
Relief Commissioners, Additional Relief Commissioners and District
Magistrates.
Mock Drills
3.10.6 Search and Rescue Teams at the National and State
Levels will carry out mock drills on various disasters situation
annually.

For floods and cyclones, these will be carried before the

monsoon and cyclone period, tentatively in March and
September for cyclones and June for floods. For
earthquakes, landslides etc., such drills can be done in the
month of March itself.

3.10.7 At the district and State levels, mock exercises will be

carried out for testing the effectiveness of all the preparedness
machinery including manpower and equipment
PREPAREDNESS

EMERGENCY OPERATIONS CENTRES (EOCS)

3.1.1 Emergency Operation Centres/Control rooms

will be set up at National, State and district levels
with requisite facilities. The EOCs/Control Rooms
already in existence at these levels will be suitably
upgraded.
Objectives of the Emergency Operations Centre
3.1.2 The EOCs/Control Rooms at National, State and District
levels will be the nerve centres for coordination and
management of disasters.
The objectives of the EOCs shall be to provide centralized
direction and control of any or all of the following functions:
• Receive and process disaster alerts and warnings from nodal
agencies and other sources and communicate the same to all
designated authorities.
• Monitor emergency operations
• Facilitate Coordination among primary and secondary ESF
Ministry/Departments/Agencies.
•Requisitioning additional resources during the disaster
phase
• Issuing disaster/incident specific information and
instructions specific to all concerned;
• Consolidation, analysis, and dissemination of damage,
loss and needs assessment data;
• Forwarding of consolidated reports to all designated
authorities.

Location of EOC
3.1.3 The EOC will be set up at a suitable location and the
building should be disaster resistant so as to withstand
the impact of disasters and remain functional during the
emergency phase.
National Integrated Operations Centre (NIOC)
3.1.6 The National Integrated Operations Center is being
maintained and run on 24 x 7 basis at MHA, North Block,
New Delhi with latest and state of
the art equipments.

SEOC and DEOC

3.1.8 State Governments and District Administration shall
set up State Emergency Operation Centre and District
Emergency Operation Centres and provide adequate
manpower for manning them on 24x7 basis round the year
and arrange training for the EOC Staff on EOC operations.
State Governments and District Administration shall
develop SOP/ Protocol for activation of SEOCs and DEOCs
during emergency/disasters
Requisitioning of NDRF Teams
3.2.3 Each NDRF Battalion/Team has been assigned
respective areas of responsibility in terms of States/UTs
and Districts.
The NDRF Battalion/Teams can be requisitioned by the
State Governments/ District Administration directly in
cases of rapid onset disasters where earlywarning/alerts
is not available and through the Director General, NDRF
andNDMA in cases where sufficient lead time is available.

The StateGovernments/ District Administration will

maintain close liaison with the NDRF Commanders
earmarked to the respective States/Districts for rapid
deployment in case of threatening disasters situation/
disasters.
Regional Response Centres (RRCs)

3.2.5 15 Regional Response Centres have been set up at

various strategic locations across the country by the
CPMFs. The RRCs are equipped with minimum Cache of
equipment to deal with floods, cyclone, earthquakes etc.
NDRF Teams can be prepositioned in these RRCs for
quick deployment when disaster is imminent. The State
Government at the time of need can requisition the
assistance from these RRCs.
 RESPONSE STAGE
The level of disaster varies and the management plans
mainly based on the severity or extent of the disaster.

Level III disaster- considered a minor disaster. The

disaster is classifies as one that involves a minimal
level of damage

Level II disaster- considered a moderate disaster that

is likely to result in major disaster. Mobilizations
of support system are necessary at this level.

Level I disaster- considered a massive disaster. This

disaster involves a massive damage to lives and
property.
 AT HOSPITAL LEVEL
Emergency medical service (EMS)

• Efficient EMS should have:

• Speedy transportation of the victim to the emergency
center
• pre-hospital therapy in the form of immediate first aid
and registration, starting from the site of accident
• Prompt and quick service
• Adequate physical facilities, equipment and stores.
• Alert well-trained and sympathetic staff who can render
immediate and appropriate life-saving
 
 SUBSIDIARY FUNCTION OF THE ACCIDENT
AND EMERGENCY DEPARTMENT :
• Collection of casualties

• Information center- to render advice on telephone or in

person for simple medical queries.

• Establish a reception in case of a disaster

• Liaison with police in medico-legal cases

• education training and research activities

•  
 planning and design consideration
• SPACE  
• As a rule of thumb, daily patient load of a hundred in
the casualty department requires a space of 1000 m2.
 
• LOCOMOTION
• Be located on the ground
• Have direct access from the main road (easy
accessibility for ambulance); and
• Have adequate space for the passage of vehicles and
covered area for patient at alight at the entrance
• readily accessible from the OT, x-ray department,
blood bank , laboratories, intensive-care and treatment
units, obstetric unit burn unit, medical records
department and morgue
•  
• 3.ENTRANCE
• Separate entrance for an ambulance with adequate space for
free passage of vehicles. The entrance should have ramps and
a two-way swinging door Separate arrangement for receiving
ambulant patient and those on trolleys
• 4.WAITING AREA
• A reception and information desk
• A comfortable and well furnished waiting area for the relatives
of patient
• Separate toilet for both the sexes
• A public telephone
• A place for keeping wheelchair and trolleys
• 5. triage station
• The triage station should be located where patient in both
critical
• And non-critical condition can be assessed prior to their entry
• Treatment area
• The treatment area should be designed with the right
combination of maximum observation and privacy in
mind. This can be done by arranging cubicle in full view
of the nurses’ station. The front curtain of the cubicle can
be left open in case of patients who require frequent
observation
•  
• 7. communication
• The emergency department should be well connected to
other department, intensive care centers, consultants
and senior doctors through telephones, intercoms
• Planning consideration of EMS
• Piped oxygen supply and suction apparatus
• Special attention should be paid to the lighting,
temperature and humidity control
• A back-up alternate power source should be available
• Doorways should be wide enough to accommodate
stretchers, trolley, portable x-ray machines, etc.
• Floor covering and wall colours should be selected to
provide a bright and functional atmosphere
 
