Disaster Nursing

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Disaster Nursing

• Christina Barrick

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Objectives

• Describe examples of natural and manmade
  disasters. attack.
• Describe the different phases of a disaster.
• Discuss the nurses 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.

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What is a Disaster?

• Forces overwhelm a community.
• Services are compromised.
• Outside assistance is required.

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Characteristics of Disaster Agents

• Predictability
• Frequency
• Controllability/Mitigation
• Time speed, duration
• Scope
• Intensity
• Community Implications

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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

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Nuclear Attack
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Nuclear and Radiological Attack

• Dirty Bomb
• Appeal to terrorists
• Availability

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Natural Disaster Tsunami
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Phases of a Disaster

• Pre-disaster
• Warning
• Impact
• Emergency
• isolation
• rescue
• remedy
• Recovery

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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

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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

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Management of the Psychosocial Aspects of a
Disaster Victim

• Impact and Emergency Phase
• reaction disaster syndrome
• Interventions prevent isolation, rumor control

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Management of the Psychosocial Aspects of a
Disaster Victim

• Recovery Phase
• reaction
• interventions

14
Reactions of Children to a Disaster

• Developments level
• Familys reactions
• Separation anxiety
• School refusals
• Enuresis
• Guilt

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Reactions of Children to a Disaster

• Interventions
• Research
• www.fema.gov/kids

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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

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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

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Criteria for Post Traumatic Stress Disorder

• The trauma is universally recognized
• Re-experience the trauma
• Demonstrate either emotional numbing or decrease
  in normal events

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Three Tier Triage System

• First Priority
• Second Priority
• Third Priority

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Three Tier Triage System

• Special Cases
• pregnancies
• injured disaster personnel
• family of rescue worker
• agitated of violent patients

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Role of the Nurse at the Disaster Site

• Insure safety
• First Aid
• Emergency care

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Role of the Nurse in a Shelter

• Objective temporary means of caring
• Assessment
• Planing
• 24/7 nursing and ancillary coverage
• Supplies
• Implementation
• Evaluation

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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

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Prevention Levels in Disaster Management

• Primary Prevention
• Secondary Prevention
• Tertiary Prevention

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Principles of Disaster Management

• Prevent the disaster
• Minimize casualties
• Prevent further casualties
• Rescue the victims
• First aid
• Evacuate
• Medical care
• Reconstruction