3 . Disaster management.ppt
- 1. Disaster Management Supervised by: Presenter: Prof. GN Mandal Sushila Hamal Medical Surgical Nursing M.Sc. Nursing 1st year BPKIHS BPKIHS
- 2. Objective of this session At the end of this session, the participant will be able to; • Definition of Disaster • Types of Disaster • Impacts of Disaster • Principles of Disaster Management • Disaster Management Cycle • Role of Nurses Before, During and After disaster 2
- 3. Hazard Vs Disaster • Hazard is an event that has potential for causing injury/ loss of life or damage to property/environment. • Disaster is an event that results in loss or damage to life, property or environment. 3
- 4. Example: Hazard Vs Disaster • Imagine you are in the desert and earthquake occurs. Since in open desert it does not cause damage to you. No threat to your life. So it does not become disaster. It remains as a hazard. Here earthquake is a hazard. • Now imagine earthquake in a city. There buildings collapse, people die or are injured, normal life is disrupted. This is a disaster situation. 4
- 5. Hazard and Disaster • Hazard is only event (potential to cause loss) • Disaster is consequences of event which causes loss of life and property. • It is the people who matter most, and without the people we have no disaster. 5
- 6. Disaster • Dis = Bad • Aster = Luck • Disaster is a sudden incident which cause huge loss of life and property and environment. This Loss is beyond the coping capacity of local affected population/society and therefore requires external help. 6
- 7. Definition of Disaster 1. Disaster is an event, natural, or manmade, sudden or progressive, which impacts with such severity that the affected community has to respond by taking exceptional measures. 2. The WHO has defined disaster as “any occurrence that causes damage, ecological disruption, loss of human lives, or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area”. 7
- 8. Definition of Disaster Common to both definitions are • Occurrence of events with high magnitude. • Loss of lives and property • Need extra ordinary response from outside 8
- 9. Types of Disaster • Earthquake • Tsunami • Flood • Landslides • Epidemics • volcanic eruptions • Avalanche etc--- Natural • War (terrorism ) • Industrial accident • Explosion • Fires • Accident Man- made 9
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- 13. Landslide 13
- 14. 14 Highway in Nepal Photo: Padma Khadka
- 18. GN Mandal 18 Airplane Accident
- 20. Impact of Disaster 1. Physical Impact: Injuries, Burns, Physical disabilities, Traumatic amputation, miscarriage 2. Mental(psychological) Impact : Distress, Flashbacks, Insecurity, Grief, Lack of trust, Helplessness, Hopelessness, Insomnia, Depression 3. Social Impact : isolation, theft, crime, domestic violence, sexual abuse, migration etc 4. Economical impact : loss of property, loss of crops, loss of public infrastructure, unemployment. 5. Environmental impact : pollution, climate change, food and water scarcity, Eruption of communicable diseases. 20
- 21. Principles of Disaster Management • Prevent the disaster • Minimize casualties • Prevent further casualties • Rescue the victims • First aid • Medical care • Evacuate • Reconstruction 21
- 22. 1. Mitigation 2. Preparedness 3. Response 4. Recovery 22 Disaster Mgmt Cycle
- 23. 1. Mitigation (Prevention/stop or lessen) : • Taking actions to prevent or reduce the long term impact and consequences (loss of life or property) of disaster. • Measures taken before an emergency or disaster occurs. • The goal of mitigation are 1. Protect people and structure during disaster. 2. Reduce cost of response and consequences. For example, to protect against sea level rise and increased flooding, communities might build seawalls or relocate buildings to higher ground, strengthening of public infrastructure etc . 23
- 24. 2. Preparedness (Action before disaster) • Taking certain actions before disaster , a harmful consequences of disaster can be reduced. • It includes : – Planning, Awareness, training and educational activities. – Developing disaster preparedness plan for what to do, where to go, and whom to call for help etc. – Emergency exercises (Drill) /training 24
- 25. 3. Response (during or immediately after disaster)- Efforts to minimize the hazards created by a disaster. It includes: – Conducting life saving measures : Search, Rescue, First Aid – Triage, tag and Transfer /Treat (3T) – Provision of food, water and emergency health care 25