• Equipment
• Centralized piped oxygen and suction supply
• Wall- mounted manometer
• Airways and resuscitation bags
• Portable defibrillators, ecg and monitoring oscilloscope
• Respiratory aids
• Special medications, intravenous equipment and fluids
• Sufficient bandages, drugs and plaster.
LOGISTIC SUPPORT SYSTEM

Separate cupboards marked as disaster shelf and should be kept in disaster control
rooms, equipped with all essential medicines and surgical supplies.
The disaster cupboard should contain-
#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

• Staffing
• Surgeon and medical specialist
• Anaesthesiologists (on call)
• Other doctors (house surgeons)
• Nursing staff including OT nurses
• x-ray technicians
• laboratory technicians
• ECG technicians
• Haematology technicians
• Nursing orderlies
• Drivers
• Sweepers
•  
• Disaster management
•   Principles of disaster management plan
• 1.the plan should be ‘simple’
• 2.the plan should be ‘flexible’
• 3. It should be ‘clear and concise’
• 4. ‘adequate’ for all hours, i.e. day and night including
holidays,
• 5. ‘extension of the normal hospital working’ so that
people can act on it immediately
•  
• Disaster management plan
• The disaster management plan involes initial alert, plan
activation and formation of command nucleus
• 1.initial alert
The hospital may be alerted by the emergency itself . this
happens in cases where
• The accident takes place near the hospital, or
• The hospital is informed on the telephone or through a person
• The person in the hospital who receives the information about
the disaster should gather details regarding casualties. These
details include:
• Place and time of accident
• Estimated number and type of casualties;and
• Source of communication
•  
• Activation of the hospital disaster management plan
• The designated hospital staff-casualty medical
officer, hospital controller, hospital administrator and
senior specialists-should be responsible for activating
the hospital disaster management plan.

• The switch-board operator, clerk on duty or casualty in-

charge should notify key personnel, activate emergency
departments such as radiology, OT, blood bank,
laboratory medical stores, supportive services (dietary
services, security mobilization.
 Formulation of command nucleus
• Includes hospital controller, matron/ senior nursing
officer & hospital administrator formulated immediately.

• Hospital controller
• Detailing staff reporting to him in cassualty dept.
• Appointing triage officer & medical controller
• Coordinating, organising, communicating, and assigning
duties to medical officers.
• He may rush to site with mobile medical team.
 Senior nursing oficer
• - identifying nursing needs
• - allocating extra nursing staff in essential area
• - re-deploying existing staff
• Recaling of staff
• Activating pre- arranged admission ward

• Hospital Administrator
• - establish information services for relatives & friends
• - liaise with fire brigade, police
• - deploy voluntary workers
Clinical principles of management of casualties

• Admission of pts
• - pt kept in same ward irrespective of age,
sex inorder to deliver complete attention
and resources used effectively

• Clinical services
• Radiology and patholgy unless considered
essential
• Cross matching must
 triage
• It is allotment of priority for treatment

• Treatment of casualties
• Restricted to basic life support measures
• TRIAGE :
– This is an approach to medical treatment
when the quantity & severity of injuries
overwhelm the operative capacity of the
health facility.
– It rapidly classifies the individuals on the basis
of severity of injuries and likelihood of survival
on prompt medical treatment.
• Red – urgent critical.
• Yellow – delayed.
• Green- minor / walking wounded.
• Black – dead / non-salvageable.
HOSPITAL DISASTER MANAGEMENT MANUAL
• Divided into various sections.
• Section I
• Introduction
• - includes disaster alert code, general principles of
conduct, brief synopsis of complete plan.
• - enumerate all aspects of DM like activation, formation
of command nucleus.
• Disaster alert code is code word given for commencing
DMP. When it is received by staff, should immediately
report to duty. This is to save time.
• Section II
• Distribution of responsibilities
• - these card describe in detail responsibility and action to be taken by
each key member like HA, medical officer in- charge of casualty,
matron, telephone operator etc.
• - it is used as soon as they report for duty.

• Section III
• Chronological Action Plan
• - discuss salient points of plan in chronological order. Eg.DMP.
• - also discuss clinical and administrative prob.

• Section IV
• Checklist Of Personnel And Items
• - it determines the degree of hospital preparation to deal with disasters.

• Section V
• Rehearsal
• - it can be pre- announced, mini-drill without moving pts,
simulating disasters.
• - test the plan and bring forth lacunae.
MODEL DMP FOR LARGE MULTI- SPECIALTIY
HOSPITAL
• PROBLEM TO BE HANDLED
• - transportation of victims to hosp.
• - provision of prompt medical attention
• - advice on prevention of outbreak of epidemics
• ORGANIZATION AND OPERATION
• DISASTER MANAGEMENT COMMITTEE
• Standing DM committee constituted by hospital
management board.
• It consist of:
• - professor in-charge, Accident and Emergency
services
• - professor and HOD of Dept of Orthopaedics
• - professor and HOD of Dept. of surgery
• - professor and HOD of Dept. of Medicine
•
-Professor and HOD of Dept. of Forensic Medicine
• - professor and HOD of Dept. of Neurosurgery
• - Professor and HOD of Dept. of Anaesthesiology
• - Professor and HOD of Dept. of Radiodiagnostics.
• - Nursing Superintendent

OPERATION PLAN
a) Control centre
- Set up in room no. x, ground floor of Y Block Wing. It functions with
Medical Superintendent as chief organizer.
- - telephone nos are ABCD and EFGH.
- - MS clearly identifies duties of his Assts and deputes a standby for
himself and others.

