dr. muhammad razzaq malik. accident an unexpected, unplanned occurrence which may cause injuries,...

Dr. Muhammad Razzaq MalikDr. Muhammad Razzaq Malik


ACCIDENTACCIDENT

An unexpected, unplanned An unexpected, unplanned occurrence which may cause injuries, occurrence which may cause injuries, deaths etcdeaths etc

Unpremeditated event resulting in Unpremeditated event resulting in recognizable damage or in sequence recognizable damage or in sequence of events which usually produces of events which usually produces unintended injuries, deaths or unintended injuries, deaths or property damage.property damage.


Accidents Accidents Kills and maim peopleKills and maim peopleDestruction / destroy familiesDestruction / destroy familiesDevastate communitiesDevastate communitiesIrreparable harm to societiesIrreparable harm to societiesGreat and instantaneous loss of lifeGreat and instantaneous loss of lifeWide spread public reaction and sorrowWide spread public reaction and sorrowInjured survivors suffer life long Injured survivors suffer life long disabilitiesdisabilitiesFinancial ruinFinancial ruin


Types of Accident Types of Accident

Road traffic accidentsRoad traffic accidents

Domestic accidentsDomestic accidents– Drowning, burns, Poisoning, FallsDrowning, burns, Poisoning, Falls– Injuries from sharp instrumentsInjuries from sharp instruments– Bites and injuries from animalsBites and injuries from animals

Industrial accidentsIndustrial accidents

Railway accidentsRailway accidents

violencesviolences


DISASTERDISASTER

Any occurrence that causes damage, Any occurrence that causes damage, ecological disruption, loss of human ecological disruption, loss of human life or deterioration of health and life or deterioration of health and health services on a scale sufficient health services on a scale sufficient to warrant an extraordinary response to warrant an extraordinary response from out side the affected from out side the affected community or area.community or area.


DISASTERDISASTER

Sudden extraordinary calamity or Sudden extraordinary calamity or catastrophy that affects or threatens catastrophy that affects or threatens life.life.– Affects health and well being of peopleAffects health and well being of people– Large no. of people are displaced, killed, Large no. of people are displaced, killed,

injured and at risk of epidemic.injured and at risk of epidemic.


DISASTERDISASTER

A sudden & great misfortune. A sudden & great misfortune.

A situation arising from the event A situation arising from the event where disruption is of great where disruption is of great magnitude in:magnitude in:– Life – human, animal and plantLife – human, animal and plant– Life supporting system ( water, Air, Life supporting system ( water, Air,

food).food).


Disaster Disaster

An ecological disruption exceeding An ecological disruption exceeding the adjustment capacity of the the adjustment capacity of the affected community.affected community.

An act of nature of such a magnitude An act of nature of such a magnitude that creates a catastrophic situation that creates a catastrophic situation in which day to day pattern of life is in which day to day pattern of life is suddenly disrupted and people are suddenly disrupted and people are plunged into helplessness and plunged into helplessness and sufferings.sufferings.


DisasterDisaster

The damage is immeasurable and The damage is immeasurable and varies with the geographical location, varies with the geographical location, climate and the type of the earth climate and the type of the earth surface/degree of vulnerability. surface/degree of vulnerability.

Influences the mental, socio-Influences the mental, socio-economic, political and cultural state economic, political and cultural state of the affected area. of the affected area.


Disaster Disaster

Completely disrupts the day to day Completely disrupts the day to day lifelife

Negatively influences the emergency Negatively influences the emergency systemssystems

Normal needs and processes like Normal needs and processes like food, shelter, health, etc. are food, shelter, health, etc. are affected and deteriorated.affected and deteriorated.


Disasters Disasters Major cause of premature deathsMajor cause of premature deathsImpair health status of the peopleImpair health status of the peopleDiminish quality of life, homelessness, loss of jobsDiminish quality of life, homelessness, loss of jobsEnvironmental changes – more premature Environmental changes – more premature mortality, morbidity and poor quality of life.mortality, morbidity and poor quality of life.Emotional stressEmotional stressEpidemics and increase in indigenous diseasesEpidemics and increase in indigenous diseasesDamages to physical structures, roads, bridges, Damages to physical structures, roads, bridges, railwaysrailwaysFood scarcityFood scarcityPopulation movements / migrationPopulation movements / migrationWater purification and disposal system destructionWater purification and disposal system destructionEnhance vector productionsEnhance vector productions


