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Disaster Nursing

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Jessica Tate

on 21 March 2013

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Transcript of Disaster Nursing

Disaster Phases Preparing for Impact (preimpact phase)
Warning period which may range from a few minutes to as much as an hour or several days.
The focus is on preparation for the aftereffects of the event.
Preparation is primarily at the local level.
Communities in disaster prone regions practice with disaster drills which provide valuable training in a low-stress environment and identify the types of resources available.
When disaster becomes imminent preparations such as evacuations are put into operation. Disaster Types
Nuclear radiation, chemical & biological weapons, natural disaster, weapons of terror, pestilence, famine. The use of microorganisms with deliberate intent of causing infection to achieve military or political goals.
Biological weapons are relatively easy and inexpensive to produce
Can be spread through the air, water, or food. Robotic delivery and "suicide coughers" can also spread the infection.
Can go undetected for an extended period because their effects are not immediate and initial symptoms are "flu-like". It may continue to spread person to person before being recognized.
Nurses and other clinicians must be familiar with the specific symptoms and clinical syndromes caused by bioterrorism agents. Early recognition is key to an effective response.
The CDC has produced online teaching and learning modules about biological agents that are considered most likely to be used in a bioterrorist attack. (Ex. of Category A substance is Anthrax; Cat. B typhus; Cat. C hantavirus) Bioterrorism Disaster Nursing "The American Red Cross defines a disaster as '...an occurrence such as a hurricane, tornado, storm, flood, high water, wind driven water tidal wave, earthquake, drought, blizzard, pestilence, famine, fire, explosion, building collapse, commercial transportation wreck, or other situations that cause human suffering or create human needs that the victims cannot alleviate without substancial assistance'." Disaster Nursing Nursing role in incidences of mass casualty, traumas, and terrorism. Communication Phase
Key element is the ability of the various agencies involved to communicate with each other. Good communication leads to a well-coordinated response.
Turf arguments could cause problems with agencies such as fire departments or police departments should be eliminated to prepare in emergencies.
Planning for news media needs to be completed because this is often overlooked especially in rural areas.
Persons designated should have experience with public speaking and be able to convey information clearly. They should be able to "think on their feet". Protection for First Responder
Nurses and other responders must always be aware of the potential dangers of any disaster.
If the health-care provider becomes injured during rescue attempts, they can no longer provide care to the victims.
Chemicals (nerve gas or toxins), biological substances, radioactive agents, and explosive devices may pose dangers to health care providers even after the disaster has occurred. After the Disaster
Postimpact phase may begin in as little as 72 hrs after the incident & may in some cases may last considerably longer.
Aftermath may continue for several years involving rebuilding of a community .
Key activities during this phase is the evaluation of disaster preparations & of how rescue & recovery efforts could be improved. Disaster Agencies:
American Red Cross
Medical Reserve Corps
National Disaster Medical System (NMDS)
Disaster Medical Assistance Team (DMAT) Impact Phase
Goal during the impact phase is to respond to the disaster, activate the emergency response, and reduce the long term effects of the disaster as much as possible.
Activation of the emergency response plans developed during the preimpact phase mobilizes all agencies involved.
Efforts are coordinated from police, fire, rescue which are first on the scene. Their goal is to identify and remove victims from dangerous situations, deal with unstable structures, and provide first aid to those who have been injured. Short Term:
Provides emergency medical assistance. Special attention is given to vulnerable groups, such as handicapped people, children, and elderly people. Triage must be done to determine the order in which patients are treated.
Provides assistance in the mobilization of necessary resources such as food shelter, medication, and water.
Works in collaboration with existing organizational structures and resources.
Long Term:
Provides assistance with resettlement programs and psychological, economic, and legal needs.
Partners with independent, objective media; local and national branches of government; international agencies; and nongovernmental organizations. Effective Response/Identification and Management
Nurses at all levels and types of health care settings have the potential to become involved.
Know the modes of transmission, incubation periods, symptoms, and communicable periods of the diseases as outlined by the CDC. Centers for Disease Control www.CDC.gov provides information related to preparation and planning regarding different types of emergencies, including state by state preparedness.
http://emergency.cdc.gov/
http://www.traumamaps.org/

The ACEP recommends that all basic nurse education programs include info on how to respond to mass casualty events. Questions A nursing student is studying about disasters & emergency preparedness. Which of the following statements by the nursing student depicts a correct understanding of the difference between a disaster and an emergency? A. Disasters are man-made only.
B. An emergency is an unforseen combination of circumstances calling for immediate action for a range of victims.
C. Man-made disasters are intentional only.
D. Emergencies are caused by acts of nature or emerging diseases. An ED nurse is working when there is a bioterrorism attack in the city. Which of the following statements is correct with regard to injuries or symptoms associated with a bioterrorism attack? A. The main purpose of biological weapon use is contained devastation.
B. It is not uncommon for the results of a biological attack to be made known several hours or days after the attack.
C. Biological attacks are usually known right away.
Detection is easy as clients go to a number of different health care facilities. Roles of the Nurse Triage The word triage comes from the Latin word tier, which means "to sort".
Patients are sorted into groups based on the severity of their health problems & the immediacy with which these problems must be treated.
Emergent patients have the highest priority and involve life-threatening conditions.
Urgent patients have serious problems or injuries but are not in immediate threat of death.
Nonurgent patients have episodic illnesses and do not require immediate treatment.
In disaster nursing, assessments must be made on whether to triage or reverse triage.
Reverse triage works on the principle of the greatest good for the greatest number. http://www.vdh.state.va.us/OEMS/Files_page/Trends/Trauma_Demographics.pdf http://www.cdc.gov/fieldtriage/ There has been a radioactive explosion nearby. The ED nurse must manage the decontamination of the client systematically. Which of the following clients would be decontaminated first? A. The client with severe injuries.
B. The client with minor injuries.
C. The client with the least injuries.
D. The client with the most injuries. http://health.state.tn.us/statistics/PdfFiles/2010_Trauma_Care_in_TN_Report.pdf
http://www.vhi.org/hospital_trauma.asp
http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/DPR
http://www.cdc.gov/fieldtriage/pdf/decisionscheme_poster_a.pdf
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