Disaster Nursing - PowerPoint

Document Sample
Disaster Nursing - PowerPoint Powered By Docstoc
					DISASTER
NURSING
DISASTERS

• Any catastrophic situation in
  which the normal patterns of
  life (or ecosystems) have been
  disrupted and extraordinary,
  emergency interventions are
  required to save and preserve
  human lives and/or the
  environment
HAZARD

• Rare or extreme event in the
  natural or man-made
  environment that adversely
  affect human life, property or
  activity to the extent of causing
  disaster
Phenomenon that poses
threat (s) to people
structure or economic
asset that may cause a
disaster either…
   -human introduces or
   -naturally occurring in
the environment
VULNERABILITY

• Extent to which the
  community, structure,
  service or geographic
  area is likely to be
  damaged or disrupted by
  the impact of a particular
  hazard
HAZARD+VULNERABILIT
Y/CAPACITY=DISASTER
RISK
PHYSICAL
VULNERABILITY
• Extent of likely
  damage/disruption on account
  of nature/construction and
  proximity to man-made
  environment (buildings and
  natural environment, forest,
  aquaculture)
CAPABILITIES

• Resources and skills people
  posses, can develop,
  mobilize and have access to
  which allow them to have
  more control over shaping
  their future
TYPES OF DISASTERS

According to
  CAUSE/OCCURRENCE

• Natural-caused by forces of
  nature
• e.g. earthquake, typhoons,
  volcanic eruptions
• Man-made- caused by errors of
  man
• e.g. war, civil strife or other
  conflicts
• Technological
• e.g. air crashes, pollution,
  nuclear accidents, explosions
According to
  PREDICTABILITY

• Sudden Onset- no warning
  issued
• Slow Onset-disasters that come
  with warnings
• e.g. typhoons, volcanic
  eruptions
According to EXTENT OF
  DAMAGE

• Large scale-effects not
  solely limited to the
  impact area
• Small scale-effects are
  localized;limited only
  to the impact area
HEALTH SERVICE

Concept of Operations
1. An emergency of
 disaster necessitates the
 mobilization of all
 medical resources in
 order to protect and
 preserve human lives
DISASTER
MANAGEMENT
• A collaborative term used to
  encompass all activities
  undertaken in anticipation of
  the occurrence of a potentially
  disastrous event, including
  prepareness and long term risk
  reduction measures
EMERGENCY RESPONSE

• The period immediately
  following a disaster when the
  exceptional measures have to
  be taken to search and find
  survivors as well as meet their
  basic needs for shelter, water,
  food and medical care
REHABILITATIONS

• Operations and decisions taken
  after the disaster with a view to
  restoring a stricken community
  to its formers living conditions
  while encouraging and
  acilitating the necessary
  adjustments caused by the
  disaster
AIM:

• Immediate repair and initial
  efforts to re establish the
  essential services associated
  with social and economic
  functions of a community
ALERT PERIOD

• Refers to the time when a
  disaster is developing and when
  it has not yert hit the
  community. Threats are
  detected, warnings are issued
  and evacuation is facilitated.
  Evacuation can take 3 forms:
  FORCED/VOLUNTARY/DISPLACE
  D
DISASTER NURSING

• The adaptation of Professional
  Nursing KNOWLEDGE , Skills
  and ATTITUDE in recognizing
  and MEETING the nursing and
  MEDICAL NEEDS of DISASTER
  VICTIMS
BASIC PRINCIPLES IN
PLANNING FOR DISASTER
NURSING
• N- ursing Plans should be integrated
  and coordinated
• U- pdate physical and Psychological
  preaparedness
• R- esponsible for Organizing,
  Teaching and Supervision
• S- timulate Community Participation
• E- xercise Competence
BASIC PRINCIPLES OF
NURSING CARE for
DISASTER VICTIMS
• A- daptation of Skills to
  Situation
• C- are for Disaster Victims
• C- ontinuous Awareness of the
  patient’s condition
• T- each AUXILLARY personnel
• S-election of Essential Care
ROLES and
RESPONSIBILITIES of a
DISASTER NURSE
• D- isseminate information on the
  prevention and control of
  environmental Hazards
• I- nterpret health laws and
  regulations
• S- erve yourself of self-survival
• A- ccepts directions and take orders
  from an organized authority
• S- erve the best of the MOST
• T- each the meaning of warning
  signals
• E- xercise leadership
• R- efer to appropriate agencies
NURSING PROCESS

• -a deliberate problem-solving
  approach that requires
  cognitive, technical and
  interpersonal skills and directed
  to meeting the needs of the
  client
Technical skills

