Disaster Nursing

1. DISASTER NURSING
2nd Semester
Richard F. Pidlaoan, RN, MAN

2. ONLINE LECTURE HOUSE
RULES/ETIQUETTE
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9. Aim of the Course:
• At the end of the whole lecture, the student/learner will be
able to understand concept of disaster nursing and
management of disaster and their roles and responsibility.

10. Course Objectives:
• Students will be able to:
-Define and discuss disaster nursing, disaster management, disaster triage and
crisis incident stress management competently.
-Explain types of disaster.
-Discuss levels of disaster.
-Explain key elements of disaster.
-Explain disaster nursing goal and principle.
-Know health effects of disaster.
-Discuss discuss how triage in a disaster differs from triage in emergency
department.
-Explain disaster management cycle.
-Explain disaster triage.
-Discuss role of nursing in disaster.
-Know legal issues in disaster.

19. COVID-19

21. INTRODUCTION
• Disaster are not confined to a particular part of the world; they can occur
anywhere and any time.
• Disasters are characteristically predictable and controllable as long as there is
an early forewarning.
• Early forwarning greatly reduce the duration, scope and intensity of impact of
disasters.
• COVID-19 infection and variants should be treated as disasters. Even
localized epidemics as disasters for which we need preparedness and
mitigation strategies. (-DOST NRCP).
• “Human activities like deforestation resulting to desertification, generating
powers, manufacting goods, and transportations triggers global warming and
therefore affects the frequency and intensity of extreme climate events thus
increasing the impacts of disaster. (impact on personal,community, economic
and environment).

22. DISASTER ALPHABETICALLY MEANS
• D- Destruction
• I- Incidents
• S- Sufferings
• A- Administrative, Financial Failures
• S- Sentiments
• T- Tragedies
• E- Erruption of Cmomunicable Diseases
• R- Reasearch Programme and Its Implementation

23. Philippine Disaster and Risk Profile
• Disaster as old as mankind. (Noah and his ark)
• Philippines was found to be one of the most disaster-prone country (3rd rank in
top 10 countries) in the world for the past century. Occupies the western rim of
Pacific Ocean (western segment of Pacific ring of fire).
• The Ring of Fire is a region around much of the rim of the Pacific Ocean where
many volcanic eruptions and earthquakes occur. Also known as “Circum-Pacific
belt”.

25. CONCEPT OF DISASTER
• Greek word dus (bad) and aster (star)- Calamity due to position of a planet or a star.It
evolves in the Italian word as disatro, French word disastre then later became disaster.
• a sudden event, such as an accident or a natural catastrophe, that causes great damage
or loss of life. -(wikipedia)
• a serious distruction of the functioning of a community or a society involving wide
spreading human, material, economic or environmental losses and impacts, which
exceeds the ability of the affected community or society to cope using its own resources.
-(UN-DRR)
• any occurence that causes damage, ecological disruption, loss of human life,
deterioration of health and health services, on a scale sufficient to warrant and
extraordinary response form outside the affected community or area. -(WHO)
• an occurence either natural or man-made that causes human suffering and creates
human needs that victims cannot alleviate w/o assistance -(American Red Cross)
• Is is an event, natural or man-made, sudden or progressive, which impacts with such
severity that the community has to respond taking exceptional measures. -(W. Nick
Carter)

26. When is an event a Disaster?
1. At least 20% population are in need of emergency
assistance/whose dwelling units have been destroyed.
2. At least 40% livelihood are destroyed
3. Disrupted flow of transport and commerce for a week.
4. Widespread destruction of agricultural products.
5. Epidemics

27. When is an event a Disaster?
(VULNERABILITY + HAZARD) / CAPACITY = DISASTER
VULNERABILITY - conditions determined by physical, social, economic and
environmental factors or processes which increase the susceptibility to the impacts of
hazards. (UNISDR)

