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DISASTER
Disaster Nursing can be defined as the
adaptation of professional nursing skills inrecognizing and meeting the nursingphysical and emotional needs resulting from
a disaster.The overall goal of disaster nursing is to
achieve the best possible level ofhealth for the people and thecommunity involved in the disaster.
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TYPES OF DISASTER
Disasters may be:
Natural
Technological
Those in between or hybrid
Another way to classify disasters isbased on speed of onset:
Rapid onset
Slow Onset
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NATURAL DISASTER
1. Geophysical (earthquakes, landslides, tsunamis andvolcanic activity)
2. Hydrological(avalanches and floods)
3. Climatological (extreme temperatures, drought andwildfires)
4. Meteorological(cyclones and storms/wave surges)5. Biological (disease epidemics and insect/animal
plagues).
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TECHNOLOGICAL DISASTERS:
Conflict and Wars leading to refugees and internaldisplacement.
Structure failure and building collapse
Transportation crashes and accidents
Military accidents
Fire disasters Terrorism
Industrial Incidents
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PHASES OF DISASTER MANAGEMENT
1. Mitigation
andPrevention
2. Preparedness3. Response
4. Recovery
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PHASES OF DISASTER MANAGEMENT
1.PreventionPhase
Mitigation activitiesactually eliminate or
reduce the probability ofdisaster occurrence, orreduce the effects ofunavoidable disasters.
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PHASES OF DISASTER MANAGEMENT
2.PreparednessPhase
Personal preparedness
Professional
preparedness Community preparedness
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PHASES OF DISASTER MANAGEMENT
4.Recovery Phase During this phase actions
are taken to repair,rebuilt, or reallocatedamaged homes and
businesses and restorehealth and economicvitality to the community.
Psychological recoverymust be addressed. Bothvictims and relief workersshould be offered mentalhealth activities andservices.
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TRIAGE SYSTEM
Triage system: The process by which a
clinician assesses a patients clinicalurgency.
Triage: A triage system is the basicstructure in which all incomingpatients are categorized into groups
using a standard urgency rating scaleor structure. Triage is a dynamicprocess and is usually done more thanonce.
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TRIAGE
- Primary Triage: is the initial triage done inthe field, allowing responders to quickly andaccurately categorize the patientscondition and transport needs.
- Based on physiologyHow well the patient is able to utilize
their own resources to deal with theirinjuries
Patients unable to physiologicallycompensate for their injuries areassigned higher priority.
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TRIAGE
- Secondary Triage: is done as patients arebrought to the treatment area.
Goal: to best match patients current andanticipated needs with available resources.
Incorporates:
A reassessment of physiology
An assessment of physical injuries
Initial treatment and assessment of
patient responseFurther knowledge of resource
availability
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Secondary Triage cont
Goals is to distinguish between:
Victims needing life-savingtreatment that can only beprovided in a hospital setting.
Victims needing life-savingtreatment initially available onscene.
Victims with moderate non-life-threatening injuries, at risk fordelayed complications.
Victims with minor injuries.
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TRIAGE CATEGORY
RED TAGFIRST
PRIORITY
TYPICAL INJURIESAirway and breathing difficulties
Uncontrolled or severe bleeding
Severe medical problems
Signs of shock
Severe Burns
Open chest or abdominalinjuries
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TRIAGE CATEGORY
YELLLOWTAG
SECONDPRIORITY
TYPICAL INJURIESBurns without airway problems
Major or multiple bone or joint
problems.Back injuries with or withoutspinal cord injury.
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TRIAGE CATEGORY
GREENTAG
THIRDPRIORITY
TYPICAL INJURIESMinor fractures
Minor soft-tissue injuries
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TRIAGE CATEGORY
BLACKTAG
FOURTHPRIORITY
TYPICAL INJURIESObvious death
Obviously non-survivable injury,
such as major open braintrauma
Respiratory arrest (if limited
resources)Cardiac arrest
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TRIAGE
The assignment of degreesof urgency to wounds orillnesses to decide the order
of treatment of a largenumber of patients or
casualties.
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START TRIAGE (Steps)
1. Calling out patients at the disaster
site.
START TRIAGE (S )
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START TRIAGE (Steps)
2. Move to the non-ambulatory patient
and check your RPM Assist respiratory status
Hemodynamic status (Pulse)
Neurologic Status
START TRIAGE (S )
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START TRIAGE (Steps)
3. Check the
RESPIRATORY None Open the
Airway
Still None? BLACK Restored? RED
Present?