- B) Alert
- - once disaster information reaches MS, he alerts those involve
through well defined channel . Telephone switch Board and Radio-
paging play important role.
•
) Reception
C centre
• - for moderate load – present casualty OPD function as reception area
• For heavy load – main hall of ground floor OPD converted. Police and
security personnel of hospital act as traffic controllers, directing pts.

• D) First Aid, Storing,Triage

• For moderate load – existing casualty medical team provide first aid and
do sorting.
• For heavy load – centre manned by 4 teams, each consisting of :
• - 1 General Surgeon
• - 1 Orthopaedic Surgeon
• - ! Physician
• - 1 Anaesthesist
• - 2 Nurses
• - 2 Nursing Orderlies
• - 1 sweeper
• - 2 teams of stretcher Bearers each having one stretcher and two
stretcher bearers.
•
• The responsibility will be :
• @ Quickly sorting out casualities into : & Action
• - priority 1 – needing immediate resuscitation
• Attended to casualty and if necessary sent to ICU
• - priority 2 – immediate surgery
• Transferred immediately to casualty OT and Minor OT
• Priority 3 – needing first aid and posssible surgery
• Given first aid and admitted if bed is available or transferred to
another hospital.
• Priority 4 – needing only first aid
Given first aid and discharged.

The area marked for holding ward are corridors of XYZ wing.
Brought – in – Dead
Temporary morgue for keeping dead bodies created in long
verandah opposite to mechanical laundry.
- Handling over bodies after medico legal clearance is the
responsibilty of Dept. of Forensic Medicine
• E) Additional Bed Space
• Extra space created in following manner
• - utilization of all preoperative bed
• - any vacant bed requisitioned by MS
• - by discharging,
• @ convalescing patients needing only nursing care
• @ elective surgical cases
• @ pts who can have domicillary care or opd advice
• - ward side rooms, seminar rooms of wards.
• F) Linen Stores
• Mattress – 40
• Bed sheets – 120
• Blankets – 80
• Pillows and covers – 60
• Patient clothing [ females] – 30
• Patient clothing [ males] – 30
• IV stand – 60
• O2 cylinder – 20
• G) Drugs and Equipments
• - medical and surgical stores officer called atonce to
open store.
• Bufferstock earmarked for casualty will be used
• - essential drug stocked in medical stores and by order
of MS. DMS, Duty officer issued.
• - dressing material of surgical store are similarly kept.
• - for immediate use, stock lying with nurse ABC is used.
• 400 crystalloid bottles kept normally.
• H) Emergency blood bank
• Blood of all available groups kept ready. volunteers.,
voluntary orgn approached.
• i) Staff
• @ Medical staff
• - in addition to regular clinical units, faculty members of
para and pre- clinical disciplines will be asked to assist.
• Duty roster available in control room
• @ Nursing Staff
• - pool of nursing staff created by NS mainly those
staying in hostel.
• - duty roster sent to duty officer.
• - 1 nurse responsible for personal belonging of pts.
• @ Class IV staff
• All available staff utilized.
• - sanitary Superintendent create pool of staffs
• - duty roster sent to duty officer.
• @ Volunteers
• Invited by DMS
• J) Documentation Centres
• - for small casualty load – done in casualty OPD.
• - for large casualty load – done in ground floor OPD at
Central registration office of OPD.
• - the staff working at registration counter and nursing
staff will be utilized for documentation. Volunteers also
used.
• k) Hospital Security
• Security officer requested to tune up and organize
security arrangement for staff, pts, hospital buildings,
equipments.
• L) Dietary services
• - dietary services under the direct supervision of HOD of
Dietetics or Dietician – in – charge of kitchen.
• - first 24 – 48 hrs – liquid/ semisolid
m) Ambulance
All 3 available ambulance utilized.
n) Information Services
Public Relation Officer [ PRO] issue information to press,
radio after getting prior clearance from competent
authorities of hospital.
o) Engineering ang MAintenanace Services
- Water and electricity made available.
- All standby electric power generation regularly checked.
- P) Discharge Procedure
- - after appropriate treatment, casualties discharged.
- - for all cases, destination will be noted by hospital and
police informed,
 Specific problems of dm

• Clinical problems
• Catastrophe like chemical leaks managed effectively

• Administrative problems
• - documentation
• 4 lists ; one kept by HA, one sent to police
• Tagged and sent
• Police documentation team
• - delayed when busy treating casualty
• Communication
• - lines busy, hence intercom used.
• Friends & relatives
• - Anxious to know welfare of kith and kin. Hence nurse administrator give
appropriate information and calm them.
• Crowd control
• - people curious to know.
• Voluntary workers
• - their distribution decided by HA. If not needed, should be politely told.

• Patient’s property
• - separate large polythene bags for each pt with name and registration
number.

• Press and broadcasting

• - dissemination of correct information by only ine person – HA / hospital
controller.

• Disposal of Dead
• - arrangement of proper disposal of dead bodies.
AT GOVERNMENT LEVEL

ACTIVATION OF DISASTER MANAGEMENT PLANS

A standard operating procedure should be developed that

defines how each task would be accomplished.  As soon
as the information regarding disaster is received
emergency control room officer on duty in consultation
with ms/ director would activate the disaster plan.
TRIGGER MECHANISM
5.1.1 This Trigger Mechanism prescribes the manner in
which the disaster response system shall be automatically
activated after receiving early warning signals of a disaster
happening or likely to happen or on receipt of information of
an incident.