28. Vulnerability to a natural hazard
depends on the following factors:
• Wealth -
• Education
• Governance
• Technology
• Age and
Gender

29. When is an event a
Disaster?
• Hazard- any phenomenon that has potential to cause disruption or damage to
people and environment. “A hazard is perceived natural event which threatens both
life and property. A disaster is a realization of this hazard.” (Whittow, J n.d.)
• Capacity or coping capacity refers to the ability of people, organizations and systems
using available skills and resources to deal with and manage conditions such as
hazards, emergencies or disasters.
Disaster occurs when hazards meets..... vulnerability.
“Disaster is a crisis situation that exceeds the capabilities.” (Duarentelli, 1985)
NATURAL HAZARD- is a threat of a naturally occuring event that has operated
troughout earth’s history.

30. • Disaster risk is the product of the possible damage caused by a hazard due to
vulnerability within a community. (Dar, 2014).
• DISASTER RISK = (HAZARD X VULNERABILITY / COPING CAPACITY)
CONCEPT OF DISASTER RISK REDUCTION (DRR)
• Disaster risk reduction is viewed as a concept and practice of reducing
disaster risks through systematic efforts to analyze and manage the causal
factors of different disasters.
is an applied science, which seeks by systematic observation and analysis of
disasters, so improve measures relating to prevention, emergency, response,
recovery, and medication.

31. 1. vs.
OVERLAND FLOODING SEWER BACKUP
NATURAL TECHNOLOGICAL
Forces of Nature “Acts of God” Caused by human-made systems
Humans have limited control Systems not designed to fall
Have occurred throughtout the history of
mankind
Humans had control
Point of blame
TYPES OF HAZARDS AND DISASTERS

32. vs Hazards and Disasters

33. NATURAL HAZARDS
• Geophysical- A hazard originating from
solid earth. This term is used to
interchangeably with the term geological
hazard.
• Meteorological- A hazard caused by
short-lived, micro-to-meso-scale exterme
weather and atmospeheric conditions that
last from minutes to days.
• Hydrological- A hazard caused by the
occurence, movement, and distribution of
surface and subsurface freshwarter and
saltwater.
• Climatological- A hazard caused by long-
lived, meso-to-macro-scale atmospheric
processes ranging from intra-seasonal to
multi-decadal climate variability.
• Biological- A hazard caused by the
exposure to living organisms and their
toxic substances (eg, venom, mold) or
vector-borne diseases that they may
carry.Ex., venomous wildlife, poisonous
plants, micro-organism carrying diseases.

34. COVID-19 Pandemic in the Philippines
• (Date) - (reported cases)
• Philippines- the fifth-highest in Southeast Asia,behind Vietnam, Indonesia, Malaysia, and Thailand.
• The first case in the Philippines was identified on January 30, 2020, and involved a 38-year-old
Chinese woman who was confined at San Lazaro Hospital in Metro Manila. On February 1, 2020, a
posthumous test result from a 44-year-old Chinese man turned out positive for the virus, making the
Philippines the first country outside China to record a confirmed death from the disease.
• Philippines confirmed its first local transmission on March 7, 2020.
• Virus has spread to the country's 81 provinces.
• March 15, 2020- imposing of community quarantines as a measure to limit the spread of the virus.
• Luzon-wide enhanced community quarantine (ECQ) that was implemented in March-May 2020.
• March 24,2020- President Rodrigo Duterte signed the Bayanihan to Heal as One Act.
• September 11, 2020- revoke and renamed as Bayanihan to Recover as One Act (Bayanihan 2- RA
11494).
• COVID-19 cases throughout the country started declining in February 2022.
• "minimal-risk case classification" with an average of only 159 cases per day recorded from May 3
to 9.

