1. Disaster Management

2. Definition of Disaster Any human-made or natural event that causes destruction and devastation that cannot be alleviated without assistance It does not have to cause injury or death to be considered a disaster

3. Types of Disasters Natural Disasters Hurricanes Tornadoes Hailstorms Cyclones Blizzards Drought Tsunamis Floods Mudslides Avalanches Earthquakes Volcanic eruptions Communicable disease epidemics Forest fires (lightning induced)

4. Types of Disasters Human-made Conventional warfare Non-conventional warfare (i.e. Nuclear, chemical, biological) Transportation accidents Structural collapse Explosions/bombings Fires Toxic materials Pollution Civil unrest ( e.g. riots, demonstrations)

5. Ways to reduce risk of injury and death United Nations initiated a campaign to educate people on ways to reduce risk Heightened public-private partnering that emphasized mitigation Mitigation – actions or measures that can either prevent the occurrence of a disaster or reduce the severity of its effects (American Red Cross, 1998)

6. Mitigation Activities Awareness and education – community meetings on disaster preparedness Disaster relief – building a retaining wall to divert flood water away from a residence Advocacy – supporting actions and efforts for effective building codes and careful land use

7. Healthy People 2010 and Disasters Disasters affect almost every Healthy People objective Unintentional injuries Occupational safety and health Environmental health Food and drug safety Nutrition and exercise

8. Healthy People 2010 and Disasters One objective of the national agenda Assure that state health departments establish training plans, and protocols and conduct multi-institutional exercises to prepare for response to natural and technological disasters CHNs are often involved in managing and participating in community exercises to prepare for a community disaster Enhanced protocols for biological agents now

9. Three Stages of Disaster Involvement Preparedness Response Recovery

10. Preparedness “...no plan will ever exactly fit the disaster as it occurs” (Stanhope & Lancaster, 2002) Personal Preparedness Conflict between family and work-related responsibilities Being physically and mentally healthy to deal with stress Assemble emergency supplies Follow Four Steps to Safety checklist

11. Preparedness Four Steps to Safety Find out what could happen to you Create a disaster plan Complete a checklist Practice and maintain your plan

12. Preparedness Find out what could happen to you Determine what types of disasters are most likely to happen Learn about your community’s warning signals Ask about post-disaster pet care Review the disaster plans at your workplace, school, and other places where your family spends time Determine how to help elderly or disabled family or neighbors

13. Preparedness Create a disaster plan Discuss types of disasters that are most likely to happen and review what to do in each case Pick two places to meet Choose an out-of-state friend to be your family contact Review evacuation plans, including care of pets Identify ahead of time where to go if evacuation is necessary

14. Preparedness Complete a checklist Post emergency numbers by telephones Teach everyone to use 911 Determine when and how to turn off water, gas, and electricity Check adequacy of insurance coverage Locate and review use of fire extinguishers Install and maintain smoke detectors Conduct a home hazard hunt and fix problem areas Stock emergency supplies and assemble a disaster kit Become first aid and CPR certified Locate escape routes from home (at least two from each room) Find safe spots in your home for all kinds of disasters

15. Preparedness Practice and maintain your plan Review your plan every 6 months Conduct fire and emergency evacuation drills Replace stored water every 3 months and stored food every 6 months Test and recharge fire extinguisher according to manufacturer’s instructions Test smoke detectors and change the batteries annually

16. Preparedness Professional Preparedness Know disaster plans at workplace and community Personal items recommended – nursing license, stethoscope, flashlight & batteries, case, extra clothing, record-keeping materials, pocket-sized reference books Creativity and willingness to improvise

17. Preparedness Community Preparedness Review community history Review institutional plans Review key organizations and professionals involved in disasters – clergy, morticians, police, fire and rescue personnel, mayor and other officials, media Review warning systems for adequacy

18. Preparedness Role of Nurse in Disaster Preparedness At workplace – initiate or update the disaster plan, provide educational programs and materials regarding disasters specific to the area, and organize disaster drills In community – provide an updated record of vulnerable populations in the community Recruit others within the organization who can help during a disaster Work with official agencies to assist with disasters within the community or nationally or internationally

19. Agencies Involved in Disaster Preparedness Federal Emergency Management Agency (FEMA) American Red Cross Other voluntary organizations Business and labor organizations Local government

20. Levels of Disasters Level III Disaster – considered a minor disaster Could result in a presidential declaration of an emergency or disaster Minimal amount of federal involvement

21. Levels of Disasters Level II Disaster – Considered a moderate disaster Major presidential disaster declaration with moderate federal involvement Federal regional resources are fully engaged

22. Levels of Disasters Level I Disaster – Significant damage with severe impact or multi-state scope Presidential disaster declaration with major federal involvement

23. Federal Response Plan Once a federal emergency has been declared, this plan may take effect, depending of the specific needs of the disaster Based on the fundamental assumption that a significant disaster or emergency will overwhelm the capability of state and local governments to carry out the extensive operations necessary to save lives and protect property

24. Federal Response Plan Recently, Homeland Security has been given authority for this plan There are 12 emergency support functions (ESF’s) Each function is headed by a primary agency and is responsible for coordinating efforts in a particular area with all of its designated support agencies In all, 26 agencies and the American Red Cross must respond if called upon

25. So how easy is it to coordinate, communicate? What are your thoughts? Thinking about recent events in New Orleans and Haiti, are there commonalities of need? What differences do you see?

26. How Disasters Affect Communities Community residents can be affected both physically and emotionally Children – regressive behaviors, fantasies that the disaster never happened, nightmares, school- related problems Adults – extreme sense of urgency, panic and fear, disbelief, disorientation and numbing, reluctance to abandon property, difficulty making decisions, feeling of a need to help others, anger, blaming and scapegoating

27. How Disasters Affect Communities Community residents can be affected both physically and emotionally Delayed reactions – insomnia, headaches, apathy and depression, sense of powerlessness, guilt, moodiness and irritability, jealousy and resentment, domestic violence

28. Role of the Nurse in Disaster Response Triage – nurses work as a member of the assessment team – it is the process of separating casualties and allocating treatment based on the victim’s potential for survival Shelter Management – usually handled by the Red Cross, nurses may be called upon to manage them in a large disaster – some other functions include stress relief and assessment and referral

29. Recovery Stage The last stage in a disaster takes place when involved agencies join together to restore the economic and civic life of the community

30. Role of the Nurse in Disaster Recovery Likely to be varied, so flexibility remains important Community clean-up can cause a variety of physical and psychological problems Prolonged effects of disasters can intensify both acute and chronic illness Observe for environment health hazards in the home or community at large Case finding and referral