EMERGENCYEMERGENCY NURSING NURSING

Emergency:Emergency:

Is a a life threatening situation wherein Is a a life threatening situation wherein there is any unplanned event that can there is any unplanned event that can cause deaths / significant injuries; or that cause deaths / significant injuries; or that can shutdown your business or disrupts can shutdown your business or disrupts operations, cause physical or operations, cause physical or environmental damage, or threaten environmental damage, or threaten reputation or revenue (eg; fire, explosion, reputation or revenue (eg; fire, explosion, or civil disturbance) or civil disturbance)

Principles / Objectives:Principles / Objectives:

1.1. Establish a patent airway and provide Establish a patent airway and provide adequate ventilation (employing resuscitation adequate ventilation (employing resuscitation measure when necessary) protecting the measure when necessary) protecting the cervical spine first and assessing chest cervical spine first and assessing chest injuries with subsequent airway obstruction.injuries with subsequent airway obstruction.

2.2. Evaluate and restore cardiac output by Evaluate and restore cardiac output by controlling hemorrhage and its consequences controlling hemorrhage and its consequences preventing and treating shock, and preventing and treating shock, and maintaining or restoring effective circulation.maintaining or restoring effective circulation.

3. Determine the patients ability to follow 3. Determine the patients ability to follow commands, evaluate motor skills and pupillary commands, evaluate motor skills and pupillary size and reactivitysize and reactivity

4. Carry out a rapid initial and ongoing physical 4. Carry out a rapid initial and ongoing physical examinations.examinations.

5. Start cardiac monitoring, if appropriate.5. Start cardiac monitoring, if appropriate.6. Splint suspected fracture6. Splint suspected fracture7. Protect and clean wounds: apply sterile 7. Protect and clean wounds: apply sterile

dressingdressing

8. Identify allergies and medical history that 8. Identify allergies and medical history that is significant.is significant.

9. Document on the medical record the 9. Document on the medical record the patients VS, neurologic status, I&O to patients VS, neurologic status, I&O to guide in decision making.guide in decision making.

DISASTERDISASTER

Large scale emergency; even a small Large scale emergency; even a small emergency if left unmanage can become a emergency if left unmanage can become a disasterdisaster

WHAT CONSTITUTES A DISASTER?WHAT CONSTITUTES A DISASTER?It is a situation resulting from an environmental It is a situation resulting from an environmental

phenomenon, confined conflict that produces phenomenon, confined conflict that produces stress, personal injury, physical damage and stress, personal injury, physical damage and economic disruptions of great magnitude; economic disruptions of great magnitude; catastrophic situationcatastrophic situation

NATURAL DISASTERNATURAL DISASTER

Triggered by natural phenomenonTriggered by natural phenomenon

(earthquakes, floods, typhoon, tsunami) (earthquakes, floods, typhoon, tsunami)

are known technically as natural are known technically as natural

hazardshazards

ENVIRONMENTAL DEGRADATIONENVIRONMENTAL DEGRADATION A special type of natural disaster that occur more A special type of natural disaster that occur more

frequently.frequently. Results typically from poor farming, forest abuse and Results typically from poor farming, forest abuse and

demands for fuel woods. Increased flooding due to demands for fuel woods. Increased flooding due to poor farming practices in a tipper potion of a watershed poor farming practices in a tipper potion of a watershed and increased desertification resulting from and increased desertification resulting from overgrazing or improper use of water resources .overgrazing or improper use of water resources .

This type of disaster is a growing concern not only This type of disaster is a growing concern not only because of the environmental consequences but also because of the environmental consequences but also large number of people can be displaced. large number of people can be displaced.

MAN-MADE DISASTERMAN-MADE DISASTER Resulting from man-made hazzards.Resulting from man-made hazzards.TYPES: TYPES: 1. Various aspects of armed conflicts and 1. Various aspects of armed conflicts and civil strife.civil strife. 2. Technological disaster ( usually a result of 2. Technological disaster ( usually a result of

accidents or incidents occuring in the accidents or incidents occuring in the manufacture, transport or distribution of fuels manufacture, transport or distribution of fuels and other toxic chemicals. and other toxic chemicals.

