2. Disasters: the scenario
A global problem: a major disaster
occurs somewhere in the world
almost on a daily basis
Affects the advances being
achieved health & socioeconomic
development
Increased vulnerability to natural
disasters due to environmental
degradation, industrialization,
pollution, threat to biodiversity
Rapid climate change
Population explosion
(overexploitation of resources)
3. Disasters
Ecological disruption
Loss of human life
Military expenditures: 6 month’s of
world’s arms spending would pay
for a 10-year program proving food
& health services in developing
countries
Deterioration of health services
to warrant an extraordinary
response from outside the affected
community or area.
Result in significant morbidity
4. Diversity of the Planet
The vastness and diversity of the planet
makes it difficult to build up an overall
picture of what needs to be done and
the impact of what has been done.
The same vast distances make it hard
to react rapidly and effectively to
sudden events - an earthquake - in
parts of the world with shifting
populations and poor communications.
New technology - fast bandwidth
reliable communications, the internet,
high resolution satellite imagery - can
provide support in these situations.
5. Classifying Disasters
Natural: earthquakes, floods, fires,
hurricanes
Technological (number of nuclear
arsenals has exceeded 50,000), deadlier
weapons, laser-guided missiles, carpet
bombs, etc ……Hiroshima (Aug 6,1945) &
Nagasaki (Aug 19, 1945); Nuclear reactor
Accident in Chernobyl (Ukraine); Toxic
gas leak in Bhopal (India)…..improper
management of industrial technologies
Chemical & Biological Weapons
Complex Emergencies (conflict-related):
Afghanistan (2.5 m), Iraq (1991, 2004-6) –
hi-tech war [2,10,000 tons of bombs in 43
days dropped in 1991
6. Disaster Planning
Pre-disaster: the identification,
understanding & analysis of natural
& other hazards
Disaster Management System: to
reduce the vulnerability of people to
damage (disaster prevention), injury
and loss of life & property resulting
from catastrophes; to prepare for
prompt & efficient rescue, care and
treatment of victims; response &
recovery
Disaster planning starts with
community awareness
7. Disaster Management
Disaster Preparedness : activities
that are carried out prior to the
advance notice of a catastrophe to
facilitate the use of available
resources, relief & rehabilitation
Disaster mitigation : ongoing effort
to lesson the impact disasters
have on people & property
Disaster Management : the process
of addressing an event that has the
potential to seriously disrupt the
social fabric of commun.
8. Pre-hospital Emergency
Preparedness
Efficient system of providing
prompt medical care to injured to
save many lives or limbs by
beginning treatment before the
patient reached the hospital: CPR,
ATLS, ACLS, closed chest cardiac
compression
Emergency Medical Services
Individual Protective Equipment
14. BCW
Routes of exposure
Inhalation hazard (Respiratory System)
Contact hazard (Skin)
Digestive system (contaminated food or
drinking water)
Degree of hazard will depend on the agent
& amount released/method by which
agent is disseminated
Biological agents have the ability to
multiply in the host
Chemical agents may be harassing agents,
incapacitating agents or lethal agents
15. Recent Outbreaks &
Incidents
Hurricane (the USA)
Avian Flu (Hong Kong)
Earthquakes (Pakistan)
Floods (Bangladesh)
Mad Cow Disease (the UK)
Marburg Virus Hemorrhagic Fever
Anthrax (the USA)
Tsunamis (Indonesia, Sri Lanka)
SARS (30 countries)
16. Earthquakes
Surviving an earthquake and
reducing its health impact
requires preparation, planning,
and practice.
Far in advance, you can gather
emergency supplies, identify and
reduce possible hazards in your
home, and practice what to do
during and after an earthquake.
17. How are avian, pandemic, and seasonal flu
different?
Avian Flu is caused by avian influenza
viruses, which occur naturally among
birds.
Pandemic Flu is flu that causes a global
outbreak, or pandemic, of serious illness
that spreads easily from person to
person.
Seasonal Flu is a contagious respiratory
illness caused by influenza viruses
18. What Injuries Occur Most
Often ?
The most severe injuries in
mass casualty events are
fractures, burns, lacerations,
and crush injuries. However,
the most common injuries
are eye injuries, sprains,
strains, minor wounds, and
ear damage.
19. Impact of Disasters
Disasters have a major impact
on the living conditions,
economic performance and
environmental assets and
services of affected countries or
regions.
Consequences may be long term
and may even irreversibly affect
economic and social structures
and the environment
20. Impact
In industrialized countries, disasters
cause massive damage to the large
stock of accumulated capital while
losses of human life are limited due
to the availability of effective early
warning and evacuation systems, as
well as better urban planning and the
application of strict building codes
and standards.
