DISASTER MANAGEMENT

INTRODUCTION:-

Disaster is an occurrence arising with little or no warning, which causes serious

disruption of life and perhaps death or injury to large number of people.

It is may be a man made or natural event that causes destruction and devastation
which cannot be relieved without assistance.

A disaster is a natural or man-made hazard that has come to fruition, resulting in an

event of substantial extent causing significant physical damage or destruction, loss
of life, or drastic change to the environment.

A disaster can be extensively defined as any tragic event with great loss stemming
from events such as earthquakes, floods, catastrophic accidents, fires, or
explosions.

In contemporary academia, disasters are seen as the consequence of

inappropriately managed risk. These risks are the product of hazards and
vulnerability. Hazards that strike in areas with low vulnerability are not considered
a disaster, as is the case in uninhabited regions.

Developing countries suffer the greatest costs when a disaster hits – more than 95
percent of all deaths caused by disasters occur in developing countries, and losses
due to natural disasters are 20 times greater (as a percentage of GDP) in
developing countries than in industrialized countries.
DEFINITION:-

A disaster is a natural or man-made hazard that has come to fruition, resulting in an

event of substantial extent causing significant physical damage or destruction, loss
of life, or drastic change to the environment. A disaster can be extensively defined
as any tragic event with great loss stemming from events such as earthquakes,
floods, catastrophic accidents, fires, or explosions.
TYPES OF DISASTER:-

Natural E.g.: earthquake, floods, hurricane, tsunami.

Manmade.Eg: nuclear accidents, industrial accidents

Hybrid e.g.: spread of disease in community, global warming

1. Natural disaster:-

A natural disaster is a consequence when a natural calamity affects humans and/or

the built environment. Human vulnerability, and often a lack of appropriate
emergency management, leads to financial, environmental, or human impact.

Various disasters like earthquake, landslides, volcanic eruptions, flood and

cyclones are natural hazards that kill thousands of people and destroy billions of
dollars of habitat and property each year.

. These natural disasters are of

(i) geophysical origin such as earthquakes, volcanic eruptions, land slides

(ii) Climatic origin such as drought, flood, cyclone, locust, forest fire. Though it
may not be possible to control nature and to stop the development of natural
phenomena but the efforts could be made to avoid disasters and alleviate
their effects on human lives, infrastructure and property

2. Man made disaster:- Man-made disasters are disasters resulting from man-
made hazards (threats having an element of human intent, negligence, or error; or
involving a failure of a man-made system), as opposed to natural disasters
resulting from natural hazards.

Examples are:-
a. Social hazards
B.Technological hazards

PHASES OF DISASTER MANAGEMENT:-

• Prevention phase

• Preparedness phase

• Response phase

• Recovery phase

Prevention phase;-

• Identify the risk factors and to develop and implement programmes to

prevent disaster.
Preparedness phase:-

• Personal preparedness
• Professional preparedness

Response phase;-

- Search, rescue and first aid:- after a major disaster , the need for search,
rescue and first aid is likely to be so great that organized relief services will
be able to meet only a small fraction of the demand . Most immediate help
comes from the uninjured survivors.
- Field care: - most injured persons converge spontaneously to health
facilities, using whatever transport is available, regardless of the facilities.
Providing proper care to casualties requires that the health service resources
be redirected to this new priority. Bed availability and surgical services
should be maximized. Food and shelter provides.
- Triage :-

• GREEN: - those who are able to get up and walk away.

• RED: - those with respiratory compromise, no palpable pulse at wrist but are
breathing, or unable to follow commands.

• Yellow:- those who are not red but cant walk

• Black:- dead

When the quantity and severity of injuries overwhelm the operative capacity of
health facilities, a different approach to medical treatment must be adopted. The
principle of first come first treated is not followed in mass emergencies.
Triage should be carried out at the site of disaster in order to determine
transportation priority and admission to the hospital or treatment centre, where
the patient needs and priority of medical care will be reassessed.

Tagging:-
All patients should be identified with tags stating their name, age, place of
origin, triage category, diagnosis and initial treatment.

Relief phase:-
This phase begins when assistance from outside starts to reach the disaster area.
The type and quantity of humanitarian relief supplies are usually determined by
two main factors
1. The type of disaster since distinct events has different effects on the
population.
2. The type and quantity of supplies available locally.

DISASTER MANAGEMENT CYCLE:-

Prevention ------> preparedness

Recovery <--------- response

LEVELS OF DISASTER:-

• Level iii disaster – considered a minor disaster. These are involves minimal
level of damage
 • Level ii disaster- considered a moderate disaster. The local and community
resources has to be mobilized to manage this situation

• Level i disaster- considered a massive disaster- this involves a massive level

of damage with severe impact.