• which includes knowledge and
  skills needed to properly and
  safely manipulate and handle
  appropriate equipment needed
  by the patient in performing
  medical or diagnostic
  procedures, such as vital signs,
  and medication
  administrations.[
DISASTER
HEALTH
ASSESSMENT
OUTLINE*
1. BACKGROUND ON
THE DISASTER
 • Type of disaster,
   occurrence
 • Immediate effects in the
   areas
 • Nature and extent of
   damage on population
• Properties and environment
• Affected population
• Changes from pre-disaster
  period (area map, indicating
  the affected areas, existing
  hazards and location of
  affected population could be
  presented)
2. HEALTH EFFECTS &
   INITIAL RESPONSE

• Water supply availability,
  adequacy and distribution
• Sanitation conditions and
  existing sanitation facilities
• Psychological stress brought
  about by the disaster and
  mental health services provided
Evaluation and using
health info
• RECORD all relevant information
  received, noting source and
  origin/date
• EVALUATE all health
  information “consistent?
  Biases?influencing reports?”
• Establish specific purpose and
  evaluation
• Decide who will evaluate
• Fix time schedule: results
  should be produced quickly in
  order to be useful
PLANNING TO MEET
DISASTER HEALTH
NEEDS & PROBLEMS
Definition of terms

• Need/s- any material/provision
  that will sustain survival if such
  is lacking, either physical, or
  psychological, disequilibrium
  and ambivalence will result
• Problem-an unmet need
Need/Problem:
INJURIES
• Objectives:
• Minimize further injury and
  prevent complications
• Relieve pain and discomfort
• Provides means of transport to
  a safer area
Interventions:

• Provide immediate and
  appropriate treatment
• Proper handling and positioning
• Immediate evacuation to
  nearest medical facility
• Provide psychological support
Need/Problem: DEATH

• Objectives:
• Provide care of the dead
• Provide supportive care to the
  bereaved family
Interventions:

• Proper identification and
  disposal
• Notification of relatives
• Spiritual blessing to the dead
• Proper mark of the grave’s site
  must be done
Need/Problem:
EPIDEMICS
• Objectives:
• Control of epidemics
• Interventions:
• Initiate preventive measures
  (isolation, immunization,
  environmental sanitation)
• Treatment of cases
• Record and report known cases to
  proper authorities
• Accomplishment of terminal
  disinfections
Interventions:

• Initiate preventive measures
  (isolation, immunization,
  environmental sanitation)
• Treatment of cases
• Record and report known cases to
  proper authorities
• Accomplishment of terminal
  disinfections
Need/Problem: POOR
SANITATION
Objectives:
• Maintenance of sanitary
  environmental condition
  conducive to healthful living
Interventions:
• Early identification of signs and
  symptoms indicative of stress
• Provide diversional, occupational
  and recreational activities
• Encourage hope. Trust in God’s
  steadfast love
• Refer to minister own faith
MODULE 7

•MANAGEMENT OF
 MASS CASUALTIES:
 RESCUE,TRANSFER,
 TRIAGE and
 TAGGING
Objectives

• -Illustrate the application of
  triage and tagging procedures
  in the management of mass
  casualties
• -Understand the priorities in
  triage and tagging, and orders
  of evacuation
MASS CASUALTY
MANAGEMENT

• MCMS is a multi-sectoral
  coordination system based on
  daily utilized procedures,
  managed by skilled personnel in
  order to maximize the use of
  existing
resources;provide prompt and
adapted care to the
victims;ensure emergency
services and emergency
services and hospital return to
routine operations as soon as
possible
IMPORTANCE OF MCI
MANAGEMENT
• Victims of MCI can be
  efficiently TRIAGED, TREATED
  and TRANSPORTED in a
  properly COMMANDED,
  CONTROLLED,
  COMMUNICATED,
  COORDINATED and orderly way
  that all tasks are carried out
MASS CASUALTY
INCIDENT
• -produces several patients
• -as few as six or as many as
  several hundred
• -affects local hospitals
• -patients are greater than
  resources of the initial
  responders
PREPARATION FOR
MASS CASUALTY
• -Pre-planning and training is
  critical
• -Establish guidelines and
  procedures
• -Early implementation of
  incident command
• -First five minutes will
  determine next five hours
MASS CASUALTY
MANAGEMENT
•   Simple
•   Triage
•   And
•   Rapid
•   Treatment/transport
TRIAGE

• -process used in sorting
  patients or victims into
  categories of priorities
  for care and transport
  based on the severity of
  injuries and medical
  emergencies
• Triage (pronounced is a process of
  prioritizing patients based on the
  severity of their condition so as to
  treat as many as possible when
  resources are insufficient for all to
  be treated immediately.
• The term comes from the French
  verb trier, meaning to sort, sift or
  select..
• There are two types of triage:
  simple triage and advanced
  triage
Simple triage

