Disaster Management

Disaster Introduction
The number of disasters, both human-made and natural, continues to increase, as does the number of people affected by them.

The cost to recover from a disaster has risen sharply because of the amount of technology that must be restored.

Nurses are increasingly getting involved in disaster planning, response, and recovery through their local health department or local government.

Disasters
Any natural or human-made incident that causes disruption, destruction, and/or devastation requiring external assistance
-Range in size
-Are expensive (lives affected, property lost/damaged)
-Developing countries experience disproportionate burden from natural disasters

***Types of disasters:
-Natural disasters
-Human-made disasters
-Chemical
-Biological
-Radiologic
-Nuclear
-Explosive

*****( Please refer to Box 14-1 TYPES OF DISASTERS, p. 249)

***There are ways to prevent or manage how people and their communities respond to disasters.
-Although the number of disasters worldwide continues to grow, the number of lives lost has decreased.

U.S. agencies, directives, and systems:
-U.S. Department of Homeland Security
-National Preparedness Guidelines
-National Response Plan
-National Incident Management System
-Public Health and Medical Preparedness and the National Health Security Strategy

Although natural disasters cannot be prevented, much can be done to prevent further increases in accidents, death, and destruction after impact.

Healthy People 2020 with Disasters
Disasters clearly affect the HP 2020 objectives that relate to unintentional injuries, occupational safety and health, environmental health, and food and drug safety.

Examples of HP2020 Objectives related to Disaster Mitigation are found on p. 251. These are the abbreviations uses for the objectives.
-EH = Environmental Health
-FS = Food Safety
-HC/HIT = Health Care and Health Information Technology
-IID = Immunization and Infectious Diseases

Disaster Management Cycle 4 Stages
1. Prevention
2. Preparedness
3. Response
4. Recovery
Stage 1 of DMC: Prevention
Mitigation

An emergency management term for reducing risks to people and property from natural hazards BEFORE they occur.

Protecting buildings and infrastructure from wind and water

Implementing non-structural measures i.e. land development restrictions ( Don’t build your house in a flood plane!)

Deterring terrorists and terrorism BEFORE they strike

Heightened inspection and improved surveillance and security operations ( Airports)

Public health and agricultural surveillance and testing

Role of the Nurse in Disaster Prevention
Awareness and Education (HP 2020 Objective: EH-21: Improve the utility, awareness, and use of existing information systems for environmental health [ )

Organizing and participating:
-Mass vaccination campaigns to prevent, treat or contain disease (HP 2020 Objective: HC/HIT-12 Increase the proportion of crisis and emergency risk messages intended to protect the public’s health that demonstrate the use of best practices

Advocacy

Stage 2 of DMC: Preparedness
Includes:
1. Personal Preparedness
-Personal Checklist
-Emergency Supplies Kit
-ARC and FEMA (American Red Cross & Federal Emergency Management Agency)
2. Professional Preparedness
-Disaster Medical Assistance Teams (DMAT)
3. Community Preparedness
-National Health Security Strategy ( NHSS)
-Disaster and Mass Casualty Exercises
Role of the Nurse in Disaster Preparedness
Help initiate or update the agency’s disaster plan

Provide educational programs and materials regarding disasters specific to the area.

Organize disaster drills.

Provide an updated record of vulnerable populations within the community.

Review individual strategies.

Stage 3 of DMC: Response
-National Response Framework
-Emergency Support Functions
-National Incident Management System
-Response to Bioterrorism
-International Relief Efforts
-Psychological Stress of Disaster Workers
Role of the Nurse in Disaster Response
Advocate

Assessment

Understand what community resources are available

Often first responder:
-Case finding and referring
-Prevention
-Health education
-Surveillance
-Triage

Depends on nurse’s experience, professional role in a community disaster plan, specialty training, and special interest

Stage 4 of DMC: Recovery
About returning to the new normal with the goal of reaching a level of organization that is as near the level prior to the disaster as is possible.
Often the hardest part of the disaster.

Occurs as all involved agencies pull together to restore the economic and civic life of the community.

Government Purpose During Recovery
Rebuilding Infrastructure
Business Purpose During Recovery
Economic Recovery
IRS Purpose During Recovery
Educate in writing of losses
Religious Organizations Purpose During Recovery
Spiritual support and comfort measures
CDC Purpose Purpose During Recovery
Surveillance and epidemiological services
Various Volunteer Agencies Purpose During Recovery
Assess needs and assist where possible
ROle of the Nurse in Disaster Recovery
Teach proper hygiene and make sure immunization records are current.

Make referrals to mental health professionals.

Be alert for environmental hazards.

Assess dangers of live or dead animals.

Case finding and referral

Understand the emotional, physical and stressful effects of disasters on the affected communities

How Disasters Affect Communities
Physical and emotional effects depend on
-Type, cause, and location
-Magnitude and extent of disaster
-Duration of disaster
-Amount of warning

Stress reactions in individuals

Stress reactions in the community ( p. 259)
-Heroic: characterized by exhausted medical care personnel who work uncessingly)
-Honeymoon: Characterized by sharing experiences and stories about their survival
-Disillusionment:
Realizing that additional aid and reinforcements are no longer coming
-Reconstruction:
The longest phase. The physical and emotional act of rebuilding toward a new normalcy.

People react to the same disaster in different ways, depending on their age, cultural background, health status, social support structure, and general ability to adapt to crises

Primary Prevention Result of Disaster Prevention Management
Participating in developing a disaster management plan for the community
Secondary Prevention Result of Disaster Prevention Management
Assess disaster victims and triage for care
Tertiary Prevention Result of Disaster Prevention Management
Participate in home visits to uncover danger that may care additional injury to victims or cause other problems

(pg. 262)

Shelter Management
Local Red Cross chapter

Nurses working in shelters:
-Provide assessments and referrals.
-Meet health care needs, such as helping clients get prescription glasses, medications, first aid, and appropriate diet adjustments.
-Keep client records.
-Ensure emergency communications.
-Provide a safe environment.

Nurses make ideal shelter managers and team members because they are comfortable with dealing with aggregate health promotion, disease prevention, and emotional support

Future of Disaster Management
Continue to plan and train in all-hazards environment, regardless of specialty practice.

The nature of disasters will retain the element of unpredictability.
-That unpredictability and the medical and public health surge requirements in disaster make prevention and preparedness activities on the part of individuals and communities even more important.