Disaster management

1. Disasters
and
Disaster Management

2. Definitions
• Disaster
• Hazard
• Types of Disasters; Internal; & External
• Common Disasters
• Type of injuries from disasters
• Disaster Management
• Disaster Impact & Response

3. Disaster
•There is no generally accepted definition of disasters.
•Everyday use “I had a disaster of a day”
•Dictionary definition “A sudden calamitous event
producing great material damage, loss and distress”
•The commonalities & ideas are more important than
strict wording

4. Definition
•A sudden ecological event of such a large
magnitude as to create a catastrophic situation in
which day to day pattern of daily life is suddenly
disrupted and people plunged into helplessness
and suffering, and vast magnitude of causalities
overwhelm the existing health care resources, and
extreme assistance is needed to tackle it.

5. Occurrence
•Disasters occur through out the world and are
generally unpredictable in location, size, and
timing. May occur on the road, in the market, at
airport, at railway station, or at sea.

6. Geographic Classification
• Internal disaster:
An event occurring within the hospital premises and
disrupting daily, routine hospital working e.g. infrastructure
failure like failure of electric supply, failure of water supply,
employee’s strike or labor dispute etc.
• External
An event occurring in the community that results in a sudden
influx of patients requiring emergency care at hospital.

7. What disasters would and could
effect our community?
MANMADE
NATURAL

8. Event Disaster Location Date Affected Death Toll
Earthquake/
Tsunami
Makran 325 BC
1935
Balochistan
earthquake
Earthquake Quetta
May 31,
1935
60,000
1945
Balochistan
earthquake
Earthquake/
Tsunami
Makran
Nov 27,
1945
4,000
Flood 1950 2,900
Wind storm Karachi
Dec 15,
1965
10,000
Flood Aug 1973 4,800,000
1974 Hunza
earthquake
Earthquake
Northern
Areas
Dec 28,
1974
97,000 5,300
Flood Aug 2, 1976 5,566,000
Flood Jun 1977 1,022,000 10,354
Flood Jul 1978 2,246,000
Flood Aug 1988 1,000,000
Disasters in Pakistan (rough figures)

9. Extreme
Temperature
Jun 11, 1991 961
Flood Aug 9, 1992 6,184,418
Flood Sep 1992 12,324,024 1,334
Wind storm Nov 14, 1993 609
Flood Jul 22, 1995 1,255,000
Flood Aug 24, 1996 1,186,131
Flood Mar 3, 1998 1,000
Drought Mar 2000 2,200,000
Earthquake Muzaffarabad Oct 8, 2005 2,500,000 78,000
Flood
Jul/Aug
2010
20,000,000
2000
Disasters in Pakistan (rough figures)

10. Summary of death, Injured and Affected 1935 to 2011
Types of Disasters Total Death Total Injured Total Affected
Floods 9,313.00 4,206.00 45,652,022.00
Rain and Snow Fall 1,116.00 666.00 7,000,000.00
Earthquake 138,653.00 87,020.00 4,650,000.00
Cyclone and Flood 330.00 2,500,000.00
Drought 200.00 2,200,000.00
Cyclone 500,231.00 155.00 657,000.00
Wind storm and Cyclone 450.00 400,000.00
Cold Wave 16.00 35,000.00
Landslides 200.00 8,000.00

11. Avalanche 149.00 81.00 3,633.00
Flash Floods 1,400.00
Landslides and Floods 100.00 300.00
Earthquake/Tsunami 4,000.00
Heat Wave 1,250.00
Influenza A (H1N1) Pandemic 29.00
Monsoon Rains 112.00
Wind Storm 10,908.00 458.00
Wind Storm tornado 60.00 600.00
Grand Total 667117 93186 63107355

12. Types of Disasters No. of events
Floods 18
Earthquake 11
Wind Storm 11
Avalanche 3
Landslides and Floods 2
Cyclone 2
Drought 2
Heat Wave 2
Wind Storm tornado 2
Landslides 1
Cold Wave 1
Cyclone and Flood 1
Earthquake/Tsunami 1
Flash Floods 1
Influenza A (H1N1) Pandemic 1
Monsoon Rains 1
Rain and Snow Fall 1
Wind storm and Cyclone 1
Grand Total 62

13. Aetiological Classification
• Natural disaster e.g Earthquakes, storms,
floods
• Technological Disasters (Man made) e.g Nuclear explosions
(intentional/unintentional)
• Complex Disasters (Natural+ Man made) e.g Earthquake
destroying a nuclear power plant

14. Natural Disasters
• Earthquakes
• Volcanoes
• Floods
• Tsunamis
• Hurricanes
• Tornadoes
• Ice-storms
• Landslides

15. Technological Disasters
• Terrorist attack
• Bombing attack
• Release of Chemicals
• Air crashes
• Major traffic accidents
• Nuclear disaster

16. Classification according to
acuteness of event
• Sudden Disasters (catastrophe)
For example earthquakes, hurricanes, sudden chemical exposure,
sudden radiation exposure, war, bomb blast, major transport
accidents etc.
• Insidious Disasters:
Slow onset, long term or continuing disasters
–Droughts, famines, epidemics etc.

