Disaster Nursing Christina Barrick

Objectives Describe examples of natural and manmade disasters. attack. Describe the different phases of a disaster. Discuss the nurse’s role in managing the disaster victim. Compare the reactions of children and the elderly. Discuss the role of the nurse in primary, secondary, and tertiary care. Apply principles of triage to select situations. Describe the principles of disaster management.

What is a Disaster? Forces overwhelm a community. Services are compromised. Outside assistance is required.

Characteristics of Disaster Agents Predictability Frequency Controllability/Mitigation Time: speed, duration Scope Intensity Community Implications

Manmade Disasters: Terrorism D.O.D estimates that as many as 26 nations possess chemical or biological agents. 10 countries are believed to possess biological agents as weapons Attack can take many forms Aerosolized agents

Nuclear Attack

Nuclear and Radiological Attack “Dirty Bomb” Appeal to terrorists Availability

Natural Disaster: Tsunami

Phases of a Disaster Pre-disaster Warning Impact Emergency Recovery isolation rescue remedy Recovery

Immediate Physical Management of the Disaster Victim Validate what you hear Perform a thorough assessment Assess for other injuries/illnesses even when symptoms are absent Is the condition life-threatening What is past medical history? Do not ignore patient fears or complaints

Management of the Psychosocial Aspects of a Disaster Victim Pre-disaster Preparations and Warning Phase reactions: apathy to panic interventions: mock drills, leadership important goal interventions: mental health services

Management of the Psychosocial Aspects of a Disaster Victim Impact and Emergency Phase reaction: “disaster syndrome” Interventions: prevent isolation, rumor control

Management of the Psychosocial Aspects of a Disaster Victim Recovery Phase reaction interventions

Reactions of Children to a Disaster Developments level Family’s reactions Separation anxiety School refusals Enuresis Guilt

Reactions of Children to a Disaster Interventions Research www.fema.gov/kids

Elderly Reactions Generally cope better Prob. related to chronic illness/resources Fear loss of independence Interventions assistance with clean up financial, legal, and tax info. refer to a support team refer to appropriate comm. agencies

Caregivers Reactions Same as Victim Role Strain Concerns over Personal Safety & Family Possessiveness towards victims Nurse - parent identification with pediatric victims Interventions clear disaster plans & disaster exercises

Criteria for Post Traumatic Stress Disorder The trauma is universally recognized Re-experience the trauma Demonstrate either emotional numbing or decrease in normal events

Three Tier Triage System First Priority Second Priority Third Priority

Three Tier Triage System Special Cases: pregnancies injured disaster personnel family of rescue worker agitated of violent patients

Role of the Nurse at the Disaster Site Insure safety First Aid Emergency care

Role of the Nurse in a Shelter Objective: temporary means of caring Assessment Planing: 24/7 nursing and ancillary coverage Supplies Implementation Evaluation

Role of the CHN in a Community Setting After a Disaster Goal: Achieve the best possible level of health for persons in a community after a disaster Primary Prevention Secondary Prevention Tertiary Prevention

Prevention Levels in Disaster Management Primary Prevention Secondary Prevention Tertiary Prevention

Principles of Disaster Management Prevent the disaster Minimize casualties Prevent further casualties Rescue the victims First aid Evacuate Medical care Reconstruction