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. Types of disaster Natural. Eg : earthquake, floods, hurricane, tsunami. Manmade.Eg: nuclear accidents, industrial accidents Hybrid Eg: spread of disease in community, global warming. 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. Phases of disaster management Prevention phase Preparedness phase Response phase Recovery phase Prevention phase Identify community risk factors and to develop and implement programs to prevent disasters from occurring. Preparedness phase Personal preparedness Professional preparedness Psychological recovery must be addressed. Recovery phase During this phase actions are taken to repair.Both victims and relief workers should be offered mental health activities and services. rebuilt. Disaster management cycle Prevention I Recovery <--------response ------> preparedness v . or reallocate damaged homes and businesses and restore health and economic vitality to the community. Community must have adequate warning system and a back up evaluation plan to remove people from the area of danger Response phase The level of disaster varies and the management plans mainly based on the severity or extent of the disaster.Key organizations and professionals in disaster management Health care community Hospitals Health professionals Pharmacies Public health departments Rescue personnel Non-health care community Fire fighters Municipal or government officials Media Medical examiners Medical supply manufactures Police Community preparedness The level of community preparedness for a disaster is only as high as the people and organization in the community make it. orthopedics. 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. .Disaster management plans Aims of disaster plans to provide prompt and effective medical care to the maximum possible in order to minimize morbidity and mortality Objectives 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 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. radiology. coordinating and disseminating the information about the disaster situation to the all concerned. medicine.surgery. nurses and pharmacological staff to respond within a short notice depending up on the time and type of disaster. Rapid response team The medical superintendent will identify various specialists. 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. anesthesiology. day care beds. seminar rooms etc. ventilators Cut down sets. Elements of disaster plan 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 Activation of disaster management plans . defibrillators. tracheostomy 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. Utilization of vacant beds.Disaster beds Requirement of beds depends up on the magnitude of the disaster. Disposable needles. suction machine and suction catheters Ecg monitors. corridors. folding beds and floor beds Logistic support system Resuscitation equipments Iv sets. syringes and gloves Dressing and suturing materials and splints Oxygen masks. Creating additional bed capacity by using trolleys. and pre-operative beds Convalescing patients. elective surgical cases and patients who can have domiciliary care or opd management should be discharged Utility areas to be converted in to temporary wards such as wards with side rooms. nasal catheters. iv fluids. needing first aid and possible surgery. including private and professional volunteers. earthquakes etc). Disaster management. availability of health care facilities in the community etc. personnel available in the community for the disaster plans and management.needing immediate resuscitation. tornados. Essential services.the local climate conducive for disaster occurrence. Implement disaster plans Focus on primary prevention activities to prevent occurrence of manmade disasters . Standard operating procedures (SOPs) Reception area Triage o Priority one. transferred immediately to operation theatre.needing only first aid-discharge after first aid. after emergency treatment shifted to intensive care unit o Priority two. Diagnose community disaster threats Determine the actual and potential disaster threats (eg. local agencies and organizations involved in the disaster management activities. explosions.immediate surgery. mass accidents. Crowd management/ security arrangement. local emergency personnel.nurse’s role in community Assess the community Assessment . Documentation Public relations. available community disaster plans and resources. 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. o Priority three. floods. past history of disasters in the community. Community disaster planning Develop a disaster plan to prevent or deal with identified disaster threats Identify local community communication system Identify disaster personnel.give first aid and admit if bed is available or shift to hospital o Priority four. 2002 4. Lewis sl. London. Lancaster J. obtaining and distributing supplies Evaluate effectiveness of disaster plan Critically evaluate all aspects of disaster plans and practice drills for speed.process and practice for promoting health.promoting and practicing the public’s health. heitkemper mm. eigsti dg. Allender j a. lemone p. 3rd edn. Clemenstone s. 1992. . water. Mosby publishers. Community health nursing. 6th edn. lancaster j. medicine. References 1. 2005 3. Stanhope M. 5th edn. 2007.louis. Mosby publishers. 6th edn.the art and science of nursing care.assessment and management of problems. Lippincott williams and wilkins. Practice community disaster plans with all personnel carrying out their previously identified responsibilities (eg: emergency triage . Conclusion Disaster is an emergency situation. Philadelphia. spradly bw. 2. lillis c. Stanhope m. 6th edn. 5. Comprehensive community health nursingfamily aggregate and community practice. therefore coordination of actions and various departments is an essential requisite for efficient management of mass casualties. Mosby publishers. Fundamentals of nursing. 6. 2004. London. providing supplies such as food. Community health nursing. Community and public health nursing. 2006. St. crises and grief counseling) Practice using equipment. effectiveness. St louis. Lippincott williams and wilkins. gaps and revisions. mcguire sl. Medical surgical nursing. Taylor c. Evaluate the disaster impact on community and surrounding regions Evaluate the response of personnel involved in disaster relief efforts. Mosby year book. London.