17. Potential Injury Creating Event
(PICE)
Now a days, the acronym PICE is being proposed to eliminate the
word disaster so as to resolve the issues surrounding the diverse
meaning of disaster.

18. Can we be prepared?
•Tornados?
•Hurricanes?
•Earthquakes?
•Tsunami?
•Blizzards?
• Flood?
• Fire?
• Terrorist attacks?
• Violence?

19. Can we be prepared?

20. Disaster Cycle

26. Preparedness
Preparedness can be effective in saving lives and preventing
injuries.
• Community awareness and education
• Proper warning system
• Mock drill
• The concerned authorities should learn about past disasters,
current potential hazards and should write a disaster plan

27. Preparedness
• Areas with established and practiced disaster plans have a marked
advantage over areas with no preparations.
• Planning is particularly important for providing adequate levels of
emergency health care, temporary shelter, and preventive health
services.

28. Preparedness
• Making viable disaster plan to respond
• Rapidly and effectively assembling adequate resources
• Collecting stocks of consumable items
• Training of personnel

29. • Implementing the disaster management plan
• Development of search and rescue team
• Setting up medical camps and mobilizing resources
• Providing adequate shelter, food and sanitary facilities
Response

30. Recovery
• Aim is to return to normal functions
• Assisted by communities and nations
• It is a long process often takes years
• Clean and rebuilding is the main focus in this phase

31. Recovery
• Counseling program for those who lost the near ones
• Restoring services like roads, communication link
• Providing financial support, employment
• Reconstruction

32. Mitigation
Long term preventive measures to eliminate/ reduce the risk
to the community.
Non –structural:
• Formation and implementation of policies
• Identifying high risk zones
Structural:
• Construction of disaster shelters

33. Mitigation
Other examples of mitigation measures include:
• Hazard mapping
• Adoption and enforcement of land use and zoning practices
• Implementing and enforcing building codes
• Flood plain mapping
• Reinforced tornado safe rooms
• Burying of electrical cables to prevent ice build-up
• Raising of homes in flood-prone areas
• Disaster mitigation public awareness programs
• Insurance programs

34. Mitigation
• The mitigation phase of the disaster cycle is almost
concurrent with the recovery phase.
• The goal of the mitigation phase is to:
prevent the same disaster caused
damages from occurring again.

35. Starting the Disaster Cycle
Again
Finally, using the lessons learned from the response, recovery and
mitigation phases of the disaster the concerned authority return
to the preparedness phase and revise their plans and their
understanding of the material and human resources needed for a
particular disaster in their community.

36. Disasters will happen but
the point is how prepared we are
and
HOW RAPID AND EFFECTIVE OUR
RESPONSE WILL BE

37. Effects of disaster
• Physical effects
• Social effects
• Psychological effects
• Health effects
• Economic effects
• Environmental effects

38. Tri-modial pattern of trauma deaths
Deaths after trauma show three peaks
1st Peak 2nd Peak 3rd Peak
Seconds
to
Minutes
Golden
Hour
Hours to
Days
Immediate
Deaths
Early Deaths Late Deaths

39. First Peak
• Fatal injuries – Immediate deaths
• Mostly in pre hospital settings
• Within seconds to minutes
• > 50% of trauma related deaths

40. Second Peak
•Life threatening injuries – Early deaths
•Mostly due to Hemorrhage
•Within hours
•30% of trauma deaths
•Preventable deaths
•Outcome: enhanced by high quality trauma care

41. Golden Hour
• Trauma is a time sensitive factor
• Following trauma, there is a window period – Golden Hour –
during which the lives of most of the critically injured persons
can be salvaged by timely EMS. However, if this, period is
wasted due to delayed evacuation, delayed transportation and
delayed resuscitation, the chances of survival decrease
tremendously.

42. Third Peak
• Within first week
• 20% of trauma deaths
• Mostly due to complications e.g. sepsis, DVT and PE

43. Multidisciplinary Team Approach
• Surgeon (Medical Controller)
• Emergency Physician
• Anesthesia Staff
• Trauma trained Nurses
• Respiratory Therapist
• Radiology Technician
• Blood Bank and Laboratory Staff

44. Triage
• Triage is derived from the French verb, Trier, meaning ‘To
choose, to pick or to sort out’
• Triage is the process of determining the priority of patients'
treatments based on the severity of their condition

45. Napoleon’s War (1854-1856)
• Start of triage system
• Use of 4 wheeled carts as ambulance for injured soldiers
• Beginning of nursing profession
• Introduction of nursing uniform
• Hospital hygiene
• Sick pay during illness

46. Types of Triage
• Field triage
Pre hospital triage, on site triage
• Hospital triage
ER triage

49. Action plan for disaster
management
•Reception of causalities
•Triage of critically injured persons
•Resuscitation and First Aid treatment
•Emergency Surgical intervention
•Non invasive and invasive ICU care
•Calling off disaster plan
•Rehabilitation of disabled patients

50. Question
Role of a technician in disaster management ?