It Include Detail Regarding Disaster.

1. Disaster Nursing
Presented By; Mr.Mihir Patel,
Nursing Tutor,
Govt.College of Nursing,Siddhpur.

2. Meaning
A sudden event causing great demands of care or loss of life.
Emergencies and disasters do not affect health and well being of
people; frequently larged number of people are displaced, killed
Or injured. Disasters cause great harm to the existing
infrastructure and threaten the future of sustainable development.

3. Definition
Disaster can be defined as “any occurrence that causes damage,
ecological disruption, loss of human life, deterioration of health
and health services on a scale sufficient to warrant an extra
ordinary response from the affected community area.

4. Classification of Disaster
Natural Disaster
Flood
Cyclone
Earthquake
Cold Wave
Thunderstorm & Lightening
Mudslides
Tornadoes Hurricane
Tsunami
Snow Avalanches
Sea Erosion
Cattle Epidemic
Forest Fire
Volcano Eruption
Manmade or Artificial Disaster
Setting or Mine Fire
Chemical and Industrial Disaster
Nuclear Disaster
Deforestation
Environmental Pollution
Road, Rail and Other Transport Accidents
Mine Flooding
Major Building Collapse
Serial bomb blasts
Festival Related Disaster
Urban Fires, Village Fires
Oil Spill
Boat Capsizing
Electrical Disaster
Drowning

5. Factors Causing Disaster
1.Earthquake : It is a sudden rapid shaking of the earth
caused by breaking and shifting of rock beneath the
earth surface.

6. 2.Cyclones : Mixture of heat and moistures from a low centre
pressure over oceans in tropical latitudes where water
temperature are over 26 degree cell. Wind currents spin and
organize low pressure over accelerating towards the center.

7. 3. Tsunamis : Faulty Movement on Sea Floor, Accompanied by
an earthquake.
4. Volcanoes : Magma Pushed upwards through volcanic vent
by pressure and mixture of dissolved gases.

8. 5. Landslides : Downslope travel of soil and rock resulting from
naturally occurring vibrations, changes in direct water content,
removal of lateral support, loading with weight & weathering and
human manipulation of water coarse.

9. Flood : Prolonged rainfall over several days can cause a river or
stream to overflow and flood the surrounding area.
Droughts: Immediate Cause – rainfall deficit ; Human induced
changes in ground surface and soil, increase of atmospheric CO2.

10. FEATURES OF DISASTER
1. Unpredictability : We can not predict about when the
disaster is going to come. It may be Sudden Effect. Ex. An
earthquake is a disaster which occurs suddenly and because of
the nature of its unpredictability there are many hazards which
directly effects the individuals, environment and sometimes not
able to reduce the effects of disaster.

11. 2. Unfamiliarity : The management of certain types of disaster
may sometimes not be familiar to the clients. Ex. When the
tsunami occurred for the first time people did not knew how to
manage it.
3. Speed : There is sudden onset of the disaster. It occurs
immediately without any warning signs. Ex. Tsunami, Earthquakes
etc.. Occur suddenly which causes lots of damages, loss of life
etc….

12. 4.Urgency : When there is a disaster which occurs uncertainly,
the disaster management should be able to manage the
emergency situation and move the people away from the
hazards as soon as possible the restoration services to meet the
immediate physical needs of the people should be done.
5.Threat : The environmental disasters are sudden threat to the
public health or well being of the environment. It cause lack of
economic resources, epidemic disease, loss of
life,poverty,impact on capital stock and environment, loss of
production and provision of services.

13. Phases of Disaster
1. Pre-Disaster Phase
 Disaster Prevention
 Disaster Mitigation
 Disaster Preparedness
2.Impact Phase
 Warning (Beginning before the actual event)
 Evacuation, search and rescue.
 Emergency Assistance (relief) –Food,Shelter,Medical Aid etc…

14. 3. Post Impact Phase
Repair and Reconstruction of life lines
Reclaim and Clear Land
Resume Services
4. Rehabilitation Phase
Replace Building
Restore Service System
Revitalize Economy
Restore Occupations

15. Effects of Disaster
1. Physical
 Loss of Life
 Severe Physical Injuries
 Damage to Health Facilities
 Food Shortage
 Damage to safe water facilities
 Major Population Movement
 Communicable Disease

16. 2. Economical
Major Business or Economical Loss
Property Damage
Industrial Damage
3. Sociological
Complete Disruption of Normal Day Life
Isolation
Disrupt the Functioning of Society

17. 4. Environmental Loss
Deforestation
Death of Animals
Major Loss in Farming Field.
Geographical Changes in the map of village, city and country.
5.Psychological
Post Traumatic Disorders
Psychological Trauma
Acute Mental Illness
Anxiety Neurosis

18. 6. Health and Political System
It negatively influences the emergency system
New health planning objectives
Major changes in political background.
Formulation of Legislation criteria’s

19. Disaster Management
The purpose of disaster management in any health care
facility is to maintain a safe environment and continue to
provide essential services to the patients during the time
of disaster.