35. Effects of Covid-19
Pandemic
in Daily Life
Economic
• Slowing of the manufacturing of essential goods
• Disrupt the supply chain of products
• Losses in national and international business
• Poor cash flow in the market
• Significant slowing down in the revenue growth
Social
• Service sector is not being able to provide their proper
service
• Cancellation or postponement of large-scale sports and
tournaments
• Avoiding the national and international travelling and
cancellation of services
• Disruption of celebration of cultural, religious and festive
• events
• Undue stress among the population
• Social distancing with our peers and family members.
• Closure of the hotels, restaurants and religious places
• Closure of places for entertainment such as movie and
play theatres, sports clubs, gymnasiums, swimming pools,
and so on.
• Postponement of examinations
Healthcare
• Challenges in the diagnosis, quarantine and
treatment of suspected or confirmed cases
• High burden of the functioning of the existing
medical system
• Patients with other disease and health
problems are getting neglected
• Overload on doctors and other healthcare
professionals, who are at a very high risk
• Overloading of medical shops
Requirement for high protection
• Disruption of medical supply chain

36. The list of top 10 global natural disasters are as follows:
1. Cyclone. 6. Flood
2. Earthquaker. 7. Wildfire
3. Tornado. 8. Drought
4. Volcanic eruption. 9. Avalanche
5. Tsunami. 10. Landslide
The 5 common disasters in the Philippines are as follows:
1. Typhoon
2. Earthquake
3. Fire
4. Volcanic eruption
5. Drought

37. Definition of Terms
• Cyclone- is an area of closed, circular fluid motion. It has low pressure on the inside and high pressure
on the outside. The center of the storm is called the eye, and it has the calmest water and the lowest
pressure.
• Earthquakes- It is the result of a sudden release of energy from the earth's crust that creates seismic
waves. They are measured using seismographs. The Valdivia earthquake also known as the great
Chilean earthquake is the biggest earthquake ever recorded. It hit Chile on May 22, 1960 with a
magnitude of 9.5 and a death toll of around 6,000 people.
The following are the top 3 strongest earthquakes in the Philippines that caused major destructions and
casualties:
1. Magnitude 8.0 earthquake in Mindanao (Aug. 17, 1976) .
This was followed by a massive tsunami which was 4 to 5 meters high. Since it occurred past midnight, it
was dark, and it claimed 8,000 lives, injuring 10,000, and leaving 90,000 more, homeless.
2. Magnitude 7.8 in Northern and Central Luzon. (July 16,1990)
A total of 2,412 people died and at least 10 - billion pesos worth of damages top public and private
properties was reported. Several hotels in Baguio collapsed trapping and burying people alive.
3. Magnitude 7.5 earthquake in Luzon (November 30, 1645)
It has caused many landslides which buried many people alive and destroyed many buildings and churches
including the Manila Cathedral.

38. Sinkholes - is a localized depression in the surface topography, usually caused by the collapse of a
subterranean structure such as a cave. Although rare, large sinkholes that develop suddenly in populated
areas can lead to the collapse of buildings and other structures.
Epicenter of an earthquake is the location directly above the hypocenter on the surface of the earth.
Hypocenter of an earthquake is the location beneath the earth's surface where the rupture of the fault begins.
Tornados (twisters)- is a violently rotating column of air that is touching both the ground and a cumulonimbus
cloud. Tornado conditions are caused when different temperature and humidity meet to form thunder clouds.
"Twisters" can attain speeds up to 100 miles an hour.
• The biggest tornado recorded was the Hallam, Nebraska tornado on May 22, 2004. It was around 2.5 miles
big and had a death toll of around 160 people.
• The deadliest tornado recorded occurred in Daultipur and Salturia, Bangladesh on April 26, 1989. One
thousand three hundred people recorded dead and 12,000 injured.
Volcanic eruptions
• A volcano is an opening in a planet's surface which allows hot magma to escape from below the surface.
Volcanic eruptions are measured using volcanic explosivity index. The highest volcano known to humans is
Olympus Mons on Mars. Olympus Mons means Mount Olympus and is bigger than Mount Everest, the
highest peak in the planet earth.The second largest volcanic eruption of the 20th century and by far the
largest eruption occurred at Mt. Pinatubo, Zambales on June 15, 1991.
• Lahar- is a type of natural event closely related to a volcanic eruption, and involves a large amount of
material originating from an eruption of a glaciated volcano, including mud from the melted ice, rock, and
ash sliding down the side of the volcano at a rapid pace. These flows can destroy entire towns in seconds
and kill thousands of people and form flash basalt.