There shall be two types of situation with different trigger

mechanisms for natural disasters:
(i) Situation I – Where Early Warning signals are available
(ii) Situation II- Where Disaster occurs without early warning
Where Early Warning signals are available
5.2.1 At the National Level Nodal Agencies have been
designated for generating/forecasting of events of natural
disasters. Onset of disaster shall be indicated through
forecasting by the Nodal Agencies in respect of their
respective hazards to NEOC, MHA as per laid down protocol.

5.2.2 Based on the forecasts from Nodal Agencies, NEOC,

MHA shall be the sole authority responsible to issue Watch,
Alerts and Warning to SEOC, DEOC, State & District level
designated authorities.

5.2.3 As soon as the Watch/Alerts/warning has been issued

by the NEOC to the SEOC, DEOC and other designated
authorities, SEOC and DEOC shall be fully activated.
5.2.4 SEOC and DEOC shall activate State/District
/Sub-Division/Block level administrative machinery to
respond to the situation with available manpower and
resources.

5.2.5 First and foremost task shall be informing the

community likely to be affected by the disaster
through a warning system and undertake evacuation.
There shall be only one responsible agency/officer
designated and authorized to issue the warning in
respect of a disaster at State and District levels to
avoid miscommunication and as also indiscriminate
warning may result in non-responsiveness of the
people.
5.2.6 Dissemination of warning to common people may
range from alarms (fires), sirens (industrial disaster), to
public announcement system like radio, television, loud
speakers, hoisting of flags (cyclones, floods, and landslides).
5.2.7 Once the warning is issued it shall be followed-up by
subsequent warnings and De-warning in order to keep the
people informed of the latest situation.
5.2.8 While warning is issued warning messages shall be
user friendly:
The warning protocols shall be designed in simple and local
languages easily understandable to a common man.
5.2.9 DDMA shall take pre-emptive measures of evacuation.
A comprehensive Standing Order, listing all necessary pre-
emptive measures based on the warning, will be prepared at
the district and the State level.
5.2.10 Thereafter, follow up action shall be undertaken
by all concerned at all levels as envisaged under
Response Phase.

5.2.11 Standing Order will be reviewed annually and

widely circulated among all concerned. The evacuation
drill with community participation at the Sub-Divisional
and district levels before onset of the monsoon and
cyclone period will be carried out.
Where Disaster occurs without early warning
5.3.1 In disaster situations where no early warning signals
are available, the primary objective of the trigger
mechanism shall be to mount immediate rescue and relief
operations and set the process in as quickly as possible.
The following procedure shall be followed in such situations:
1. The field functionary at ground zero shall inform the
DEOC, District Magistrate of the incident.
2. DEOC shall be fully activated for managing the incident.
3. DEOC/District Magistrate shall inform the SEOC/ SDMA,
SEC and seeks assistance if required.
4. SEC is activated and NEOC is informed. FIR is submitted
to NEOC.
5. Quick Response Teams (QRTs), Search and Rescue
Teams, medical and Para-medical teams shall be deployed
6. District Magistrate shall review the situation and activate
coordination, command and control
7. Incident Command Teams shall be deployed
8. Meeting of DDMA shall be convened to review situations
9. Team for rapid assessment of damage shall be deployed
10. Line Departments/agencies shall begin work for restoration
of power, tele-communication, surface transport etc
11. Arrangements shall be made for supply of food material,
drinking water etc
12. Thereafter, follow up action shall be undertaken by all
concerned at all levels as envisaged under Response and
Relief Phases.
 RESPONSE TO NATURAL DISASTERS
NATIONAL LEVEL
NEOC shall discharge the following functions:
1. On receipt of information either from State/District or from
Early Warning Agencies or any other reliable sources, National
Emergency Operation Centre, MHA shall be activated as per
laid down protocol.
2. It shall send alerts/warning to all designated authorities
3. NEOC shall collect all relevant information and apprise the
status to the designated authorities
4. It shall activate ESFs if the situation warrants central
assistance to States/UTs
5. It shall prepare Daily Situation Report
National Crisis Management Committee (NCMC)
1. On direction of the Cabinet Secretary, meeting of the NCMC
shall be convened.
2. NCMC will take stock of the situation.
3. It shall give necessary directions to NEC, MHA, other Central
National Executive Committee (NEC)
1. JS(DM), MHA shall take order from Union Home Secretary
for convening the meeting of NEC
2. NEC shall assess the situation and give directions to the
concerned Ministries/Departments of the Govt. of India, the
State Governments and the State Disaster management
Authorities regarding measures to be taken by them in response
to any specific threatening disaster
situation or disaster.
3. NEC shall coordinate response of various agencies
4. It shall depute a team of Officials to visit the affected States
for on the spot assessment of the situation and coordinate with
State Governments.
5. It shall mobilize resources and dispatch them to concerned
States.
6. It shall monitor and review the situation on a regular basis
STATE LEVEL
6.2.1 Following shall be the sequence of action at the State
level:
SEOC shall discharge the following functions:
1. On receipt of information either from NEOC/DEOC or from
Early Warning Agencies or any other reliable sources, State
Emergency Operation Centre, shall be activated fully as per laid
down protocol.
2. SEOC shall issue alerts/warning to all designated authorities
at the State level and Districts including for Public Information to
AIR/Doordarshan/Press.
3. SEOC shall send First Information Report to NEOC, MHA
and thereafter Daily Situation Report till situation normalizes.
4. SEOC shall collect all relevant information and appraise the
status to the designated decision making authorities.
5. It shall arrange Meetings of SEC
6. It shall activate ESFs of State if the situation so warrants
State Disaster Management Authority (SDMA)
1. Meeting of the SDMA shall be convened on the direction of
Chief Minister
2. SDMA will take stock of the situation.
3. SDMA shall give necessary directions to SEC, Deptt. Of
Disaster Management and other Departments/agencies of the
State Government and concerned DDMAs.
4. SDMA shall decide on Inter-State assistance and
cooperation.
State Executive Committee (SEC)
1. Secretary (DM) shall convene the meeting of SEC
2. SEC shall assess the situation and give directions to the
concerned Departments/agencies of the State Govt. and
DDMAs concerned regarding measures to be taken by
them in response to any specific threatening disaster
situation or disaster.
3. SEC shall coordinate response of various agencies
4. SEC shall requisition NDRF or Armed Forces if the
situation so demands.
5. SEC may depute a team of Officials to visit the affected
Districts for on the spot assessment of the situation and
supervise the response & relief measures.
6. SEC shall mobilize resources and dispatch them to
concerned Districts.
7. SEC shall monitor and review the situation on a regular
basis
8. SEC shall keep the NEC and NDMA informed of the
situation.
9. SEC shall constantly evaluate their own capabilities to
handle that situation and project the anticipated requirements
for the central resources well in time.
10. SEC shall deploy State level Incident Command Team on
the request of the DDMA as and when required.
11. In the event of calamity of severe nature, the SEC will
consider appointment of Senior Officers, delegate powers
and assign specific areas for timely and effective, efficient
management of disasters.

