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Emergency and Disaster Nursing

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Tami Bland

on 24 July 2014

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Transcript of Emergency and Disaster Nursing

NURSING
Tami Bland, DNP, CPNP
DISASTER
Definitions and Categories
Disaster: Occurrence, natural or man-made, causes human suffering and creates human needs that victims cannot alleviate without assistance

ANYTIME NEEDS EXCEED RESOURCES
NATURAL
DISASTERS
Organizations Involved in Disaster Planning & Relief
References
Holzemer, S. & Klainberg (2014). Community health nursing: An alliance for health. Burlington, MA: Jones and Barlett.
Maurer, F. & Smith, C. (2013). Community/Public health nursing practice: Health for families and populations (5th ed.). St. Louis, MO:Elsevier.
Truglio-Londrigan, M. & Lewenson, S. (2011). Public health nursing: Practicing population-based care, Sudbury, MA: Jones and Bartlett.
CATEGORIES
Natural
Flood, Hurricane, Tornado, Earthquake, etc.
Human-Made: Accidental
Industrial, Transportation, Environmental, War/Conflict
Human-Made: Intentional
Terrorism (bomb, biochemical, water/food/airborne, nuclear)
Mass casualty event: usually > 100 casualties

Multiple casualty event: < 100 persons injured
Agents of Harm or Damage
Agent: the physical item causing injury or destruction
Primary: falling buildings, water, wind, biological agent
Secondary: Bacteria or viruses thriving as a result of the disaster
DISASTER
CYCLE
Nondisaster/interdisaster
period between disasters
time for developing and operationalizing prevention and preparedness measures
Predisaster/warning
disaster is imminent
warning is made to the public
protection and emergency plans are activated
Impact
destruction, injury, and death actually occur
Emergency/
relief/isolation
relief and assistance are provided to victims
search and rescue
basic infrastructure restored
most of the damage has been done
Reconstruction/rehabilitation
normal services are reestablished
buildings and factories reconstructed
life returns to normal
Vulnerability
Environmental: Chemical, physical, biological, & social
Effectors of Scope and Severity
Warning time & proximity to disaster
Individual perception & response
EARTHQUAKES & TSUNAMIS
Limited ability to provide advance warning
Building codes and guidelines important
At risk population preparedness vital
Complex traumatic injuries from structural collapse
FLOODS
most common disaster
accounts for most weather-related US deaths
educate communities in flood prone areas
HEAT
children and the elderly are most vulnerable
hydration status, underlying health status, and degree of work-stress effort major factors in affects of heat
community preparedness important
monitoring by local health department
HURRICANES
associated with heavy rainfall, strong winds, and storm surges with coastal flooding
evacuation methods/routes important
trauma and submersion injuries
National Weather Service predictions, tracking, and warning systems important
TORNADOS
wind speed correlates to destructive power
safe and proper shelter is key
Complex injuries such as burns, electrocutions, fractures
early warning system somewhat limited
WILDFIRES
most are anthropogenic (human-made)
workforce mortality and morbidity high
expect inhalation and burn injuries, work stress and heat-related illness
WINTER STORMS
freezing temps lead to frostbite, hypothermia, cardiac events, CO poisoning (using cars for heat), burn injuries (space heaters and fires)
NWS very accurate with predictions
monitoring of community status important
Areas of Disaster Planning
Engineering to reduce risks
Public education about potential hazards
Surveillance systems to detect environmental hazards
coordinated emergency response
systematic assessment of disaster effects
Community Level
Fire department
Police department
Red Cross
Hospitals
Public health department
Volunteers
Shelter Care
1. Prevent occurence
2. Minimize casualities
5. Provide first aid
8. Promote reconstruction of lives
7. Provide definitive care
6. Evacuate the injured
4. Rescue the victims
3. Prevent further casualities
Principles
of Disaster Management
9. Lessons learned and applied
Mental Health
Stages of emotional response to disaster
denial
strong emotional response
acceptance
recovery
Long-term problems may occur, including PTSD
Children frequently develop mental or behavioral problems years later
Responders also susceptible to pschological trauma!
Worry
Fear
Anger
Fatigue
Loss of
appetite
Sleeplessness
Helplessness
Confusion
ANTHROPOGENIC
DISASTERS
Chemical Agents
Can be released by variety of intentional or accidental means
Agent or method of exposure may be unknown
Some significant release occurs almost daily, most do not require patient decontamination
Ingestion
Inhalation
Absorption
DISASTER TYPES
EXPLOSIVE AND TRAUMATIC
Explosive devices account for about 75% of terror events worldwide
Number of criminal bombings in the US doubled in the last decade
Injuries can be blunt, penetrating, thermal or all three
Psycological trauma is common
NUCLEAR/RADIOLOGICAL AGENTS
Readiness to respond saves lives
Nuclear event - nuclear detonation and accompanying massive explosion
Radialogic event - release of radioactive materials to human-populated areas (with or without explosion)
Blast injuries, thermal burns, radiation toxicity
Workforce Preparedness
Scene safety and security
Personal protective equipment
Radiation exposure monitoring
Casualty decontamination
Biological Agents
Rising global concerns about bioterrorism and emerging infections
Public health and medical professions are the front lines of detection, diagnosis, treatment, and response
Responder safety and infection control paramount
Most victims initially present with subtle symptoms or flu-like symptoms
few tests are available for quick results
CDC Category A
highest severity and priority for bioterrorism threats
Easy dissemination and/or transmission
High mortality with potential for major health impact
May cause public panic and social disruption
Special action for public health preparedness
Smallpox
Anthrax
Plague
Botulism
http://www.atsdr.cdc.gov
NURSING AND PUBLIC HEALTH
Adapting nursing skills to recognize and meet needs resulting from a disaster
Includes C/PHN from state/local HD
Volunteers from disaster teams
American Red Cross
U.S. Public Health Services
CORE FUNCTIONS
Prevent epidemics and spread of disease
Protect against environmental hazards
Prevent injury
Promote healthy behaviors and mental health
Respond to disasters and assist communities in recovery
Assure quality and accessibility of health services
All agencies need a disaster plan
Education regarding disaster preparedness is a good community education program
Full transcript