Disaster Nursing

Christina Barrick

Objectives

Describe examples of natural and manmade disasters. attack. Describe the different phases of a disaster. Discuss the nurses role in managing the disaster victim. Compare the reactions of children and the elderly. Discuss the role of the nurse in primary, secondary, and tertiary care. Apply principles of triage to select situations. Describe the principles of disaster management.
2

What is a Disaster?

Forces overwhelm a community. Services are compromised. Outside assistance is required.

Characteristics of Disaster Agents

Predictability Frequency Controllability/Mitigation Time: speed, duration Scope Intensity Community Implications
4

Manmade Disasters: Terrorism

D.O.D estimates that as many as 26 nations possess chemical or biological agents. 10 countries are believed to possess biological agents as weapons Attack can take many forms Aerosolized agents
5

Nuclear Attack

Nuclear and Radiological Attack

Dirty Bomb Appeal to terrorists Availability

Natural Disaster: Tsunami

Phases of a Disaster

Pre-disaster Warning Impact Emergency

isolation rescue remedy

Recovery
9

Immediate Physical Management of the Disaster Victim

Validate what you hear Perform a thorough assessment Assess for other injuries/illnesses even when symptoms are absent Is the condition life-threatening What is past medical history? Do not ignore patient fears or complaints
10

Management of the Psychosocial Aspects of a Disaster Victim

Pre-disaster Preparations and Warning Phase

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

11

Management of the Psychosocial Aspects of a Disaster Victim

Impact and Emergency Phase

reaction: disaster syndrome Interventions: prevent isolation, rumor control

12

Management of the Psychosocial Aspects of a Disaster Victim

Recovery Phase
reaction interventions

13

Reactions of Children to a Disaster

Developments level Familys reactions Separation anxiety School refusals Enuresis Guilt

14

Reactions of Children to a Disaster

Interventions Research www.fema.gov/kids

15

Elderly Reactions

Generally cope better Prob. related to chronic illness/resources Fear loss of independence Interventions

assistance with clean up financial, legal, and tax info. refer to a support team refer to appropriate comm. agencies
16

Caregivers Reactions

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

clear disaster plans & disaster exercises

17

Criteria for Post Traumatic Stress Disorder

The trauma is universally recognized Re-experience the trauma Demonstrate either emotional numbing or decrease in normal events

18

Three Tier Triage System

First Priority Second Priority Third Priority

19

Three Tier Triage System

Special Cases:

pregnancies family of rescue worker agitated of violent patients

injured disaster personnel

20

Role of the Nurse at the Disaster Site

Insure safety First Aid Emergency care

21

Role of the Nurse in a Shelter

Objective: temporary means of caring Assessment Planing:

24/7 nursing and ancillary coverage Supplies

Implementation Evaluation
22

Role of the CHN in a Community Setting After a Disaster

Goal: Achieve the best possible level of health for persons in a community after a disaster Primary Prevention Secondary Prevention Tertiary Prevention

23

Prevention Levels in Disaster Management

Primary Prevention Secondary Prevention Tertiary Prevention

24

Principles of Disaster Management

Prevent the disaster Minimize casualties Prevent further casualties Rescue the victims First aid Evacuate Medical care Reconstruction
25