- 26. 4. Recovery/Reconstruction (After Disaster) - Returning the community to normal. – Rebuilding and reconstruction or restoration. – Rehabilitation – Rebuilding damaged buildings, – Providing financial support to people. 26
- 28. What is disaster for the hospital? • When the work load exceeds the available resources, it is declared as disaster for the hospital(usually >30 victims at a time) • A situation can be disaster for one hospital may not be disaster for another hospital 28
- 29. Role of Nurses in Disaster Management (Before, During and After) Role of Nurses Before Disaster(disaster preparedness) 1. Assess the community for hazards 2. Collect past history of any disaster. 3. Assess the health care facilities/local agencies and personnel. 4. Diagnose the potential or actual disaster threat. 5. Develop Disaster Plan/Protocol: Helps to provide prompt and effective medical care to the maximum possible in order to minimize morbidity and mortality 29
- 30. Elements of disaster plan • A disaster plan should have the following elements – Declaration of disaster – Information system – Chain of authority – Lines of communication – Routes and modes of entry – Routes and modes of transport – Routes and modes of evacuation – Mobilization of resources – Triage – Treatment protocol – Care of dead bodies 30
- 31. 6. Formulate Disaster Management Team/RRT : Every hospital should have a Disaster Management Team which include:. • In charge –Head of Department of Emergency and members are • Head of Department of Surgery • Head of Department of medicine • Head of Department of Anesthesia • Head of Department of Radiology • Head of Department of Laboratory • Head of Department of Neurology • Head of Department of Orthopedic • Head of Department of Nursing • Head of Department of eye/ENT • Nursing in charge of Emergency • Administrative Staff • Security Officer • Communication Officer • Police, Forensic Officer, Public relation Officer 31
- 32. 7. Have a disaster stock • There should be separate disaster stock in each hospital with all necessary drugs/equipment. • Key should be available at all the time or should be available whenever necessary. 32
- 33. 8. Drill exercise • Mock exercise and drills at regular intervals are conducted to ensure that all the staff in the general and those associated with management of causalities are fully prepared and aware of their responsibilities. 33
- 34. Summary (Before disaster) • Assessment of Risk • Formulation of Disaster plan • Formulation of Disaster mgmt Team/RRT • Drill Exercise • Have a disaster stock b ready at all the time 34
- 35. Role of Nurses (Prior to the arrival of casualty) 1. Identify the source of information/communication – Receive information from the authorized person about the type, number of casualties and the seriousness of injuries – Communicate information to members of Disaster Management Team • For this telephone operator will begin to call persons on the established list. • Alarming bell can be used to communicate the message 35
- 36. 2. Preparation of human resources • Call nurses – From different wards – on leave and who stay on hospital hostel. – Call final year nsg and medical stds • Alert different departments to remain standby: operation theatre, all indoor units, laboratory, radiology, kitchen, maintenance, etc. 36
- 37. 2. Preparation of Equipment and supplies – Extra wheel chairs, stretchers, portable beds, suture materials, etc – Drugs-emergency drugs, IV fluids, IV cannula, plaster of Paris, etc – Others- Triage Tags, police case stamps etc. – Be ready to receive the casualty Note: 1. Preparation of resources depend upon the kinds of disaster. 2. Suspend all other regular hospital activities except for the critical ones. 37
- 38. Role of Nurses during Disaster 1. Triage and Tag : the most important 2. Postpone all routine activities for certain period 3. Mobilization of Key Staffs-Time to activate the team. Nurse incharge then mobilize the key members of the hospital e.g. shift incharge/ shift coordinator / Juniors. 38
- 39. 3. Management of Extra Human Resources • Pull in Nursing and other health personnel from other wards leaving only skeleton staff. • Call Nurses who are on leave, and who stay in hospital hostel. • Assignment of work (as per demand/need) 39