Above 30 RED Below 30 Check
Perfusion
START TRIAGE (S )
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START TRIAGE (Steps)
4. Check the
CIRCULATION No pulse or
Greater than 2 RED
Present or Lesserthan 2 CheckMental Status
START TRIAGE (St )
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START TRIAGE (Steps)
5. Check MENTAL
STATUS Can not follow
simple
commands RED
Can follow
simplecommands -
YELLOW
START TRIAGE SUMMARY
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START TRIAGE SUMMARY
START TRIAGE SUMMARY
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START TRIAGE SUMMARY
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MILITARY VS CIVILIAN TRAIGE
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MILITARY VS CIVILIAN TRAIGE
MILITARY CIVILIANPriority is to get as manysoldiers back into action
as possible.
Priority is to maximizesurvival of the greatest
number
Those with least seriouswound may be the first
treatment priority
Those with most seriousbut realistically
salvageable injuries are
treated firstIn both models, victims with clearly lethal injuries orthose who are unlikely to survive even with extensiveresource application are treated as the lowest priority.
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EMERGENCY
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EMERGENCY
A situation that arises
suddenly and threatens thelife or welfare of a person or agroup of people, as a naturaldisaster, medical crisis, ortrauma situation.
EMERGENCY NURSING
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EMERGENCY NURSING
Nursing care provided to prevent
imminent severe damage ordeath or to avert serious injury.
Require urgent intervention to
prevent a worsening of thesituation, although in somesituations, mitigation may not be
possible and agencies may onlybe able to offer palliative care forthe aftermath.
The Father of Modern Medicine
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The Father of Modern Medicine
In fifth century BC,Hippocrates was one of
the first people in theworld to studyhealthcare, earning himthe title of "the father of
modern medicine".Western European concepts
of nursing were firstpracticed by male
Catholic monks whoprovided for the sick andill during the Dark Agesof Europe.
NURSING
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NURSING
In 17th Century Europe, Nursing care wasprovided by persons serving punishment. Itwas associated with prostitutes, and womenserving time for other crimes.
These persons had a reputation of being drunkand obnoxious, a view amplified by thephysicians of the time to make themselvesseem more important and able.
FRANCE
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FRANCE
By the 1600s the French Sisters of mercy wasone of the first organized nursing orders thatresponded to care for epidemic victims.
FRANCE
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FRANCE
During the French Revolution (1789), after seeingthe speed with which the carriages of theFrench flying artillery maneuvered across thebattlefields, French military surgeon DominiqueJean Larrey applied the idea of ambulances, or
"flying carriages", for rapid transport ofwounded soldiers to a central place wheremedical care was more accessible and effective.Larrey manned ambulances with trained crews
of drivers, corpsmen and litter-bearers and hadthem bring the wounded to centralized fieldhospitals, effectively creating a forerunner.
USA
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USA
Nurses in the United States Army actually startedduring the Revolutionary War when a generalsuggested to George Washington that the heneeded female nurses "to attend the sick andobey the matron's orders. In July 1775, a plan
was submitted to the Second ContinentalCongress that provided one nurse for every tenpatients and provided that a matron be allottedto every hundred sick or wounded"
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WWII
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WWII
There were no male nurses in the American military untilyears later
Army and Navy nursing was highly attractive and a largerproportion of nurses volunteered for service higherthan any other occupation in American society
POST WAR CARE
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POST WAR CARE
The military nurses returnedhome as the nations
experts in blood transfusionand the application of newdrugs like penicillin. Whenthe nurses returned home
they used the previouslypowerless American NursesAssociation to take controlof the nursing profession
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PARAMEDICS
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PARAMEDICS
At the same time ERs were becoming more recognized,transport of patients to hospitals for care was also
gaining attention
PARAMEDICS
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PARAMEDICS
Community leaders recognized that lessons learned fromWWII and the Korean Conflict about triage, field care
and rapid transport could be translated to civilianpractice
Korea Air ambulance transport was initiated.
ED TRIAGE
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ED TRIAGE
1. Identify patients requiring immediate care.
2. Determine the appropriate area for treatment3. Facilitate flow through the ED and avoid
unnecessary congestion.
4. Provide continued assessment and
reassessment of arriving and waitingpatients.
5. Provide information and referrals to patients
and families.6. Ease patient and family anxiety and enhance
public relations.
EMERGENCY SITUATION?
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EMERGENCY SITUATION?
Emergent situations are potentially
life-threateningUrgent situations are serious but not
life-threatening if treatment is delayed
briefly;
Nonemergency situations are notacute and are considered minor tomoderately severe
HOSPITAL INCIDENT COMMAND SYSTEM (HICS)
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HOSPITAL INCIDENT COMMAND SYSTEM (HICS)
System for managing emergent and
non-emergent situations Provides hospitals with required tools
to address the event
HICS initiated by an internal/externalevent
Flexible in scale
Only those positions needed areactivated
Administrative position assumes role
as Incident Commander
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