20. Objectives of Disaster Management
1. To ensure that appropriate,Procedures,Resources and systems are in the
place to prompt, effective assistant to disaster victims, thus facilitating
relief measures and rehabilitation services.
2. To reduce the impact on the life of the individuals and health through
emergency services.
3. To participate in the disaster team efforts to minimize the loss of life,
damage to property, social and economic disruption.
4. To make initiation of psychological rehabilitation.

21. Principles of Disaster Management
Prevent the occurrence of the disaster whenever possible.
Minimize the number of casualties if disaster cannot be
prevented.
Prevent further casualties from occurring after the initial impact
of the disaster.
Rescue Victims
Provide First Aid to the Injured.
Use of referral Services.
Evacuate the injured.
Provide definitive medical care
Promote reconstruction of Life.

22. DISASTER MANAGEMENT CYCLE
There are three Fundamental Aspects of Disaster
Management;
a) Disaster Response
b) Disaster Preparedness
c) Disaster Mitigation

23. a) Disaster Response
 Search, Rescue and First Aid
 Field Care
 Triage
 Tagging
 Identification of Dead

24. Search, Rescue and First Aid.
After a major disaster the need for search, rescue and first aid of
victims organizes relief services.
Search for moderate or severely injured, dead victims, clients in
life threatening conditions.
Rescue for trapped people.
Health team as well as uninjured team also participate in this
service.

25. FIELD CARE
Provide health facilities according to priority and severity of
injury.
Transfer severely injured or threatened client to hospital
using whatever transport is available.
Provide proper care to casualties.
Bed availability, surgical services should be maximized.
Provision should be established to respond to enquiries.
Priority should be given to victim’s identification.
Adequate mortuary space should be provided.

26. Triage
(To sort out or to Choose)
Triage is the process which places the right patient in the
right place at the right time to receive the right level of
care.
Principal of Triage
Never move a casualty backward (Against the flow)
Never hold a critical patient for the further care.
Triage providers do not stop to treat patients.

27. Triage System : Four Color System
Red Color : Indicates high priority or urgent treatment or trasfer.Having life
threatening injuries, Hypoxia,Shock,Chest Wounds, Burns(20-60%),Head
Injuries.
Yellow Color : Indicates Medium Priority. Patient appears stable enough to
withstand up to 2 hrs. can wait without immediate risk egg: multiple
fractures, spine injuries.
Green Color : Indicates ambulatory patient, it is third priority. Patient have
minor injuries with no complications these patients can wait for more than 2
hrs for treatment Egg. Simple Fracture, Minor Burn, Sprain etc….

28. Black Color : Indicates dead or moribund patient.
(Triage should be carried out at the site of the disaster in order to
determine transportation priority and admission to the hospital)

29. TAGGING
All patients should be identified with tags stating their name, age,
place of origin,triage,category,diagnosis and initial treatment.
Identification of Dead
Taking care of dead is an essential part of the disaster Management.
Care of Dead Includes;
1. Removal if dead from disaster scene
2. Shifting to mortuary
3. Identification
4. Reception of bereaved relatives
5. Proper respect for dead person

30. Relief Phase
This phase is begins when assistance from outside starts to reach at disaster
area. The type and quantity of relief supplies are determined by;
The type of disaster, its effect on population.
Type, quantity of supplies available locally
A rapid damage assessment must be carried out in order to identify needs
and resources.
Large quantity of donation- supplies of food, blankets, clothing, shelter,
sanitary engineering equipments and constructional material etc.