Disasters Disasters Major natural disasters:Major natural disasters:

FloodsFloods

CyclonesCyclones

DroughtDrought

EarthquakesEarthquakes

Minor natural disasters:Minor natural disasters:

Cold waveCold wave

ThunderstormsThunderstorms

Heat wavesHeat waves

Mud slidesMud slides

StormsStorms


Man-made hazardsMan-made hazardsDisasters having an element of human Disasters having an element of human intent, negligence, error or the ones intent, negligence, error or the ones involving the failure of a system:involving the failure of a system: Man-made hazards are in turn categorized Man-made hazards are in turn categorized as technological or sociological.as technological or sociological.TechnologicalTechnological hazards are results of hazards are results of failure of technology, such as engineering failure of technology, such as engineering failures, transport accidents or failures, transport accidents or environmental disasters.environmental disasters.Sociological Sociological hazards have a strong hazards have a strong human motive, such as crimes, suicidal human motive, such as crimes, suicidal attacks, riots and war. attacks, riots and war.


DisastersDisastersMajor manmade disasters:Major manmade disasters:

Setting of fires,Setting of fires, Epidemics Epidemics DeforestationDeforestation Chemical Chemical pollution pollution Pollution due to cultivationPollution due to cultivation WarsWars

Minor manmade disaster:Minor manmade disaster:

Road / train accidents, riotsRoad / train accidents, riotsFood poisoning Food poisoning Industrial disasters / crisisIndustrial disasters / crisisEnvironmental pollution Environmental pollution


Disasters Disasters Climatological Disasters:Climatological Disasters:– More frequent, e.g. Floods, stormsMore frequent, e.g. Floods, storms

Geological disasters:Geological disasters:– Earthquakes, volcanic eruptions, TsunamiEarthquakes, volcanic eruptions, Tsunami

ASIA is more prone to natural ASIA is more prone to natural disastersdisasters

1 disaster in USA, Europe, Australia1 disaster in USA, Europe, Australia

10 in Latin America10 in Latin America

15 in Asia15 in Asia


TYPES OF DISASTERSTYPES OF DISASTERSNatural disastersNatural disasters– Earthquakes, floods, storms, droughts, Earthquakes, floods, storms, droughts,

cyclones, landslides, tsunamicyclones, landslides, tsunami

Man made disastersMan made disasters– Violence, terrorism, accidents, dam collapse,Violence, terrorism, accidents, dam collapse,– Fires, food poisonings etc.Fires, food poisonings etc.– Bhopal, India- pesticide plant release of Bhopal, India- pesticide plant release of

chemical- methyl isocyanatechemical- methyl isocyanate

Man made disasters are caused by human Man made disasters are caused by human activitiesactivities


Disasters Disasters Sudden onsetSudden onset: human factors are involved: human factors are involved– Bhopal tragedyBhopal tragedy– Chernobyl nuclear power plantChernobyl nuclear power plant– Liquid gas tank explosion in Mexico cityLiquid gas tank explosion in Mexico city

Insidious and continuous disastersInsidious and continuous disasters – Leakage of toxic chemical from a dump siteLeakage of toxic chemical from a dump site– Tainting of soil with dioxin in oils spray on roadsTainting of soil with dioxin in oils spray on roads– Leakage of radioactive material from nuclear Leakage of radioactive material from nuclear

weapons production facilitiesweapons production facilities


DisastersDisasters

Long term and continuing:Long term and continuing:– Global warmingGlobal warming– Wars Wars – Civil conflictsCivil conflicts– Droughts Droughts

1990s international decade for 1990s international decade for natural disasters reduction by UNnatural disasters reduction by UN


DisastersDisastersClimatological disastersClimatological disastersGeological disastersGeological disastersCatastrophic events:Catastrophic events:– Fires, explosions, crashes, spills with release of toxic Fires, explosions, crashes, spills with release of toxic

chemicals, chemicals,

Sudden chemical exposures:Sudden chemical exposures:– Italy 1976- explosion in chemical plantItaly 1976- explosion in chemical plant– Bhopal tragedyBhopal tragedy– Switzerland 1985-release of pesticide into the riverSwitzerland 1985-release of pesticide into the river

