EMERGENCY DISASTER MANAGEMENT

JOJI ESPER B. MARMOLEJO, RN Chapter Service Representative Community Health and NursingService Philippine Red Cross Iloilo Chapter

Topic Summary
Philippine Geography Definition of Terms Classification of Disaster Disaster Continuum Effects of Disaster on Health Disaster Nursing Triaging

PHILIPPINE GEOGRAPHY

PHILIPPINE AS A DISASTER PRONE AREA

As an Earthquake Prone Country

Surrounded by 2 major plates Eurasian Pacific

Aside from the Phil. Sea Plate and 9 minor plates within its territory.

EARTHQUAKE

VOLCANIC ERUPTION

TYPHOON

FLOOD

TERMINOLOGIES
Emergency Disaster Vulnerable Capacity Hazard Disaster Management

is a sudden occurrence demanding immediate action that may be due to epidemics, natural or technological catastrophes, strife or any other human-induced causes.

A serious disruption in the functioning of a society, causing widespread human, material or environmental losses which exceeds the ability of the affected society to cope within its own resources

VULNERABILITY
the extent to which a community, structure, service or geographic areas are likely to be damaged or disrupted by the impact of a particular hazard.

CAPACITY - communitys actual or potential ability to withstand

disasters through the presence of material and human resources that aid in the prevention and effective response to disasters.

is a phenomenon that poses threat to the people, structure or economic assets and which may cause a disaster. It could be natural or human-induced.

Refers to the range of activities designed to maintain control over disaster and emergency situation and to provide a framework for helping at risk persons to avoid or recover from the impact of the disaster.

is the consequence of a natural hazards which affects human activities.

1. The rapid increase in the utilization of transportation poses a huge threat to the development of transportation accidents which nowadays are very evident. 2. The use of hazardous materials to fuel industrial breakthroughs contributes much in todays disasters

3.

Globalization/Climate Change.

4. 5.

Complex Humanitarian Emergencies

worst disaster that can befall on populations.

The ready availability of weapons and munitions means that small groups of people with violent intents can terrorize large populations

Disaster
Natural Biological Disasters Insect Infestations Epidemics Animal attacks Geophysical Disasters earthquakes tsunamis Volcanic eruptions Dry mass movements avalanches landslides rockfalls
Subsidences

ManMade Climatologica l Disasters droughts

Extreme temperatures

Hydrological Disasters floods Wet mass movement

Meteorologic al Disasters storms

wildfires

General Floods

Flash Floods

ManMade/ Technological

Industrial Accidents Chemical spills Collapse of Industrial infrastructure Explosions Fires

Transport Accidents

Miscellaneo us Accidents Collapse of domestic/ non industrial structures Explosions Fires

Gas Leaks
Poisoning

COMPLEX EMERGENCIES

Displaced Filipino family flee with their farm animals to an evacuation center in Talayan town Maguindanao in Southern Island of Mindanao Philippines September 2008

FAMINE, FOOD SECURITY

POPULATION MOVEMENT AND DISPLACED PEOPLE

Emergency Response

DISASTER

Warning

Rehabilitation

Disaster Preparedness

Disaster Reconstruction Disaster DevelopmentPrevention Mitigation

Disaster Nursing
is the adaptation of professional nursing knowledge and skills in recognizing and meeting the medical and nursing needs evolving from a disaster situation.

Core Competencies Required

Fundamental attitudes towards disaster nursing Systematic assessment and provision of disaster nursing care Care provision for vulnerable people and their families Care management in disaster situations Professional Development

urses plans should be integrated and coordinated along with the other health team members pdate physical and psychological preparedness

esponsible for organizing, supervising and teaching

timulate community participation

xercise competence

daptation of nursing skills to situation

ontinuous awareness

each auxiliary personnel

election of essential nursing care

isseminate information on environmental health hazards

nterpret health laws and regulations

ave yourself

ccept directions and take orders

erve the best for the most

each meaning of warning signals

xercise leadership

efer to appropriate agencies

Planning to Meet Disaster Health Needs and Problems

Need - Any material/provision that will sustain survival if such is lacking, both physical or psychological, disequilibrium and imbalance will result.

Problem - an unmet need.

NURSING CARE PLAN: NEED/PROBLEM

INJURIES DEATH LACK OF RESOURCES (5Ms) EPIDEMICS POOR SANITATION (Congestion in a

Evacuation Center)

PSYCHOLOGICAL

INJURIES
OBJECTIVES:
Minimize further injury and prevent complications Relive pain and discomfort Provide 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
The above must be met within 6 hours after the disaster.