39. Tsunami means harbor wave and it is caused by the displacement of a large body of water normally an ocean
or a large lake.
• The biggest tsunami ever happened at Lituya bay, Alaska on juy 9, 1958. The mega - tsunami was around
150 meters tall.
• The tsunami caused by 2004 Indian Ocean Earthquake, is the 6u dead lieur ant ural disaster in recorded
history with a death toll of 230, 210 - 280,000 people.
Floods are caused when water overflows from a water body.
One of the biggest floods in the world is probably the yellow river in China in 1887, which killed around 900,000
people.
Wildfire - is any uncontrolled fire in the countryside or wilderness. It is also known as brushfire, bushfire, forest
- fire, desert - fire, grass - fire, hill - fire, peat - fire, vegetation fire, and veld fire.
Drought - is a long period of time in which a certain region receives a shortage of water. Lasting 3 years from
1958 to 1961, the great Chinese famine is the worst on record, 15 to 43 million
died as a result.
Avalanche - is a sudden drop of snow. The biggest avalanche happened on Mt. Hwascarany with a death toll
of 20,000.
Landslide or a landslip - is a movement in the ground with a shallow flow of debris.
The largest landslide in history happened because of Mt. St. Helena, when 3 km. of rock moved downhill.

40. Unusual natural disasters.
1. Firenadoes - aka “firewhirl, firedevil or fire tornadoes.”
- is a column of smoke and fire caused when fire gets into a tornado.
HOW DO THEY FORM?
- intense heat that rises and combine with
winds
- forms pockets of swirling winds
- swirling winds can tighten into twister-like
structure

41. 2. Limnic eruptions or explosion is also called a lake overturn and is caused by an explosion no of
gas from the lake (normally carbon dioxide) erupting and suffocating people.
There are only three exploding lakes. They are lake Menoun, lake Nyos, and lake Kivu.
The biggest eruption ever recorded is Lake Nos killing 1,800 people and many animals. The biggest
danger is Lake Kivu which would cause a methane explosion and possibly kill million people. All
these lakes are in Africa and both Menoun and Nyos are in Cameroon.

42. B.2. Man - made (Human-Induced) Hazards and Disasters
1. Terrorism
What is Terrorism in the Philippines?
In Anti-Terrorism Act (ATA) of 2020 Section 4, terrorism is said to be committed by any
person who, within or outside the Philippines, regardless of the stage of execution
engages in acts intended to cause death or serious bodily injury to any person, or
endangers a person's life. Terrorism is also engaging in acts intended to cause extensive
damage or destruction to a government or public facility, public place or private property. It
is also terrorism to do acts intended to cause extensive interference with, damage or
destruction to critical infrastructure.
* A man - made hazard is a threat having an element of human intent, negligence or
error, or involving a failure. A man - made hazard may eventually lead to man - made
disaster.
FBI definition of terrorism: “The unlawful use of force or violence against
persons or property to intimidate or coerce a Government, the civilian population,
or any segment thereof, in furtherance of political or social objectives.”

43. 2. Technological Disasters
• Radioactive Spills
• Hazardous Waste
• Toxic Chemicals
• Oil Spills
• Chemical or hazardous waste accidents
• Fire
3. Transitional Human Shelters (Complex Humanitarian) Disaster
• Transitional Human Shelters are rapid,
post disaster shelters made from materials
that can be upgraded or re-used in more
permanent structures or that can be
relocated from temporary sites to
permanent locations.