12. SEC will also take necessary steps to pool the resources
for better management of crisis situation. This includes the
pooling of food grains funds and other resources available in
the districts under various Government schemes.

However, these resources will be reimbursed to the

respective schemes/Departments once the situation
becomes normal.
DISTRICT LEVEL
DEOC shall discharge the following functions:
1. On receipt of information either from NEOC/SEOC or from
Early Warning agencies or field functionaries from Sub-
divisions, Blocks, Tehsils or any other reliable sources,
District Emergency Operation Centre shall be activated fully
as per laid down protocol.
2. DEOC shall issue alerts/warning to all designated
authorities at the District level.
3. DEOC shall send First Information Report to SEOC and
NEOC, MHA and thereafter Daily Situation Report till situation
normalizes.
4. DEOC shall collect all relevant information and appraise
the status to the designated decision making authorities.
5. DEOC shall maintain all records and documents related to
the response
6. It shall activate ESFs of District if the situation so warrants
District Disaster Management Authority (DDMA)
1. DDMA shall assess the situation and give directions to the
concerned Line Departments/Agencies at the District level
regarding measures to be taken by them in response to any
specific threatening disaster situation or disaster.
2. DDMA shall take such other action as may be necessary
for coordinated response to natural disasters. These may
include the following:
a. Assessing situations based on
reports received from various sources and giving directions
to different agencies for immediate response, relief and
restoration of critical infrastructure
b. Reviewing the resources and capacities of different
agencies to deal with the situations and giving directions for
pooling available manpower, equipments and resources
available with different agencies for speedy and
effective response
c. Requisitioning assistance from NDRF/ Armed Forces/ other
specialized agencies, if necessary
d. Coordinating with civil society and Non-Governmental
Organizations for supplementing the efforts of government
agencies
e. Monitoring and reviewing the situations on a regular basis
 RECOVERY STAGE
During this phase the community take actions to repair,
rebuilt, or reallocate damaged homes and businesses
and restore health and economic vitality to the
community.

Psychological recovery must be addressed. The

emotional scars of witnessing a disaster may persist for
long duration.

Both victims and relief workers should be offered

mental health activities and services.
How disasters affect the community ?

PHYSICAL

EMOTIONAL

SOCIAL

SPIRITUAL
HEALTH
7.4.1 During post disaster phase many factors increase the risk
of diseases and epidemics. These include poverty, insecurity,
overcrowding, inadequate quantity and quality of water, poor
environmental and sanitary conditions, inadequate shelter and
food supply.
Medical Response
7.4.2 Medical response has to be quick and effective. The
execution of medical response plans and deployment of medical
resources warrant special attention at the State and District level
in most of the situations.
The following measures shall be taken by the States/Districts:
1. A mechanism for quick identification of factors affecting the
health of the affected people shall be established for
surveillance and reporting.
2. An assessment of the health and nutritional status of the
affected population shall be done by experts with experience of
emergencies and, if possible, local knowledge.
. The voluntary deployment of the nearest medical resources
to the disaster site,
4. Mobile medical hospitals and other resources available
with the Central Government shall be provided to the
States/UTs.

5. Adequate supply of medicines, disinfectants etc. shall be

made.
6. Where necessary inoculation shall be done.
7. Vaccination of the children & pregnant women shall be
undertaken.
8. Vector-borne diseases are a major cause of sickness and
death in many disaster situations. Vector control measures
shall be undertaken.
9. Water borne diseases may cause sickness and deaths
and therefore adequate measures shall be taken to prevent
such outbreaks.
 REHABILITATION
• Identifying persons with existing disabilities in temporary
shelters and camps.
• Responding to the specific health care needs of persons with
existing disabilities, such as insulin for diabetics,
soft mattresses for people with spinal cord injuries and
spectacles for people with low vision.

• Identifying people with injuries and providing

appropriate trauma care to save lives and minimize
future functional impairment and disability.

• Implementing other curative and therapeutic

interventions that can prevent disability such as
prevention of pressure sores and possible deformities.
 REHABILITATION

• Transferring people with severe injuries and/or newly

acquired disabilities to referral centres for medical
rehabilitation.