31. Epidemiological Surveillance and Disease Control
Prevention and control of communicable diseases can be achieved through
Avoid overcrowding and maintain well sanitary facility in resettlements
Prevention of acute respiratory tract infection while displacing the population
Prevention and control of contamination of water supply.
Direct properly, the delivered funds and personnel towards the control program.
Arrange control measures to reduce breeding of vectors.
Arrange control measures to reduce breeding of vectors.
Arrange veterinary to evaluate the risk of zoonotic disease, displacement of
domestic and wild animals in separate temporary shelters.
Organize a reliable disease reporting system.
To identifying outbreaks and to promptly initiate control measures.
Investigate all reports of disease outbreaks rapidly.

32. Nutrition
The immediate steps for ensuring safe food supply.
Assessing the food supply after the disaster.
Gauging the nutritional needs of the affected population.
Calculating daily food rations and nutritional need for large population
groups.
Monitoring the nutritional status of the affected population.

33. Rehabilitation
It starts from the very first moment of disaster.
In first weeks after disaster, the pattern of health needs will change rapidly,
moving from casualty to more routine primary health care.
Priorities shift health care to environmental health care measures; some of
them are as follows.

34. WATER SUPPLY
Survey of all public water supplies, distribution and water source
Determine bacteriological and chemical quality of water, microbiological
contamination.
Do chlorination of water
Repairing, disinfecting and cleaning of water sources
Protection of new water sources : Restrict access to people and animals
Ensure adequate excreta disposal at a safe distance from water source
Prohibit bathing, washing animal husbandry upstream of intake points in
rivers and streams.
Prevent contamination wells

35. Food Safety
Hygiene of food items
Safe and adequate water supply
Hygiene during preparation of food
Personal hygiene of worker preparing food
Maintain sanitation in kitchen
Proper storage and distribution of food

36. Basic Sanitation and Personal Hygiene
Washing, cleaning and bathing facilities should be provided.
Hand washing before and after toilet.
Sanitary disposal of excreta.
Emergency latrines should made available.

37. Vector control
Arrange prevention and control measures against dengue fever,
malaria, leptospirosis and rat bite fever, typhus, plague.
Fly.
Environmental sanitation e.g. clean house and its surroundings.
Sanitary disposal of waste material, animal excrete.
Stop open air defecation.
Provision of sanitary latrines.
Use of insecticides, larvicide’s.
Use fly stick paper.
Screening of house, food market, restaurants.

38. Mosquito
Source reduction e.g. filling, leveling and drainage of breeding places.
Application of oils into water
Paris green ( stomach poison) micro crystalline powder kills mainly
anopheles larvae because they are surface feeders
Use of larvicide’s ( Fenthion, chlorpyrifos, abate)
Use small fish (Gambusia affine and lobster reticulates) in burrow
pits, sewage oxidation ponds, ornamental plants etc.
Use spraying of DDT, Pyrethrum extract.
Use mosquito net, screening of building with copper.

39. Disaster Preparedness
Preparedness refers to proactive planning efforts designed to
structure the disaster response prior to its occurrence.
Goals:
1. To strengthen the overall capacity and Capability of the
country to manage efficiently all types of emergencies.
2. To ensure that appropriate systems, procedures,
resources are in place to provide prompt effective
assistance to disaster victims.

40. 3. The disaster planning is broad in scope and must address
collaboration across the agencies and organization, advance
preparations as well as need assessments, event Management.
4. Describe the role of emergency agencies in responding to a
range of emergencies that might arise.
5.Adequate planning can assess many of issues in advance and
even eliminate some problems.
6.Information system need to be identified or developed that will
tract patients across multiple setting.

41.  Warning
1. Risk Identification
2. Risk Assessment
3. Protective Action Search
4. Protective Action Assessment
 Early Warning System
INDIAN METROLOGICAL DEPARATMENT : It is mandated to
monitor and give warning regarding tropical cyclone. The
metrological satellite has made a tremendous impact on the
analysis of cyclones.

42. NURSES' RESPONSIBILITIES
Opportunities and Challenges for Nurses in Disaster Management
Leadership
Roles and Functions (Clinician,Planner,Scientsts,Educator)
Health Promotion and Disease Prevention
Quality Care
Policy Development
Evidence Based Practice
Critical Thinking Skills

43. Role of Team Members in Disaster Management
Physicians : Identify victim condition, diagnosis and
transfer to hospital.
Surgeons : Cleaning and Dressing of wounds and
suturing.
Psychologist : Psychological Support.
Nurses : Adequate Space for Accomodation,Listen victim
Carefully, Provide Basic Needs, Keep Record of Dead
Person, Arrange counseling programmers.

44. Thank You