44. Impact of Man-made Hazards and Disasters
- Direct Casualties, Emergency Workers suffered from radiation, diseases caused by
radiation, increased birth defects, thyroid cancer, suicide and violent death.
- Environmental impact- contaminated soil, ground water, air, foods.
-Biological disasters- microorganisms that is delivered using dusting airplanes or small
perfule atomizers that has the ability to generate immediate offects. (Ex. ebola/swine flu)
-Chemical disasters - these can be corrosive, toxic or explosive when there is an
irresponsible handling or excessive use and misuse of chemicals in industries.
-Fire accidents -heavy damage or loss of life, property.
-Travel accidents- ex. air crash, train crash, vehicle collisions, capsizing of boats and
ships. (large no. of people involved).
-Terrorism- eg. use of bombs, guns (-Marawi City, 2017)
-Epidemic of infectious disease (dengue, cholera).Involves large no. of people at one time.
*Pandemic- epidemic of infectious disease like Covid-19 infection which affects the whole
continent or worldwide. Both affects health, disrupts services and business, brings
economic and social costs.

45. Impact of Man-made Hazards and Disasters
- Climate change-
- Global Warming- term used to describe gradual increase in the temperature of the earth’s
atmosphere and oceans.
* Greenhouse gases such as carbon dioxide, nitrous oxide and methane absord heat
emitted from the earth surface.
*Carbon Dioxide
*Methane
*Nitrous Oxide
Greenhouse effect-the earth’s atmosphere heat up because greenhouse gases trap the
heat from the sun and doesnt radiat it back to the space anymore.

46. Causes of Global Warming and Climate Change
*Natural Cause
-Earth’s orbit
-Sun’s intensity
-Circulation of the ocean and atmosphere
-volcanic activities
* Man-made
-burning of fossil fuel
-deforestation
-growth in consumption exceeds
-increase in fertility

47. Effects of Climate change and global warming!!!
1. Temperature→ extreme weather (hot days and warm nights)
• hotter heatwaves, longer dry periods intensified by drought ,
powerful hurricanes→flash floods, landslides,
• 2. Environmental→ sea level rises (early snowmelt), ocean
acidification→ destruction of agriculture and fisheries,
disruption of habitats, fish kill, forest fires
• 3. Health→ allergies, asthma and infectious disease
outbreaks, nutritional insecurity.
4. Economic→ loss of livelihood.

48. * Displaced Population - people abandon homes.
* Health Risks - unsterile drinking water due to flooding
- waterborne microorganisms.
* Food Scarcity - crops and other agricultural supplies are
destroyed. Food prices rice demand resulting to famine
and malnutrition.
* Emotional Aftershocks-
- serious pychological condition resulting from
extreme trauma left untreated that can lead to lasting
pychological damage and emotional distress.

50. Assessing Hazards and Risk
• Risk is a statement of probability that an event will cause an
amount of damage or a statement of the economic impact in
monetary terms that an event will cause.
• Risk assessment involves both the assessment of hazards from a
scientific point of view, but also socio economic impacts of a
hazardous events. This includes:
1. Hazard assessment
2. Location of buildings, highways, infrastructures
3. Potential exposure to the physical effectsof a hazardous
situation.
4. Vulnerability of the community.

51. PREDICTION AND WARNING
• PREDICTION- involves a statement that an event may
occur based on scientific observation and technology.
Also known as “forecasting”.
• Early warning- is a statement that a high probability, of a
hazardous event will occur, based on the prediction for
forecast.
EFFECTIVENESS OF A WARNING
√ timeliness of the warning
√ public information system with effective
communications.

