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DISASTER MANAGEMENT

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DISASTER MANAGEMENT Lt.Col.Karesh Prasad M.Sc (N) Principal People s College of Nursing & Research Centre Bhopal EFFECTS ON HEALTH OF BHOPAL GAS DISASTER NIGHT OF ... – PowerPoint PPT presentation

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Title: DISASTER MANAGEMENT


1
DISASTER MANAGEMENT
  • Lt.Col.Karesh Prasad M.Sc (N)
  • Principal
  • Peoples College of Nursing Research Centre
  • Bhopal

2
EFFECTS ON HEALTH OF BHOPAL GAS DISASTER
  • NIGHT OF TRAGEDY - 2 3 DEC 1984
  • CULPRIT - UNION CARBIDE
    FACTORY STAINLESS STEEL TANK
    NO 610 , HAD 42 TONS OF LIQUID METHYL
    ISOCYNATE.
  • SUFFERINGS - 2500 DEATHS IN 48
    HOURS
  • 85000
    AFFECTED
  • 5 Lac
    EXPOSED
  • PLANTS
    , ANIMALS
    INCLUDING FISHES

3
EFFECTS ON HEALTH- CONTD.
  • Main symptoms
  • Lacrimation and burning of eyes
    breathlessness, cough chest pain
  • Agent -MIC
  • Colourless liquid ,boils at 39º C stablized with
    phosphogene polymerisation with metals
    exothermic reaction with water

4
EFFECTS ON HEALTH - CONTD.
  • Event water leaked in tank ,
  • increase in temp
  • MIC convertad to
    vapour/gas foam ,
  • Increased pressure ,
  • leaked into atmosphere ,
  • in cool still air , setteled over
    nearby areas upto 2-3 km

5
EFFECTS ON HEALTH- CONT
  • HAVOC Over 100000 people visited hospital and
    equal numbers attended mobile /make shift
    dispensaries .
  • Immediate effects and prolonged effects on health
    of exposed persons , psychological effects.

6
EFFECTS ON HEALTH CONTD
  • RESOURCES TO DEAL DISASTER
  • Negligible/meagre to cope such a large medical
    emergency, no enough doctors,nurses,paramedicals,e
    quipments like oxygen mask regulators ,drugs
    besides beds and hospital space even not enough
    means to dispose deads.

7
HEALTH EFFECTS 3-4 YRS FOLLOW UP
8
Continuation
9
EFFECTS OF HEALTH CONTD.
  • OTHER CHANGES
  • EARLY CASES OF RESP GP-ESTABLISHING INTO
  • Bronchiolitis obliterans
  • Reactive airway dysfunction syndrome
  • like Bronchial asthma ,chronic bronchitis
  • bronciactasis , emphysema kochs
  • POSSIBLY LEADING TO
  • COPD , cor pulmonale , chronic bronchitis

10
EFFECTS OF HEALTH CONTD.
  • ADVERESLY AFFECTED BY/ PRECIPITATION
  • Smoke , dust fumes of coal , wood kerosene
    used for cooking
  • 15.4 children 6-15 years age group at exposure
    have evidence of obstructive lung disease

11
EFFECTS OF HEALTH CONTD.
  • EYES
  • Cases of lacrimation/burning
  • corneal opacities , early age cataract incl
    fundus changes poly chromatic lusture
  • MENTAL HEALTH
  • Neurotic depression anxiety fortunately
    amenable to treatment
  • ENDOCRINES No effect on thyroid
  • IMMUNE SYSTEM Detrimental effect

12
EFFECTS OF HEALTH CONTD.
  • GENETICAL CHANGES
  • Increased chromosomal aberrations
  • NO CARCINOGENESIS EVIDENCE YET.