Sudden radiation exposuresSudden radiation exposuresDroughts and faminesDroughts and faminesWars and civil conflictsWars and civil conflicts


Meteorological Disasters Meteorological Disasters

StormsStorms– HurricanesHurricanes– CyclonesCyclones

Cold spellsCold spells

Heat wavesHeat waves

Drought Drought

Smog Smog


Topological DisastersTopological Disasters

FloodsFloods

Avalanches Avalanches

Landslides Landslides


Tectonic and Telluric disastersTectonic and Telluric disasters

Earth quacksEarth quacks

Volcano eruptionsVolcano eruptions


Accidents Accidents

Failure of structuresFailure of structures– Dams, tunnels, mine explosions, firesDams, tunnels, mine explosions, fires– Collisions, shipwrecks, train crashesCollisions, shipwrecks, train crashes– Poison entering water supplyPoison entering water supply


Atomic explosionsAtomic explosions

Sudden onsetSudden onset

Serious and immediate threatsSerious and immediate threats


Wars and conflictsWars and conflicts475 wars with >100 M deaths since 1700475 wars with >100 M deaths since 1700

90% in 2090% in 20thth century century

After world war II, 135 wars with 22 M After world war II, 135 wars with 22 M deathsdeaths

1987 - 27 wars were underway with 1987 - 27 wars were underway with 24,77,000 deaths and 85% were civilians24,77,000 deaths and 85% were civilians

Chemical weaponsChemical weapons

Biological weaponsBiological weapons


Wars and conflictsWars and conflictsOne hour’s world spending on arms = 20 year One hour’s world spending on arms = 20 year effort to eradicate small poxeffort to eradicate small pox2 hour’s cost = WHO total budget2 hour’s cost = WHO total budgetHalf day cost = full immunization of all Half day cost = full immunization of all children against common diseaseschildren against common diseases4 days cost = 5 year program to control 4 days cost = 5 year program to control malariamalaria3 weeks cost = PHC for every child including 3 weeks cost = PHC for every child including safe water supply and immunizationsafe water supply and immunization6 months cost = 10 year program providing 6 months cost = 10 year program providing health needs and food in developing countrieshealth needs and food in developing countries


Wars and conflictsWars and conflicts

Famine Famine

MalnutritionMalnutrition

Exposure to epidemic diseasesExposure to epidemic diseases

Environmental contaminationEnvironmental contamination

Social, political and military problemsSocial, political and military problems

Chemical & biological weaponsChemical & biological weapons


Natural disastersNatural disastersFloods:Floods:– China -1969China -1969– Northern Italy -1985Northern Italy -1985– Bolivia and Colombia – 1986Bolivia and Colombia – 1986– Bangladesh – 1991Bangladesh – 1991

Storms:Storms:– Caribbean – hurricanesCaribbean – hurricanes– Cyclones – Indian oceanCyclones – Indian ocean– Pacific – typhoonsPacific – typhoons– PhilippinesPhilippines– USA tornadoesUSA tornadoes– Tsunami Indonesia 2005Tsunami Indonesia 2005– Katrina in USA 2005Katrina in USA 2005


Natural disastersNatural disasters

Geological earth quacksGeological earth quacks– China 1976China 1976– Mexico city 1985Mexico city 1985– Chile, Philippine Chile, Philippine 19871987– Ecuador, ArmeniaEcuador, Armenia 19881988– San FranciscoSan Francisco 19891989– Pakistan Pakistan 20052005


Man made disastersMan made disastersSudden explosionsSudden explosions– Butane storage facility – Mexico – 1984Butane storage facility – Mexico – 1984– Texas petrochemical plant Texas petrochemical plant - 1989- 1989– Ojhri camp in RawalpindiOjhri camp in Rawalpindi - 1990- 1990Fires Fires – Las VegasLas Vegas hotelhotel 19801980– Brazil shanty townBrazil shanty town 19841984– California oil refineryCalifornia oil refinery 19891989– Oil refineryOil refinery KuwaitKuwait 19901990– Iraq Iran WarIraq Iran War– Haji camp MINA - MECCAHaji camp MINA - MECCA 19971997


Man made disastersMan made disastersCrashes Crashes – Japan airliner Japan airliner 19851985– Lockerbie Lockerbie ScotlandScotland 19891989

Chemical exposure:Chemical exposure:– Italy Dioxin 1976Italy Dioxin 1976– Bhopal India 1984Bhopal India 1984– Switzerland Switzerland pesticidespesticides 19871987

Spills Spills – Alaska, Texas, Karachi, GulfAlaska, Texas, Karachi, Gulf


FireFire


Tsunami Tsunami


Earthquake Earthquake


Volcano Volcano


Earth quack Earth quack


Earth quackEarth quack


Disaster planning & Management Disaster planning & Management

Plan: a blue print for taking actionPlan: a blue print for taking action– ProgramProgram: is a sequence of activities : is a sequence of activities

designed to implement policies and designed to implement policies and accomplish objectives.accomplish objectives.