52. EFFECTS OF HAZARDS
PRIMARY EFFECTS COLLAPSE OF BUILDING DUE
TO EARTHQUAKE
SECONDARY EFFECTS DESRUPTION OF ELECTRIC SUPPLY
-FIRES IGNITE
-LOSS OF HABITAT
-FOOD SHORTAGE, WATER SHORTAGE
-MALNUTRITION
TERTIARY EFFECTS

53. RESILIENCE FACTORS
• Social Support
• Coping Confidence
• Hope - being optimistic
-confidence
-religious faith
-practical resources, including housing,
job and money.

54. PHASES OF DISASTER
• 1. PRE -IMPACT
- initial phase of disaster, prior to the actual occurence. A warning is
given at the sign of the first possible danger top of unity with the aid of weather
in the parts in satellite many meteorological disasters can be predicted.
- period when emergency preparedness plan is put into effect.
Emergency symptoms are open by the local civil, detention authority.
- Communication is very important for during this space.
* The role of the nurse during this morning face is the esses in preparing
shelters, an emergency, eight stations and establishing contact with other
emergency service group.

55. PHASES OF DISASTER
2. Impact Phase
– Occurs when the disaster actually happens. This is the time of
enduring hardship or injury end of trying to survive.
– May last for several minutes (for example, after an earthquake,
lean, crush, or explosion.) or for days or weeks (example flood,
famine or epidemic.)
– This is the time where they were agency operation center is
established and put in operation. It serves as the center of
communication and other government agencies of health care
providers to staff shelters.
* The nurse is responsible for psychological support to victims in
the shelter.

56. PHASES OF DISASTER
• 3. Post-Impact Phase
– This is the time of recovery, and it begins during the emergency
phase and ends with the return of normal community order and
functioning.
1. Denial - During this stage, the victims lady night, the magnitude of
the problem I have not fully registered. The victims may appear
usually unconcerned.
2. Strong Emotional Response- in this second stage, the person is
aware of the problem, but regards, it is overwhelming and
unbearable. Victims have the following reactions: trembling,
tightening of muscles, weeping, restlessness, sadness etc.

57. 3. Acceptance- During this third stage, the victim begins to
accept the problems caused by the disaster and makes a
concentrated effects to solve them.
4. Recovery- The fourth stage represents a recovery from the
crisis reaction. Victims feel that they are back to normal. A
sense of well-being is restored. Victims develop the realistic
memory of the experience.

58. • Generally, speaking, this, disasters are becoming less deadly, but more
costly. Fewer people are dying in disasters, but damages are costing
more in money. Improve science and technology are the main reasons
why fewer lives are lost. We are now better at forecasting, disasters, and
our buildings and other structures can better withstand the physical
impacts. This increases our resilience to hazards. Growth in population
and economy is a main reason that more money is lost. Simply put,
society now has more of value that is exposed to hazards. Even though
much of this is also more resistant to damage, the total money amount of
damage has been increasing. There is also an increase in the number of
disasters reported, which can be caused by population, growth,
economic growth, or changes and reporting standards.
• Nurses can make a lot of difference. I need disasters with adequate
knowledge, skills, and positive attitude.

59. DISASTER NURSING-DEFINITION
• Disaster nursing can be defined as “the
adaptation of professional nursing
knowledge, skills and attitude in
recognizing and meeting the nursing
health and emotional needs of disaster
victims.”

63. GOAL OF DISASTER NURSING
• The overall goal of disaster nursing is
to achieve the best possible level of
health for the people and the
community involved in the disaster.

64. Other goals of disaster nursing are the following:
1. *To meet the immediate basic survival needs of
populations affected by disasters (water, food,shelter,
and security).
2. *To identify the potential for a secondary disaster.
3. *To appraise both risks and resources in the
environment.

65. 4. *To correct inequalities in access to healthcare or
appropriate resources.
5. *To empower survivors to participate in and
advocate for their own health and well-being.
6. *To respect cultural, lingual, and religious diversity
in individuals and families and to apply this principle in
all health promotion activities.
7. *To promote the highest achievable quality of life for
survivors.