1. Disaster Nursing
Christina Barrick

2. 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.

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

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

5. 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

6. Nuclear Attack

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

8. Natural Disaster: Tsunami

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

10. 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

11. 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

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

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

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

15. Reactions of Children to a Disaster
Interventions
Research

16. 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

17. 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

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

19. Three Tier Triage System
First Priority
Second Priority
Third Priority

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

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

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

23. 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

24. Prevention Levels in Disaster Management
Primary Prevention
Secondary Prevention
Tertiary Prevention

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