– Program gives step by step approach to Program gives step by step approach to guide the action necessary to reach guide the action necessary to reach predetermined goals.predetermined goals.

– Program must be closely related with Program must be closely related with objectives objectives


ScheduleSchedule

It is a time sequence for the work to It is a time sequence for the work to be done.be done.

PROCEDURESPROCEDURES– Are a set of rules for carrying out work Are a set of rules for carrying out work

which help to ensure the maximum use which help to ensure the maximum use of the resources and efforts.of the resources and efforts.

POLICIES:POLICIES:– Are guiding principles stated as Are guiding principles stated as

expectationsexpectations


Pre-planning Pre-planning

Preparation for planningPreparation for planning

Government interestGovernment interest

LegislationLegislation

Organization for planningOrganization for planning

Administrative capacity Administrative capacity – For coordination of activities and For coordination of activities and

implementation of the plan at all levels.implementation of the plan at all levels.


Planning cyclePlanning cycleA process of analyzing a system, defining A process of analyzing a system, defining the problems, situational analysis, the problems, situational analysis, formulating goals and objectives to alleviate formulating goals and objectives to alleviate needs, initiating a necessary action for its needs, initiating a necessary action for its implementation and monitoring the system implementation and monitoring the system to ensure proper implementation of plan in to ensure proper implementation of plan in the light of stated objectives.the light of stated objectives.Planning must take into considerations the Planning must take into considerations the problems, feasibility, SES attitude, political problems, feasibility, SES attitude, political values, resources and capacity profiles of values, resources and capacity profiles of the health system and Govt. machinerythe health system and Govt. machinery


Planning cyclePlanning cycleSituational analysisSituational analysisEstablishment of objectivesEstablishment of objectivesAssessment of resourcesAssessment of resourcesFixing prioritiesFixing prioritiesDesign alternative programme Design alternative programme Selection of best programmeSelection of best programme– Feasibility, cost effectiveness.Feasibility, cost effectiveness.

Plan implementation and executionPlan implementation and execution– Selection, training, defining roles and tasks, motivation Selection, training, defining roles and tasks, motivation

and supervision, organization and communication and and supervision, organization and communication and efficiency of institutions like hospitals.efficiency of institutions like hospitals.


Analysis of situationAnalysis of situation

Collection, assessment and Collection, assessment and interpretation of information – picture interpretation of information – picture of health situationof health situation– Population ,age and sex structurePopulation ,age and sex structure– Morbidity and mortality dataMorbidity and mortality data– Epid. and distribution of different diseasesEpid. and distribution of different diseases– Medical care facilitiesMedical care facilities– Man power availableMan power available– Attitude and beliefs of the population.Attitude and beliefs of the population.


DISASTER MANAGEMENTDISASTER MANAGEMENTP – PlanningP – Planning– To meet health needs and demand of peopleTo meet health needs and demand of people– economic utilization of resourceseconomic utilization of resources– Fixation of prioritiesFixation of priorities

O – OrganizingO – OrganizingS – Staffing S – Staffing D – Directing and motivating D – Directing and motivating CO – coordinating CO – coordinating R – Reporting R – Reporting B – budgetingB – budgetingE- Evaluation periodicallyE- Evaluation periodicallyD- Development - enhancementD- Development - enhancement


Surveillance cycleSurveillance cycleRescue of victimsRescue of victims

Provision of emergency medical careProvision of emergency medical care

Evacuation of populationEvacuation of population

Elimination of physical dangersElimination of physical dangers

Provision of preventive and routine medical Provision of preventive and routine medical carecare

Provision of food, safe water, clothing, Provision of food, safe water, clothing, shelter, shelter,

Disposal of human bodies, wastesDisposal of human bodies, wastes

Control of vector borne diseasesControl of vector borne diseases


Aims & objectives Disas. ManagAims & objectives Disas. Manag

Promptly resuscitate and transport Promptly resuscitate and transport the injured to appropriate health the injured to appropriate health facilityfacility

Triage and coding of patientsTriage and coding of patients

Protection of life, property & Protection of life, property & environmentenvironment

Reduction of vulnerability & Reduction of vulnerability & protection of the society.protection of the society.