13
EFFECTS OF HEALTH
  • SYMPTOMS SIGNS
  • OPHTHALMIC
  • Intense burning in eyes as if chillies puf in
  • Continous profuse lacrimation
  • Difficulty to see clearly
  • Conjunctival hyperaemia
  • Superficial corneal ulceration
  • RESPIRATORY
  • Breathlessness , gasping , cough with or without
    expectoration pain chest

14
EFFECTS OF HEALTH CONTD.
  • LUNGS - Crypts/rails-ronchi no cyanosis
  • X-RAY- Patchy opacities , increased broncho
    vesicular markings , massive opacity of pulmonary
    odema
  • GI Nausea , vomiting , pain abo
  • General Fatigability , weakness
  • MENTAL Disturbed psychae

15
EFFECTS OF HEALTH CONTD.
  • TREATMENT
  • oxygen
  • steroids
  • antibiotics
  • sodium thiosulphate

16
EFFECTS ON HEALTH CONTD.
  • FOLLOW UP - RESEARCH
  • 80021 persons affected area
  • 15931 control unaffected area
  • Six Monthly survey
  • Medical check up , lab investigation
  • Involvement of multiple specialists persons/
  • agencies , ICMR and almost all pioneer
    Medical/social institutes.

17
EFFECTS ON HEALTH CONTD.
  • REMEDIAL NECESSITIES
  • Chemotherapy , environmental sanitation
  • Pollution control , replacing cooking fuel to
    LPG
  • Abstinence from smoking
  • Social sciences. To prevent ills of easy money
    coming in AIDS-drugs , alcohol etc
  • Disaster control plans , resource allocation etc

18
INVESTIGATION OF EPIDEMIC
  • PURPOSE
  • To investigate determinants of disease - Agent,
    Host, Environment
  • To meet public service and scientific needs

19
STEPS
  • Determine/confirm existence
  • Verification/confirmation of diagnosis
  • Define/count cases and distribution
  • Analyze time, place, person.

20
Steps continued
  • Formulate hypothesis
  • Compare/ test
  • Plan systematic study
  • Report
  • Measures for control and prevention

21
OBJECTIVE
  • To define magnitude of epidemic -
    time,place,person
  • To determine factors responsible
  • To identify cause, source of infection and modes
    of transmission

22
PREPARATION/TOOLS FOR INVESTIGATION
  • Notification to people/organization auth
  • Identification of material needs
  • Travel needs - Questionnaire samples,
    stationery, calculator, computer, camera, lab
    sampling container, pocket reference on
    agent/diseases, internet access code etc

23
CONFIRMATION OF DIAGNOSIS
  • Clinical examination of sample cases
  • Lab investigations
  • Case definition
  • Case finding - Mapping house numbering
  • Population denomination
  • Rapid Search - Medical survey

24
EPIDEMOLOGICAL CASE SHEET
  • Population/Sample Survey
  • Name, Age, Sex, Occupation, Social Class,
    Movements H/O contacts, Time of onsets of
    Symptoms
  • Symptoms/Signs, Past History, Any special events
    Eg. Party, Picnic etc.

25
ENVIRONMENTAL FACTORS
  • Sanitation state
  • Water supply
  • Fresh supply
  • Any breakdown in the above mentioned systems

26
ATMOSPHERIC CONDITIONS
  • Temperature
  • Humidity
  • Pollution
  • Entomological data etc

27
POPULATION AT RISK
  • History of exposure to suspected/potential
    vehicle
  • Attacked/spared distribution

28
DATA ANALYSIS
  • Time
  • Place
  • Person Distribution

29
HYPOTHESIS
  • Possible Source
  • Causative agent
  • Mode of spread
  • Environmental Factors
  • Further study - if required
  • Report - Format
  • Measures for control and prevention

30
REPORT FORMAT
  • Back ground
  • Geographical location
  • Climatic condition
  • Demographic and Socio-economic situation
  • Health Services Org Systems of report
  • Normal disease prevelance

31
FIRST CASE
  • Methodology
  • Case definition
  • Format for investigation
  • Survey technique
  • Analysis of Data
  • Clinical
  • Frequency
  • Course
  • D/D
  • Sequlae/Death

32
EPIDEMIOLOGICAL DATA
  • Mode
  • Time
  • Place
  • Person Affected

33
MODE OF TRANSMISSION
  • Source
  • Route of Excretion
  • Factors Affecting Transmission

34
LAB RESULTS
  • Identification
  • Serological
  • Significance

35
INTERPRETATION
  • Comprehensive Picture of Outbreak
  • Hypothesis
  • Statistical Analysis

36
CONTROL MEASURES
  • Define Strategies
  • Constraints

37
RESULT
  • Evaluation - Significance of Result
  • Cost Effectiveness
  • Preventive Measures

38
THANK YOU
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