DISASTER MITIGATION:-

• Disaster mitigation refers to actions or measures that can either prevent the
occurrence of a disaster or reduce the severity of its effects. (American Red
Cross).

• Mitigation activities include awareness and education and disaster

prevention measures

Aims and objectives:-

• to provide prompt and effective medical care to the maximum possible in

order to minimize morbidity and mortality

- To optimally prepare the staff and institutional resources for effective

performance in disaster situation

- To make the community aware of the sequential steps that could be taken at
individual and organizational levels

Disaster management committee:-

• Disaster management committee

• The following members would comprise the disaster management
committee under the chairmanship of medical superintendent/ director
• Medical superintendent/ director
• Additional medical superintendent
• Nursing superintendent/ chief nursing officer
• Chief medical officer (casualty)
• Head of departments- surgery, medicine, orthopedics, radiology,
anesthesiology, neurosurgery
• Blood bank in charge
• Security officers
• Transport officer
• Sanitary personnel

• Disaster control room

• The existing casualty may be referred as the disaster control room.

• Rapid response team

• The medical superintendent will identify various specialists, nurses and
pharmacological staff to respond within a short notice depending up on the
time and type of disaster.
• The list of members and their telephone numbers should be displayed in the
disaster control room.

• Information and communication

• The disaster control team would be responsible for collecting, coordinating
and disseminating the information about the disaster situation to the all
concerned.
• To temporary wards such as wards with side rooms, corridors, seminar
rooms etc.
• Creating additional bed capacity by using trolleys, folding beds and floor
beds

• Logistic support system

• Resuscitation equipments
• Iv sets, iv fluids,
• Disposable needles, syringes and gloves
• Dressing and suturing materials and splints
• Oxygen masks, nasal catheters, suction machine and suction catheters
• ECG monitors, defibrillators, ventilators
 • Cut down sets, tracheotomy sets and lumbar puncture sets
• Linen and blankets
• Keys of these cupboards should be readily available at the time of disaster

• Training and drills

• Mock exercise and drills at regular intervals are conducted to ensure that all
the staff in the general and those associated with management of causalities
are fully prepared and aware of their responsibilities.

ELEMENTS OF DISASTER PLANS :-

A disaster plan should have the following elements

• Chain of authority
• Lines of communication
• Routes and modes of transport
• Mobilization
• Warning
• Evacuation
• Rescue and recovery
• Triage
• Treatment
• Support of victims and families
• Care of dead bodies
• Disaster worker rehabilitation
Disaster management and role of nurse in community :-

• Assess the community

• Assessment - the local climate conducive for disaster occurrence, past
history of disasters in the community, available community disaster plans
and resources, personnel available in the community for the disaster plans
and management, local agencies and organizations involved in the disaster
management activities, availability of health care facilities in the community
etc.

• Diagnose community disaster threats

• Determine the actual and potential disaster threats (eg; explosions, mass
accidents, tornados, floods, earthquakes etc).

• Community disaster planning

• Develop a disaster plan to prevent or deal with identified disaster threats
• Identify local community communication system
• Identify disaster personnel, including private and professional volunteers,
local emergency personnel, agencies and resources
• Identify regional back up agencies and personnel
• Identify specific responsibilities for various personnel involved in the
disaster plans
• Set up an emergency medical system and chain for activation
• Identify location and accessibility of equipment and supplies
• Check proper functioning of emergency equipments
• Identify outdated supplies and replenish for appropriate use.

• Implement disaster plans

• Focus on primary prevention activities to prevent occurrence of manmade
disasters
• Practice community disaster plans with all personnel carrying out their
previously identified responsibilities (eg: emergency triage , providing
supplies such as food, water, medicine, crises and grief counseling)
• Practice using equipment; obtaining and distributing supplies

• Evaluate effectiveness of disaster plan

 • Critically evaluate all aspects of disaster plans and practice drills for speed,
effectiveness, gaps and revisions.
• Evaluate the disaster impact on community and surrounding regions
• Evaluate the response of personnel involved in disaster relief efforts

Conclusion:-

• Disaster is an emergency situation; therefore coordination of actions and

various departments is an essential requisite for efficient management of
mass casualties.
References:-

• Allender j a, spradly bw. Community health nursing- promoting and

practicing the public’s health. 6th edn. Lippincott Williams and Wilkins.
• Clemenstone s, mcguire sl, eigsti dg. Comprehensive community health
nursing- family aggregate and community practice. 6th edn. Mosby
publishers. St Louis. 2002
• Park k. , textbook of preventive and social medicine. 19th edition page no.
650
 DEPTH STUDY
OF
DISATER MANAGEMENT

SUBMITTED TO: - RESPECTED NAMITA MAM

SUBMITTED BY: - KANCHAN THAKUR

M.sc 1st year