Functions of health teamFunctions of health teamFirst aidFirst aidEmergency careEmergency careAmbulatory careAmbulatory carePatient referralPatient referralMembers of a health team:Members of a health team:– Carefully selectedCarefully selected– Aware of their responsibilitiesAware of their responsibilities– Capable of assembling quicklyCapable of assembling quickly– Be able to get help from local communityBe able to get help from local community– Proper training and rehearsalProper training and rehearsal– A leader to supervise all activities, present in control A leader to supervise all activities, present in control

station station


Response to disasterResponse to disasterSearch, rescue and first aidSearch, rescue and first aid– Proper care of casualtiesProper care of casualtiesField care:Field care:– Bed availability, surgical services, Bed availability, surgical services, – Provision of food, shelterProvision of food, shelter– Identification of victims and mortuary spaceIdentification of victims and mortuary space– Inquiry office to respond inquiriesInquiry office to respond inquiriesTriage Triage – No principle of first come, first treated is No principle of first come, first treated is

followed in mass emergencies.followed in mass emergencies.– Priority is granted to victims whose prognosis Priority is granted to victims whose prognosis

can be affected by simple intensive care.can be affected by simple intensive care.


Triage Triage

Magnitude of disaster and available Magnitude of disaster and available resources should be knownresources should be known

Very critical ill patients: little chance Very critical ill patients: little chance to survive – no careto survive – no care

Slightly injured patients may have to Slightly injured patients may have to wait for a considerable timewait for a considerable time

Triage team must not involve in Triage team must not involve in treatment of patientstreatment of patients


Hospital triageHospital triageArrival of patients to the hospitalArrival of patients to the hospitalDiagnostics like X-ray, Blood bankDiagnostics like X-ray, Blood bankOperation theaters Operation theaters Emergency suppliesEmergency supplies– Resuscitation kitResuscitation kit– Drug kitDrug kit– Dressing kitDressing kit– Fluid kitFluid kit

Identification tags, coverings with sheets, Identification tags, coverings with sheets, Mortuary.Mortuary.


During floodsDuring floodsDrink boiled water. Drink boiled water. Keep your food covered, don’t take heavy Keep your food covered, don’t take heavy meals. meals. Use raw tea, rice-water, tender coconut-Use raw tea, rice-water, tender coconut-water, etc. during diarrhoea; use ORS and water, etc. during diarrhoea; use ORS and treatment. treatment. Do not let children remain on empty stomach. Do not let children remain on empty stomach. Use bleaching powder and lime to disinfect Use bleaching powder and lime to disinfect the surroundings. the surroundings. Help the officials/volunteers distributing relief Help the officials/volunteers distributing relief materials. materials.


High-Rise FiresHigh-Rise Fires

Calmly leave the apartment, closing Calmly leave the apartment, closing the door behind you. Remember the the door behind you. Remember the keys! keys!

Pull the fire alarm near the closest Pull the fire alarm near the closest exit, if available, or raise an alarm by exit, if available, or raise an alarm by warning others. warning others.

Leave the building by the stairs. Leave the building by the stairs.

Never take the elevator during fire! Never take the elevator during fire!


If the exit is blocked by smoke or If the exit is blocked by smoke or fire:fire:

Leave the door closed but do not lock it. Leave the door closed but do not lock it.

To keep the smoke out, put a wet towel in To keep the smoke out, put a wet towel in the space at the bottom of the door. the space at the bottom of the door.

Call the emergency fire service number Call the emergency fire service number and tell them your apartment number and and tell them your apartment number and let them know you are trapped by smoke let them know you are trapped by smoke and fire. It is important that you listen and and fire. It is important that you listen and do what they tell you. do what they tell you.

Stay calm and wait for someone to rescue Stay calm and wait for someone to rescue you. you.

dr. muhammad razzaq malik. accident an unexpected, unplanned occurrence which may cause injuries,...

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