• Simple triage is used in a scene of mass
  casualty, in order to sort patients into
  those who need critical attention and
  immediate transport to the hospital and
  those with less serious injuries.
• This step can be started before
  transportation becomes available.
• The categorization of patients based on
  the severity of their injuries can be aided
  with the use of printed triage tags or
  colored flagging.
• S.T.A.R.T. (Simple Triage and
  Rapid Treatment) is a simple
  triage system that can be
  performed by lightly-trained lay
  and emergency personnel in
  emergencies. It is not intended
  to supersede or instruct
  medical personnel or
  techniques.
Triage separates the injured into four
  groups:
• The deceased who are beyond help
• The injured who can be helped by
  immediate transportation
• The injured whose transport can be
 delayed
• Those with minor injuries, who need
  help less urgently
•   However, these descriptive words are by no means
    standard; different regions use different designations.
•   In the UK and Europe, the triage process used is similar
    to that of the United States, but the categories are
    different:
•   Dead - those who are pronounced as such by a medically
    qualified person or paramedic who is legally qualified to
    pronounce death
•   Immediate - patients who have a trauma score of 3 to 10
    (RTS) and need immediate attention
•   Urgent - patients who have a trauma score of 10 or 11
    and can wait for a short time before transport to
    definitive medical attention
•   Delayed - patients who have a trauma score of 12
    (maximum score) and can be delayed before transport
    from the scene
Evacuation

• Simple triage identifies which people need
  advanced medical care. In the field, triage also sets
  priorities for evacuation to hospitals. In S.T.A.R.T.,
  casualties should be evacuated as follows:

• Deceased are left where they fell, covered if
  necessary; note that in S.T.A.R.T. a person is not
  triaged "deceased" unless they are not breathing
  and an effort to reposition their airway has been
  unsuccessful.

• Immediate or Priority 1 (red) evacuation by
  MEDEVAC if available or ambulance as they need
  advanced medical care at once or within 1 hour.
  These people are in critical condition and would die
  without immediate assistance.
• Delayed or Priority 2 (yellow) can have
  their medical evacuation delayed until all
  immediate persons have been transported.
  These people are in stable condition but
  require medical assistance.

• Minor or Priority 3 (green) are not
  evacuated until all immediate and delayed
  persons have been evacuated. These will
  not need advanced medical care for at
  least several hours. Continue to re-triage in
  case their condition worsens. These
  people are able to walk, and may only
  require bandages and antiseptic.
Advanced triage

• In advanced triage, doctors may decide
  that some seriously injured people should
  not receive advanced care because they
  are unlikely to survive. Advanced care will
  be used on patients with less severe
  injuries. Because treatment is intentionally
  withheld from patients with certain
  injuries, advanced triage has ethical
  implications. It is used to divert scarce
  resources away from patients with little
  chance of survival in order to increase the
  chances of survival of others who are more
  likely to survive.
• Principles:
• CARDINAL RULE: “Do the greatest
  good for the greatest number”
• Preservation of life takes
  precedence over preservation of
  limbs
• immediate threats to life:
  HEMORRHAGE
TRIAGE CATEGORIES

• FIRST PRIORITY
  -immediate, red tag
  -victims with serious injuries
  that are life threatening but has
  a high probability of survival if
  they received immediate care
• They require immediate surgery
  or other life-saving intervention,
  and have first priority for
  surgical teams or transport to
  advanced facilities; they
  "cannot wait" but are likely to
  survive with immediate
  treatment.
SECOND PRIORITY
 -intermediate,
 observationyellow tag
 -victims who are seriously
 injured and whose life are not
 immediately threatened
 -can delay transport and
 treatment for 2 hours
• Their condition is stable for the
  moment but requires watching
  by trained persons and frequent
  re-triage, will need hospital care
  (and would receive immediate
  priority care under "normal"
  circumstances).
LOW PRIORITY
Wait (walking wounded)
 -delayed, green tag
 -patients/victims whose care
 and transport can be delayed
 until last.
 -hold care; can delay transport
 up to 3 hours
• They will require a doctor's care
  in several hours or days but not
  immediately, may wait for a
  number of hours or be told to go
  home and come back the next
  day (broken bones without
  compound fractures, many soft
  tissue injuries).
LOWEST PRIORITY
Dismiss (walking wounded)
  -patients/victims who doesn’t require
  care
They have minor injuries; first aid and
  home care are sufficient, a doctor's
  care is not required. Injuries are
  along the lines of cuts and scrapes,
  or minor burns.
Black / Expectant
  • They are so severely injured that they
    will die of their injuries, possibly in
    hours or days (large-body burns, severe
    trauma, lethal radiation dose), or in life-
    threatening medical crisis that they are
    unlikely to survive given the care
    available (cardiac arrest, septic shock,
    severe head or chest wounds);
  • they should be taken to a holding area
    and given painkillers as required to
    reduce suffering.
END of DISASTER
NURSING
TENK YOU!!! 



UP NEXT



UNIT EXAMINATION 