• In settings where such centers do not

exist, efforts should be made to ensure that such
persons are treated by specialists in existing facilities.
RELIEF CAMP
7.8.1 The following steps shall be taken for setting up relief
camps in the affected areas:

1. Adequate numbers of buildings or open space shall be

identified where relief camps can be set up during
emergency.
2. The use of premises of educational institutions for setting
up relief camps shall be discouraged.
3. One member of the Incident Command Team of the
district trained in running and management of relief camps
will be deputed for management of relief camps.
4. The requirements for operation of relief camps shall be
worked out in detail in advance.
5. Agencies to supply the necessary stores will be
identified in the predisaster
phase.
6. The temporary relief camps will have adequate
provision of drinking water and bathing, sanitation and
essential health-care facilities.
7. Adequate security arrangements shall be made by local
police
8. Adequate lighting arrangements shall be made in the Camp
Area including at water points, toilets and other common areas.
9. Wherever feasible, special task forces from amongst the
disaster affected families will be set up to explore the possibility
of provision of food through community kitchens, provision of
education through the restoration of schools and anganwadis.
10. Efficient governance systems like entitlement cards,
identification cards, bank accounts for cash transfers etc shall
be developed.
RELIEF
7.1.1 In the aftermath of disasters the affected people must be
looked after for their safety, security and the well being and
provided food, water, shelter, clothing, medical care etc. so as
to ensure that the affected people live with dignity.
State Governments shall be responsible for providing prompt
and adequate relief assistance to the victims of disasters. The
minimum standards of relief shall b laid down by the NDMA and
by the SDMAs in terms of sections 12 and 19 respectively.

FOOD & NUTRITION

7.2.1 People affected by disasters may be deprived of food and
therefore food aid shall be provided to sustain life. The
following measures shall be taken:
1. Where necessary free distributions of food shall be made to
those who need the food most.
2. The food distribution will be discontinued as soon as
possible.
3. Wherever possible dry rations shall be provided for home
cooking.
4. Community Kitchen for mass feeding shall be organised
only for an initial short period following a major disaster
particularly where affected people do not have the means to
cook
5. While providing food assistance, local food practices shall
be kept in mind and commodities being provided must be
carefully chosen, in consultation with the affected population.

6. Foods must be of good quality, safe to consume, and

appropriate and acceptable to recipients.
7. Rations for general food distributions shall be adopted to
bridge the gap between the affected population's
requirements and their own food resources
8. Food distributed should be of appropriate quality and fit
for human consumption
6. Foods must be of good quality, safe to consume, and
appropriate and acceptable to recipients.

7. Rations for general food distributions shall be adopted

to bridge the gap between the affected population's
requirements and their own food resources

8. Food distributed should be of appropriate quality and fit

for human consumption
• Food
• Minimum maintenance level of food energy
• intake is accepted internationally as 2100 kcal
• per person per day.
• When this falls below 1500 kcal a day mortality
• rises rapidly in populations already stressed.
• Locally prepared food with local ingredients
• is best received and therefore of greatest use.
• If food cannot be obtained locally, then the provision
• of dried imported food still allows local preparation.

• Assessing malnutrition in children aged < 5 years

WATER
7.3.1 Water supply is invariably affected in natural disasters.
Safe drinking water might not be available particularly in hydro-
meteorological disasters.
The following measures shall be taken by the State
Governments/ district administration:
1. The State Governments shall identify alternative sources of
water and make necessary arrangements for supply to the
affected population.
2. The State Governments shall ensure that affected people
have adequate facilities and supplies to collect, store and use
sufficient quantities of water for drinking, cooking and personal
hygiene.
3. It shall be ensured that drinking water supplied conforms to
the prescribed quality standards
4. It shall be ensured that water made available for personal
and domestic hygiene should not cause any risk to health.
 DRINKING WATER

• All camp residents must have equal accessibility to :

• - Adequate sources of potable water
• Achieved by :
• - Installing water distribution points
• - Provision of lidded buckets to each family.
• - Water is chlorinated just before distribution
• and again each time they are refilled.
• - Effective health education
• Sanitation
• After water, the greatest need is for sanitation.
• Ensure there is at least one latrine seat for
• every 20 people.
• Each dwelling should be no more than one
• minute’s walk from a toilet.
• For every 500 people there must be at least
• one communal refuse pit measuring
• 2 m × 5 m × 2 m.
Sanitation and Hygiene

Soap, detergents, sanitary napkins and other sanitary items

should be made available to ensure personal hygiene, health,
dignity and well-being.

In the relief camps, toilets should be sited,designed, constructed

and maintained in such a way as to be comfortable, hygienic
and safe to use

Vector Control viz. Control of disease vectors (mosquitoes,

flies,rats and fleas) is a critical environmental health
measure
SHELTER

The following measures shall be taken by State/District

authorities for providing shelter to the affected people:

1. Disaster affected people who have lost their dwelling units

or where such units have been rendered damaged/useless
shall be provided sufficient covered space for shelter.
2. Disasteraffected households shall be provided access to
appropriate means artificial lighting to ensure personal
security.
3. Disaster-affected households shall be provided with
necessary tools, equipment and materials for repair,
reconstruction and maintenance for safe use of their
shelter.
• .
• WHO recommendations for Shelter
• WHO recommends 30 sq. m of living space per
• person , plus the necessary land for communal
• activities, agriculture, and livestock.
• Of this total living space, 3.5 sq. m is the absolute
• minimum floor space per person in emergency
• shelters.
CLOTHINGS & UTENSILS
7.6.1 During disasters, people lose their clothings and utensils.
The following measures shall be taken by State/District
authorities:
1.The people affected by the disaster shall be provided with
sufficient clothings, blankets etc. to ensure their dignity, safety
and well-being.