In developing countries, on the
other hand, fatalities are usually
higher owing to the lack or
inadequacy of forecast and
evacuation programs
21. Impact
Disasters can lead to widespread
loss of life, directly and indirectly
(primarily or secondarily) affect
large segments of the population
and cause significant
environmental damage and largescale economic and social harm
the deterioration in the social
well-being of the population
23. Goal of Emergency Preparedness
To reduce:
loss of lives
damage to property
impact on environment
impact on community
24. Activation of External
Disaster Plan
Information from the Red
Crescent Ambulance authorities
Arrival of casualties without prior
warning
Doctor on Duty to inform ED Chief
ED Chief to contact the Disaster
Executive Committee (Hospital
Director, Executive Director,
Medical Director, Nursing
Director)
25. Activation of External
Disaster Plan
Disaster Executive Committee
[DEC] will assess the situation &
determine the activation of the
plan
DEC to initiate Code Black/Green
through the Switchboard
Switchboard will start Page
announcement for Code Black,
Bleep 555 for all concerned
26. Activation of DM Plan
Beep to Transport Department for
arranging 2 Ambulances
Advise Transport Section to send
Ambulances around the hospital
housing to alert residents about
disaster
To send cars to commute staff
Contact all other DM personnel
Inform Nursing Supdt to arrange
nurses
27. Activation of the plan
Chief of each department to arrange
return of off-duty personnel
Ambulance to commute 2 medical
teams (disaster Site Triage Team)
to site of disaster
Other departments (Radiology,
Labs, Blood Bank, Pharmacy,
Medical Records, Patient Services,
Security, Emergency Supplies,
Nutrition, etc will activate their DM
plan
Security personnel to regulate
traffic to & from the Reception area
29. Disaster Executive Committee
Coordination all Disaster
Management activates
Coordinate all aspects of clinical
management
Notify local authorities
Receive regular updated progress
of DM
Media management
To announce ‘All Clear’ at the end
of Disaster
30. Coordination Team
Assess the number of
casualties & Beds available
Maintain contact with Triage
teams, Treatment teams &
wards
Allocate Medical staff in
different teams
Give updated info to Disaster
& Executive Committee
31. Disaster Site Triage Team
Triaging patients (Red,
Yellow, Green, Black) to give
priorities for evacuation
Inform the Disaster Executive
Committee about the situation
to take decision for activation
of Disaster Plan
Give frequent updates on the
situation at the scene
32. Hospital Triage Team
Receiving the Disaster
Patients
Screening (Triaging)
Transferring all incoming
disaster patients to
different treatment areas
33. Red Area Team
To resuscitate,
stabilize patients on
red area and shifting
them to definitive care
areas
34. Yellow Area Team
To resuscitate and stabilize
patients with serious non lifethreatening injuries
Provide care to those patients
who are seriously injured and
likely to die
Transferring resuscitated
patients to definitive care areas
37. Evacuation Team
Making beds available
for casualties from the
disaster by bed
expansion and
discharging current cold
patients
38. Evaluation Team
Monitoring the
management of the
disaster and forward a
final report to the Chief
of the Disaster
Management Committee.
39. Triage Team
Hospital triage is team
responsible for:
receiving the disaster
patients
screening the disaster
patients
transferring all incoming
disaster patients to different
treatment areas
40. Responsibility of the Yellow area
team
to resuscitate patients with serious
non-life threatening injuries
stabilize patients with serious nonlife threatening injuries
to provide care to those patients
who are seriously injured and
likely to die
transferring resuscitated patients
to definitive care areas
41. National Policy-making
Risk and vulnerability
assessment
Development of training
programmes
Public health in disasters
The management of programs
involving refugees and internally
displaced people
Shelter needs in disasters
42. National Policy-making
The development of disaster management
policy and plans
Aspects of the management of disasters
resulting from conflict
The role of the military in disaster
management
The management of civil emergencies and
transport accidents
Co-ordination in disaster management
The establishment of control rooms
43. National Policy-making
Leadership and decision making
in disaster management
Managing incidents involving
terrorism or civil unrest
Crowd management
The development context of
disaster management
Disaster relief logistics
44. Biochemical Weapons
Identify the hazard
Evaluate the hazard
Introduce risk reduction strategies
(control contamination)
Chemical detection & identification
(lab dx. By DNA based & other
molecular methods)
Risk communication & dissemination
of information
Contamination control (entry & exit
control)
45. BCW
Decontaminate both materials &
persons
Triage
Medical care & evaluation of
casualties
Definitive decontamination (a
final decontamination of the site)
Command, control &
communication
46. Pak Earthquake
The death toll from the
7.6-magnitude earthquake
that was centered near
Muzaffarabad, on October
8 stands at over 86,000 in
Pck and in NWFP.
Over 79,000 people
injured and estimated 3
million displaced or
47. India
The latest official death toll is 1,309 in Indian-
controlled Kashmir (IcK). Officially, 6,622
people reportedly injured and 150,000
displaced (Oct-17, AFP). Worst-hit areas are
around Tangdhar and Uri towns in Kupwara
and Baramulla districts respectively, along
the disputed Line of Control (LoC). Third
worst-hit area is Poonch district.
65. Tsunami Disaster of
Indian Ocean 2005
It is said that some kids
were playing on a bridge
when suddenly the
earthquake came, the
bridge broke down into 2
pieces, all those kids
went down inside the
bridge and died. The
mothers of those kids
were standing besides
the bridge and
helplessly watching
their kids die.