DEATH
OBJECTIVES:
Provide care of the dead
Proper identification and disposal Notification of relatives Spiritual bless to the dead

Provide supportive care to the bereaved family

LACK OF RESOURCES
OBJECTIVES:
Maximize existing resources

INTERVENTION:
Organize manpower by teams
First aid Communication Transportation Distribution of relief

Survey Education and publicity Family service Establish priorities Initiate collection of funds

Activities: a. Delineation of functions and responsibilities of personnel (use of volunteers and on-the-job training) b. Selective use of medicines and supplies c. Selective referral of cases to physicians d. Improvisation of needed facilities e. Approach socio-civic organization and agencies f. Encourage self-help activities

EPIDEMIC
OBJECTIVES:
Control of epidemics

INTERVENTION:
Epidemiological surveillance Initiate preventive measures
Early recognition of signs and symptoms of communicable disease Isolation precaution Immunization Environmental sanitation Public health information dissemination

 Treatment of cases Record and referral of noted cases to proper agencies Application of proper disinfection protocols.

POOR ENVIRONMENTAL SANITATION

OBJECTIVES:
Maintenance of proper environmental sanitation INTERVENTIONS: Dissemination of health information on the effects of poor sanitation:
Personal and community hygiene
Proper hand washing technique Proper use of toilets facilities Proper disposal of waste and garbage

Insect and vermin control

 Secure assistance from authorities for maintenance of safe water supply Organize teams for an effective implementation of the identified activities

PSYCHOSOCIAL PROBLEMS
Panic Anxiety Confusion Depression Shock Trauma Spiritual needs

 OBJECTIVES:
Provide supportive measures in meeting crisis situation Provide spiritual assistance

INTERVENTION:
Early identification of signs and symptoms indicative of stress
Establish rapport Encourage verbalization Apply therapeutic communication technique

 Provide diversional techniques Assist to adhere to his/her faith and belief. Refer to proper agency any cases of severe psychological manifestations.

MASS CASUALTY INCIDENCE

large number of victims disrupt the normal capabilities of the local health service. the greatest good for the greatest number of injured

 evaluation and categorization of the sick or wounded

Triage

commonly used in crowded emergency rooms and walk-in clinics to determine which patients should be seen and treated immediately.
prioritize the use of space or equipment, such as operating rooms, in a crowded medical facility. In mass casualty situations, triage is used to decide who is most urgently in need of transportation to a hospital for care (generally, those who have a chance of survival but who would die without immediate treatment) and whose injuries are less severe and must wait for medical care

START (Simple Triage and Rapid Treatment)

The categories in START are:
the deceased, who are beyond help the injured who could be helped by immediate transportation the injured with less severe injuries whose transport can be delayed those with minor injuries not requiring urgent care.

Color-coding Scheme
Red tags - (immediate) Yellow tags - (observation) Green tags - (wait) White tags - (dismiss) Black tags - (expectant)

Color Tagging
Ideally, the following information should be contained in the patients Color Tag:
Patients sequence number Name of patient Injuries Identified Previous interventions given at the scene

RED TAG
1st priority: Life-threatening- needs to be treated within 1-3 hours; Transport Immediately. Example: obstruction/damage to airway breathing disturbance (RR = 30/min or RR<10/min) Circulation disturbance (HR = 100/ min or weak pulses) Altered level of consciousness External bleeding with CVS collapse

YELLOW TAG
2nd priority: Urgent- needs to be treated within 4-6 hours; Transport after Red Cases
Example: Major burns: involving hands, feet or face (excluding respiratory tract); complicated by major soft tissue trauma Spinal injuries; long bone or pelvic fractures Environmental injuries (heat/cold exposure)

GREEN TAG
3rd priority: Requires minor treatment or can be delayed, Transport after Red and Yellow
Example: Minor injuries not threatened by ABC instability Minor fractures Minor soft tissue injuries Minor burns

BLACK TAG
Last priority: Expectant- Dead or Nonsalvageable given the available resources; Lowest transport priority Example:
Injuries so severe that survival cannot be expected even under the most ideal conditions; obviously mortal wounds where death is certain Death or moribund state

8. Age : 60 Perfusion: No Radial Pulse Respiratory Status: No breathing LOC/Ambulation: Unresponsive Complaint: Multiple trauma 9. Age : 59 Perfusion: Radial Pulse 90 Respiratory Status: 24 & Regular LOC/Ambulation: Alert Complaint: Open leg fracture

Black

Yellow

10. Age : 60 Perfusion: Radial Pulse 80 Respiratory Status: 18 & regular LOC/Ambulation: Alert & walking Complaint: scalp wound & 1% burn
11. Age : 35 Perfusion: Radial Pulse 120 Respiratory Status: 36 & laboured LOC/Ambulation: Unresponsive Complaint: 50% burns

Green

Red

Nursing is not for everyone. It takes a very strong, intelligent, and compassionate person to take on the ills of the world with passion and purpose and work to maintain the health and well-being of the planet. No wonder we're exhausted at the end of the day!

~Donna Wilk Cardillo

When you're a nurse you know that every day you will touch a life or a life will touch yours.

~Author Unknown

Caring is the essence of nursing.

~Jean Watson