1. DISASTER PREPAREDNESS

2.  Definition:  Any situation/event that overwhelms existing resources or ability to respond.

3. Definition of Disaster: External  Multi patient incident  event resulting in fewer than 10 in fewer than 10 casualties casualties  Multi casualty incident  results in 100 or fewer casualties, strains facilities  Mass casualty incident  results in more than 100 casualties, overwhelms existing facilities

4. Definition of Disaster: Internal  Any situation that results in the health care facility becoming partially or totally inoperable

5. Assessment: 1. Loss of life 2. Physical injuries 3. Psychological trauma 4. Property damage 5. Environmental destruction 6. Economic/Business loss Disaster Response

6. Emergency Preparedness Plan  Disaster command center  Administrative operations center  Medical operations center  Nursing operations center

7.  Personnel operations center  OR operations center  Security operations center  ED operations center Emergency Preparedness Plan

8.  Confirm disaster activation response  ED operations center  Assignments of on-duty supervisor  Staff assignments  Evacuation of patients from hospital  Secure environment  staffing considerations  Communication Response

9.  Disaster casualty patient coordination  Triage (before and after arrival to hospital)  Acuity assessment  Disaster tags  Registration log  Treatment area  All documentation on disaster packet  Tracking with disaster tags  Family Response continued

10.  Stress reducers  Assess staff during breaks or rounds  Educate staff regarding delayed stress reaction  Critical Incident Stress Debriefing. Stress Management

11.  Support resources meeting demand  Institutional needs assessment  Critique—what worked, what needs improvement Deactivation of Disaster

12.  Radiation exposure  Chemical exposure  Biological agents  Viral agents  Toxin agents Weapons of Mass Destruction

13.  Depends on dose  Symptoms-  Nausea, vomiting, or bloody diarrhea within 3 hours  Radiation safety officer  Decontamination of all patients  Safety of decontamination team Radiation

14.  Industrial or terrorist  Recognition of agent  PPE  Decontamination  Specific agents Chemical

15.  Occur naturally in environment  Types of biological agents  Bacteria: anthrax, plague  Viruses: smallpox, ebola,  Toxins: botulism, staphylococcal enterotoxin B, ricin Biological agents

16.  Onset of signs and symptoms 7 – 10 days  Quarantine  Supportive therapy  No approved antiviral medication Viral agents

17. Toxins  Botulism  Neurotoxin  Ricin  Blocks protein synthesis  Onset 8-24 hours  Staphylococcal enterotoxins  Sudden onset of high fever, headache, & chills in aerosol exposures