DISASTER MANAGEMENT DISASTER MANAGEMENT STEPS STEPS

Must start with an inventory of risk and Must start with an inventory of risk and assessment of exposure from these assessment of exposure from these risks. Infrastructure issues will likely to be risks. Infrastructure issues will likely to be seen as the one that presents the most seen as the one that presents the most risks.risks.

1. Mitigation: 1. Mitigation: - sustained action that reduces or eliminates - sustained action that reduces or eliminates

long-term risks to the people and property long-term risks to the people and property from natural hazards and their effects.from natural hazards and their effects.

- ongoing process/effort to lessen the impact of - ongoing process/effort to lessen the impact of disaster on people and property.disaster on people and property.

- avoiding construction in high risk areas such - avoiding construction in high risk areas such as flood plains, engineering buildings to as flood plains, engineering buildings to withstand wind and earthquakes. withstand wind and earthquakes.

2. Preparedness: 2. Preparedness: - preparing for emergency before it occurs - preparing for emergency before it occurs - key to effective emergency management is - key to effective emergency management is

being ready to provide a rapid emergency being ready to provide a rapid emergency response .response .

- being ready includes training and exercises as - being ready includes training and exercises as well as logistics.well as logistics.

- Emotionally, psychologically and physically - Emotionally, psychologically and physically prepared.prepared.

- Government agencies at all levels have - Government agencies at all levels have an obligation to prepare themselves and an obligation to prepare themselves and the public for emergency.the public for emergency.

- Community groups, service providers, - Community groups, service providers, businesses, civic and volunteer groups businesses, civic and volunteer groups are all partners in this effort. are all partners in this effort.

3. Response3. Response4. Recovery 4. Recovery

OBJECTIVES OF DISASTER OBJECTIVES OF DISASTER MANAGEMENTMANAGEMENT

1.Reduce/ avoid the human, physical and 1.Reduce/ avoid the human, physical and economic losses suffered by individual, by the economic losses suffered by individual, by the society and by the country at large.society and by the country at large.

2. Reduced personal suffering2. Reduced personal suffering3. Speed recovery3. Speed recovery4. Provide protection to victim or person whose 4. Provide protection to victim or person whose

lives or property are threatened by armed lives or property are threatened by armed conflict, tribal animosity, religious persecutions, conflict, tribal animosity, religious persecutions, etc. etc.

DISASER PREVENTION DISASER PREVENTION - are measures designed to preclude natural - are measures designed to preclude natural

phenomena from causing or resulting to disaster or phenomena from causing or resulting to disaster or emergency situation.emergency situation.

DISASTER MITIGATION DISASTER MITIGATION - are action taken to reduce the effects of extreme - are action taken to reduce the effects of extreme

natural phenomena, on both human suffering and natural phenomena, on both human suffering and property loss.property loss.

DISASTER PREPAREDNESSDISASTER PREPAREDNESS - action designed to minimize loss of life and damage - action designed to minimize loss of life and damage

and to organize, facilitate timely and effective rescue, and to organize, facilitate timely and effective rescue, relief and rehabilitation in cases of disaster.relief and rehabilitation in cases of disaster.

6 ELEMENTS OF 6 ELEMENTS OF DISASTER MANAGEMENTDISASTER MANAGEMENT

1.1. RISK MANAGEMENTRISK MANAGEMENT - identifying threats, determining their - identifying threats, determining their

probability of occurrence, estimating probability of occurrence, estimating what are the impact of the threat might what are the impact of the threat might be to the constituents.be to the constituents.

2. LOSS MANAGEMENT2. LOSS MANAGEMENT - includes human, structural, and - includes human, structural, and

economic losses.economic losses.