2. Each disaster-affected household shall be provided with

cooking and eating utensils

Clothing is often sent to stricken areas, but its transport is

expensive and its storage difficult and costly.

Financial support to larger agencies is usually the

better way of addressing such needs
• ImmuniSation
• Immunisation of children against measles is the most
important and cost effective preventive measure.
• Infants (as young as 6 months old) often contract measles in
refugee camps, with increased risk of dying due to impaired
nutrition.
• Measles immunisation programs (along with vitamin A
supplements) are recommended in emergency settings for
all children from the ages of 6 months to 5 years (even upto
12-14 years).
• Ideally, measles immunisation coverage in refugee camps
should be greater than 80%.
• Immunisation programmes should eventually include all
antigens
• recommended by WHO’s expanded programme on
immunisation (EPI).
MENTAL HEALTH SERVICES
7.5.1 Disasters cause tremendous mental trauma to the
survivors. Psychosocial support and mental health services
should be made available immediately in the aftermath of
disaster so as to reduce the stress and trauma
of the affected community and facilitate speedy recovery.

The following measures shall be undertaken by States/UTs:

1. A Nodal Mental Health Officer shall be designated for
each affected District.
2. Rapid needs assessment of psycho-social support shall
be carried out by the Nodal Officer/ Health Department.
3. Trained man power for psycho-social and mental health
services shall be mobilized and deputed for psycho-social
first aid and transfer of critically ill persons to referral
hospitals.
4. Psycho-social first aid shall be given to the affected
community/ population by the trained community level
workers and relief and rescue workers.
5. Psycho-social first aid givers shall be sensitized to local,
cultural, traditional and ethical values and practices.

6. Psycho-social support and mental health Services shall be

arranged in relief camps set-up in the post disaster phase.
7. Where large number of disaster victims have to be provided
psychosocial support a referral system for long term treatment
shall be followed.
8. The services of NGOs and CBOs may be requisitioned for
providing psycho-social support and mental health services to
the survivors of the disasters.
9. Community practices such as mass prayers, religious
discourse etc. should be organized with four preventive and
promotive mental health services.
• Strategies for dealing with stress:[American Red Cross
2002]:

– Get enough sleep.

– Take breaks away form the disaster.
– Avoid alcohol.
– Eat frequently in small amounts.
– Use humor to break tension.
– Use positive self-talk.
– Stay in touch with people at home.
– Provide mutual support.
• Rehabilitation of special groups:
1. Aged people can be helped by
Ø Keeping them with their near & dear ones
Ø Visiting them regularly & spending time with them
Ø Touching them & allowing them to cry
Ø Reestablishing their daily routines
Ø Making them feel responsible by giving them some work to
carry out which is not too difficult
Ø Getting them involved in relief work by requesting for their
suggestion & advice etc.
Ø Keeping them informed of positive news
Ø Attending to their medical ailments
Ø Organising small group prayer meetings
•
2. Disabled people
Ø Removing them to places of safety
Ø Keeping them informed what is happening
Ø Getting them involved in activities
Ø Integrate them in group discussions
Ø Attend to their specific needs (wheel chairs, hearing aids)
Ø Helping them overcome their feeling of insecurity
Ø Taking cognizance of the fact that mentally challenged
people, especially the women & children are vulnerable to
sexual abuse, & help them.
• . Women:
•
Ø Help them to be with their families
Ø Keep informing them what is happening
Ø Involve them in activities
Ø Involving them in relief & rehabilitation activities
Ø Initiating self-help formation
Ø Involve them in recreation
Ø Making them to spend time with young widows or
people who have lost their children & supporting them.
• 4. Children:
Ø Letting him/her to be close to adults who are loved &
familiar
Ø Reestablishing some sort of a routine for them like eating,
sleeping, Going for programs
Ø Actions like touching, hugging, reassuring them verbally
Ø Allowing them to take about the event
Ø Encourage them to play
Ø Involve them in activities like painting & drawing, where
then can express their emotions.
Ø Organise story telling sessions, singing, songs and
games.
Ø Praising coping behaviour
Ø Provide referral if required
Ø Spending time on their studies once they return to school.
•  
•  
 OVERALL RESPONSIBILTY OF NURSE

• The activities to be performed by the nurse

are:
– Community assessment .
– Case finding and referring.
– Triage .
– Surveillance.
– Health education.
– Working with aggregates.
– First aid and health care.
 ROLE OF NURSE AT COMMUNITY LEVEL

ASSESS THE COMMUNITY

Assess 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 THREAT

Determine the actual and potential disaster threats (eg;

explosions, mass accidents, tornados, floods,
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

Identify outdated
 ROLE OF NURSE IN PREPAREDNESS
• Community measures in Disaster
A nurse should be the part of the team for disaster planning.

a. Community Participation: The community heath nurse

maintains the link between professional group pf experts in
disaster management and community.
b. Mock trails/training: The training of various inter-
disciplinary forces like school children, voluntary
organizations can be imparted by community health nurse
and her team,
c. Mass awareness: The community should have the
knowledge of all the Channel communication system, stand
by equipment supplies and other resources; otherwise
disaster preparedness will be failure.
d. Education: Mass awareness through media, booklets,
panel discussion, films and televisions information is very
essential.
 ROLE OF A NURSE IN DISASTER PREPAREDNESS
 Facilitate preparedness in the community & work place.

 Help Initiate or update the disaster plan.

 Provide educational programs and materials.