- 40. 4. Management of Space • Admit: Serious victims should be admitted (make more vacant beds). Patients should be admitted to any vacant bed of any wards. • Discharge: Minor victims should be given first aid, if necessary outside the hospital and can be discharged. • Refer: Serious victims can be refereed to higher center where the facility is available. • Create Extra Space: • Extra places near the hospital can be used. • If needed, extra beds should be made available even on floor. • Utility areas to be converted in to temporary wards such as wards with side rooms, corridors, seminar rooms etc. • Creating additional bed capacity by using trolleys, folding beds and floor beds 40
- 41. 5. Management of extra equipment and drugs: Use your own disaster stock and borrow from other wards, store and pharmacy if necessary . 6. Co-ordination: make coordination with various departments, the police, security, and ambulance are necessary. 41
- 42. 7. Crowd controlling • Is extremely important and should be managed in collaboration with security, police and other volunteers. • The main hospital gate should be closed and only vehicle and individual carrying casualty should be permitted. • People from media should be allowed entrance only as far as the information center or reception area. • All visitors and other non-hospital staff should be requested to leave the hospital immediately. 42
- 43. 8. Evacuation • Minor cases can be discharged • If necessary, the Red Cross and other available organization/ institution should be requested to provide ambulance services to transfer the patients to other health institution /facilities. 43
- 44. 9. Care of Dead body • Provide dead body care as institutional policy. • Never handover the Dead body to relatives without post-mortem 44
- 45. Role of Nurses After Disaster 1. Recording and Reporting –Document all cases with their full details –Document all cases as Medico-legal Cases –Collect all Medico-Legal evidences if possible, e.g.-X-rays, Vomitus, Bullets, –Keep records of all expired cases. –Inform to police if cases are discharged referred, or expired. 45
- 46. 2. Debriefing: report all cases to concerned authority (number of victims, expenditure of resources, outcome) 3. Rearrangement: cleanliness of all used equipment according to the hospital’s policy, replacement of used items, rearrangement of disaster inventories. 4. Conduct /participate in post- disaster meeting 5. Analyze strength and weaknesses 6. Give feedback to the team. 46
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- 49. Research article • Title: Disaster management and role of academic Institutions in Nepal: current status and way forward • Published on: 4 May 2020 • This study attempts to figure out the status and role of Nepalese academia for the contribution of disaster risk reduction and management (DRRM). The methodology adopted for the study is reviewing the literature, policies, and academic documents including university curricula. Ten major universities of Nepal have incorporated disaster components including preparedness, response, recovery, and mitigation-related academic curricula in their undergraduate and graduate levels academic programs. 49
- 50. RESULTS AND DISCUSSION • This study depicts the current practices and role of academic institutions for disaster risk reduction and management (DRRM) in Nepal. It is found that the disaster research and innovation in terms of participation, cooperation, innovation, human and environment centric approaches of higher educational institutions were just at the satisfactory level in Nepal. The sustainable management of disaster issues requires a higher level of knowledge, skills, and capabilities. However, the academic curricula of many higher educations are still in remembering, understanding, and recalling phases where they missed the practical applicability in terms of analysis, research and innovations. 50
- 51. References 1. Sharma M., Kalpana P., Gautam R. "Essential Textbook of Medical Surgical Nursing". 2nd ed. Ghattekulo Rautahadevi Marga, Kathmandu: Samiksha Publication Pvt. Ltd; 2017. 2. Mandal G.N. "Textbook of Medical Surgical Nursing". 6th ed. Baneshwor, Kathmandu: Safal Publication House Pvt. Ltd; 2019. 3. Chugh S N. "Textbook of Medical Surgical Nursing". 1st ed. New Delhi: Avichal Publishing Company; 2013. 4. Pant RR, Bishwakarma K, Ghimire A, Shrestha K, Maskey R, Joshi BR, et al. Disaster Management and Role of Academic Institutions in Nepal: Current Status and Way Forward. Himal Biodivers. 2020;(May):27–35. 5. Nepal P, Khanal NR, Pangali Sharma BP. Policies and Institutions for Disaster Risk Management in Nepal: A Review. Geogr J Nepal. 2018;11(1998):1–24. 51
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