3. CONTROL OF EVENTS3. CONTROL OF EVENTS - anticipation of a disaster and its cause and effects.- anticipation of a disaster and its cause and effects. - Accurate information collection and its assessment.- Accurate information collection and its assessment. - a balance response. - a balance response. - action must be placed in a timely manner and undertaken before - action must be placed in a timely manner and undertaken before

demands and needs escalates.demands and needs escalates. - Leadership- disaster management should lead, rather than follow - Leadership- disaster management should lead, rather than follow

public action.public action. - Discipline- disaster managers, disaster management system and - Discipline- disaster managers, disaster management system and

organizations are the key personnel in the relief and disaster organizations are the key personnel in the relief and disaster management system must operate in an orderly, precised and management system must operate in an orderly, precised and discipline manner. The appearance of discipline and self-discipline manner. The appearance of discipline and self-assuredness will reassure the public and promote acceptance assuredness will reassure the public and promote acceptance

4. EQUITY OF ASSISTANCE4. EQUITY OF ASSISTANCE

- all disaster assistance should be - all disaster assistance should be provided in an equitable and fair manner.provided in an equitable and fair manner.

5. RESOURCE MANAGEMENT5. RESOURCE MANAGEMENT

- Disaster manager should be familiar with - Disaster manager should be familiar with the resources available.the resources available.

6. IMPACT REDUCTION6. IMPACT REDUCTION - Disaster can have an impact far beyond the - Disaster can have an impact far beyond the

immediate human, physical or economic immediate human, physical or economic losses.losses.

- Disaster can also be a serious setback to the - Disaster can also be a serious setback to the country’s entire development program.country’s entire development program.

- Managing the disaster in such a way that - Managing the disaster in such a way that recovery is accomplished quickly and that the recovery is accomplished quickly and that the recovery efforts contribute to the overall recovery efforts contribute to the overall restoration of everything.restoration of everything.

HOW DO YOU HOW DO YOU PRIORITIZED A PRIORITIZED A DISASTER? DISASTER?

TRIAGE - a French verb means TRIAGE - a French verb means

“ “to sort”to sort”

The goal of TRIAGE is to do the greatest The goal of TRIAGE is to do the greatest good for the greatest number of good for the greatest number of individuals. individuals.

It is accomplished by having a system to It is accomplished by having a system to quickly assess patients categorize and quickly assess patients categorize and prioritize them according to their needs.prioritize them according to their needs.

Also used in hospital setting.Also used in hospital setting.

T – TraumaT – TraumaR – RespiratoryR – RespiratoryI - Intracranial pressure andI - Intracranial pressure and mental status mental statusA – An infectionA – An infectionG – Gastrointestinal (upper)G – Gastrointestinal (upper)E – Elimination (lower GI)E – Elimination (lower GI)

4 TREATMENT 4 TREATMENT CATEGORIESCATEGORIES

GREEN – lowest priority and is used for GREEN – lowest priority and is used for walking, wounded or patients who may not walking, wounded or patients who may not need to go to the hospital. Patients in this need to go to the hospital. Patients in this category may have minor musculoskeletal or category may have minor musculoskeletal or soft tissue injuries. They can wait for treatment.soft tissue injuries. They can wait for treatment.

YELLOW – next priority, patients who definitely YELLOW – next priority, patients who definitely need to go to a hospital but not immediately. need to go to a hospital but not immediately. These patients have injuries that are serious These patients have injuries that are serious but not life threatening. but not life threatening.

RED – Highest priority; used for critically injured RED – Highest priority; used for critically injured patients with treatable life threatening injuries. patients with treatable life threatening injuries. These might include airway and breathing These might include airway and breathing difficulties, decreased mental status and difficulties, decreased mental status and uncontrolled bleeding. These people will be uncontrolled bleeding. These people will be transported from the scene first.transported from the scene first.

BLACK – the final category, used for dead and BLACK – the final category, used for dead and salvageable patients such as someone in salvageable patients such as someone in cardiac arrest. These victims will be removed cardiac arrest. These victims will be removed from the scene only after all the living from the scene only after all the living salvageable patients.salvageable patients.