 Provide update record of vulnerable population in the

community.
 Gather information of the other people in that area /
institution who are trained and can be of use during a
disaster.
 Assess & report health hazards in the community.
 Undergo disaster programs conducted by different
agencies & register in them.
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 disturbing

supplies.
• ITEM REQUIRED IN DISASTER MANAGEMENT
• Copy of professional license.
• Professional equipment such as stethoscope.
• Flash light & extra batteries.
• Cellular phone.
• Cash & travelers checks.
• Clothing as per the climate.
• Protective shoes.
• Record keeping materials.
• Reference books.
• Watch.
• Role of the Nurse at the Disaster Site 
• Insure safety

• First Aid

• Emergency care
• TRIAGE :
– This is an approach to medical treatment
when the quantity & severity of injuries
overwhelm the operative capacity of the
health facility.
– It rapidly classifies the individuals on the basis
of severity of injuries and likelihood of survival
on prompt medical treatment.
• Red – urgent critical.
• Yellow – delayed.
• Green- minor / walking wounded.
• Black – dead / non-salvageable.
 ROLE OF NURSE IN DISASTER RECOVERY:

• Varies as per the problems.

• Flexibility is necessary.
• Take part in community clean –up efforts.
• Provide physical & psychological support.
• Case finding and referral.
 ROLE OF NURSE
• Ø Nurse along with the health team needs to utilize primary
health care intervention in acute emergencies as follows:-
· Nursing Management
· Immunization and preventive health
· Management of diarrheas and dehydration.
· Management of acute respiratory infections.
· Setting up a health information system.
· Safe drinking water supply.
· Sanitation.
· Training and support for health workers.
· Other basic services.
 ROLE OF NURSE

• In addition to above the following psychosocial

intervention are provided by the nurses:
· Crises intervention / counseling
· Group work
· Telephone contact services.
· Disaster response managements
· Health education
· Community services like facilitation of self help
groups etc.
SHELTER MANAGEMENT PLANS

Nurses can act as shelter managers

Listen to the victims and retell their feelings related to

disaster

Encourage victims to share their feelings

Help victims to over come the crisis

Delegate tasks to team members and coordinate activities

Provide the basic necessities(food, water, shelter etc)

Provide compassion and dignity to the victim

• Principles of nursing care in PTSD:
1.1 Consistent empathic approach to help the clients tolerate
the intense memories and emotional pain.
1.2 Simple reorienting, reassuring statements to prevent
suicidal ideation
1.3 Trusting relationship to covey a sense of respect,
acceptance of their distress and belief in the client's
reactions.
1.4 Reconnect the individuals with the existing support
system,
1.5 Restart activities that provide a sense of mastery
1.6 Promote independence and the client's highest level of
functioning.
1.7 Manager counter transference reactions
1.8 Group therapies to decrease isolation, to discuss the
effect of trauma and develop alternative coping mechanisms.
1.9 Encourage the client to write/verbalise to manage
reactions and feelings
• 1.10 Help the client identify community resources
1.11 Teach anxiety management strategies like
relaxation, breaking techniques and diverting the
individuals mind through involvement inactivities.
1.12 Changes in life style such as following a healthy
diet, avoiding stimulants/intoxicants, regular exercise
and adequate sleep. Use medication as recommended.
•
Rehabilitation of disaster victims:
In the post-disaster period, along with relief,
rehabilitation and the care of physical health and injuries,
mental health issues need to be given importance. Apart
from material and logistic help, the suffering human
beings will require human interventions.
•  
 ROLE OF NURSE IN HOSPITAL

• - identify nursing needs

- allocating extra nsg staff in essential areas
- Redeploying existing staff
- Recalling of staff
- Activating pre- arranged admission ward
- Co – ordinate with health care team in treatment of casualties
- Formulating duty roster plan.
- Taking charge of personal belonging of pt
- Conduct CNE, workshop on DM
- Orient new staff to hospital policies.
- Treat patient according to triage
- Provide psychological support
- Associate with voluntary orgn
- Safe blood transfusion
- Involve in outreach programme
- Crowd mgt.
 ROLE OF NURSE IN EDUCATION
• NATIONAL LEVEL
• - INC syllabus on DM
• STATE LEVEL
• - SRC, universities prescribe hours
requirements
• COLLEGE LEVEL
• - disaster area visits, drills, participate in
disaster activity.
• STUDENT ROLE IN DISASTER
Attend disaster drills .
• Conduct mock drills in various areas to provoke
awareness among people.
• Students have disaster in their curriculum.
• During any disaster, students go to the community area
and offer service.
• During clinical posting, can help the staff in managing
mass casualty.
• Provide psychological support and guidance to affected
victims.
• Referral to any voluntary agency for relief and other
rehabilitation measures.
•  
• Referral for any of these issues:
Ø Livelihood issues-procurement of materials & grants
Ø Children education needs, adoption or fostering &
financial assistance
Ø Paralegal issues like compensation, reassessment of
homes & FIRs
Ø Medical issues - health problem, special needs of
crutches or pregnancy related issues
Ø Housing plans, like assessing & getting construction
Ø Women support group, like special needs of a material
single parent who faced violence, rape victims
Ø Emotional issues
 STRATEGIES

• Insurance
• Government relief funds
• Awareness programmes
• Guidance and support
• Old age homes, shelter
• Adoption can be emphasized
 CONCLUSION

Disaster is an emergency situation, therefore

coordination of actions and various departments is
an essential requisite for efficient management of
mass casualties.
 BIBLIOGRAPHY
• Kay kittrell chitty & Beth Pery Black ; professional nursing 5 th edition Elsevier
publication, Missouri.
• Lucy Hood & Susan Kun Leddy, conceptual Bases of professional Nursing 6 th
edition Lippincott Williams & Wilkins, Philadelphia
• .
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