80 terms

Community Exam 3--Disaster Management

CH 28
any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources
mass casualty
disaster involving 100+ individuals
multiple casualty
disaster involving 2-99 individuals
direct victim, indirect victim, displaced person, or refugee
how are casualties classified?
events that require a swift, intense response on the part of existing community resources; personal
natural disasters
tornadoes, hurricanes, earthquakes, etc.
man-made disasters
terrorism, riots, war
NA-TECH (natural/technological) disaster
natural disaster that creates or results in a widespread technological problem
cause premature death, illnesses

destroy local health care infrastructure & prevent effective response to emergency

create environmental imbalances (increasing risk for communicable diseases & environmental hazards)

affect people's psychological, emotional, & social well-being

cause food & water shortages

displace populations of people
disasters may do the following...
scope & number of casualties
characteristics of disasters
how often disasters occur
ability to tell when and if a disaster event will occur
actions taken to avoid disaster
speed of onset of impending disaster
scope & number of casualties
range of effect, geographic area involved, # of people affected
level of destruction & devastation
by the amount of resources needed
how are levels of a disaster determined?
three ways to classify a disaster
requires activation of the local emergency medical system

costs <$10,000
level I
costs >$10,000 but <$50,000
level II
costs >$50,000 but <$250,000
level III
costs >$250,000 but <$2.5 mil
level IV
costs >$2.5 mil
level V
disaster medical assistance teams (DMAT)
in a federal disaster, ________________ supplement local & state medical care needs & can be activated
before the disaster event occurs
when does disaster management begin?
stages of disaster
preventing occurrence of disaster or limit consequences

occurs in nondisaster & predisaster stages
primary prevention
search, rescue, & triage of victims
assessment of destruction & devastation
implemented once disaster occurs
secondary prevention
recovery & restoration of community to previous level of functioning

aimed at preventing a recurrence or minimizing effects of future disasters
tertiary prevention
initiates proactive mitigation activities, trains 1st responders, manages National Flood Insurance Program & US Fire Administration
US Public Health Service
responsible for clean drinking water, food, shelter, & medical care
American Red Cross
provides disaster relief, not a gov't agency, has great emphasis on preparedness
dept of health & human services
monitors for disease outbreaks, their cause, risk factors, & implements interventions for control
national incident management system
oversees actions of protecting against, responding to, recovering from, & preventing effects of disaster
identification of hazards
analysis of vulnerability
assessment of risk
pre-disaster planning should include...
identification of hazards
first step in planning for an effect response
analysis of vulnerability
predicts who will be affected the most & identifies community resources that are available for a response
place on Earth most vulnerable to natural disasters
tend to be physically isolated, disabled, unable to access disaster services

have fewer resources or less ability to withstand/survive a disaster without physical harm
assessment of risk
solid disaster plan
participate in yearly mock drills
adequate warning system
backup evacuation plan to remove individuals who hesitate to leave their home from areas of danger
community's need for disaster preparedness
1. promote confidence
2. develop skills
3. coordinate activities
4. coordinate participants
mock disasters: objectives
effort to prevent identified risks from causing a disaster
initiate measures to limit damage, disease, disability, & loss of life among members of a community
how does mitigation work?
level of disaster
response is determined by..
office of emergency management (OEM)
develops & coordinates emergencies within their defined area
directs nurses' response to a countrywide disaster
manages blood service & bone marrow registry
assists military with leaves
provides disaster training for health care professionals
takes part in disaster preparedness, response & recovery
provides individual/family assistance to meet emergency needs (food, shelter)
coordinates distribution of emergency relief supplies
works with FEMA in federal disasters
teaches first aid, water safety, CPR
administers Project Share
American Red Cross duties
operates shelters
provides feeding services
provides individual & family assistance
provides disaster health services
handles inquiries from concerned family
coordinates relief activities with other agencies, business, labor, & gov't
seeks contributions
American Red Cross responsibilities in disaster (7)
project share
provides emergency energy assistance to elderly & disabled in peak winter & summer months for Alabamians
safety & welfare of the community
the local government is responsible for the...
how many people are affected, injured, or dead?
how much fresh water & food is available?
what are the areas of risk or sanitation problems?
initial response assessment
triage victims
prioritize care
transfer those requiring immediate attention to medical facilities
give tetanus shots, first aid, & medical attention to victims
shelter nursing
what is the nurse's role in response?
process of separating casualties & allocating treatment based on the victim's potential for survival
"Simple Triage And Rapid Treatment"
used in multicasualty or mass casualty incident
to occur in <1 min
uses people with minor injuries to assist
person is tagged with colored triage tag
victims moved to the treatment area
START triage system
1st check for respirations
2nd check for perfusion by capillary refill
3rd check mental status by asking simple ?s beginning with "who are you?"
1 minute assessment guideline
victims who have life-threatening injuries but have a high probability of survival once stabilized
who is given highest priority?
victims who have injuries with systemic complications that are not yet life-threatening but can wait up to 45-60 mins for tx
who is given second priority?
victims with local injuries without immediate complications & can wait several hours for medical attention
who is given last priority?
dead or no hope of living
--multiple severe injuries
top/highest priority
--amputations, impalement
second priority
--simple fractures
local injuries
--walking around wounded with minor injuries (cuts & abrasions)
stabilization of community and return of disaster area to its previous status
the government; business community
who take the lead in rebuilding efforts? provide economic support?
continuing death, chronic illness, and/or disability
population shift if recovery prolonged
contamination of food/water supplies (infectious diseases)
decreased access to care
PTSD & delayed stress reaction (DSR)
adverse health effects after disaster
heroic phase
occurs at time of disaster
intense excitement and concern for survival
honeymoon phase
post-disaster period (2 wk-2 mo)
individuals feel support from government
disillusionment phase
several months to a year or more
contains unexpected delays in receiving aid
reconstruction phase
several years
attempt to rebuild
extreme and widespread property damage
serious and ongoing financial problems
high prevalence of trauma
when human intent cause the disaster
4 factors that increase the risk of long-term mental health problems
use of force or violence against people or property in violation of the criminal laws of the US for purposes of intimidation, coercion, or ransom
can be easily disseminated or transmitted from person-to-person

results in high mortality rates

have the potential for major public health impact

might cause public panic & social disruption & require special attention for public health preparedness
categories of bioterrorism agents
highest priority; easily transmitted & have high mortality rates

anthrax, plague, botulism, smallpox, tularemia, viral hemorrhagic fevers
category A
moderately easy to disseminate, moderate morbidity rate, low mortality rates

typhus, cholera, salmonella, shigella, e.coli
category B
emerging pathogens that can be engineered for mass dissemination bc they are easily produced

hantavirus, tickborne viruses, yellow fever, multi-drug resistant TB
category C
small sore that develops to blister, then skin ulcer with a black area in center; does NOT hurt

if left untreated. 80% of infected individuals do not die
cutaneous anthrax
nausea, loss of appetite, bloody diarrhea, fever followed by bad stomach pain

more serious, 1/4 - more than 1/2 of cases lead to death
GI anthrax
first s/s cold/flu-like
later s/s cough, chest discomfort, SOB, tiredness & muscle aches

half cases end in death; more severe

*anthrax incubation period 1 wk-42 days; Cipro with antianthrax vaccine to prevent anthrax infection
inhalation anthrax
incubation period 7-17 days

s/s: high fever, fatigue, severe HA, *rash that turns to pus-filled lesions*, vomiting, delirium, excessive bleeding

no cure; *international health emergency!!*
dept of homeland security becomes involved
detect outbreak (most crucial aspect)
determine cause
ID factors that place people at risk
implement measures to control outbreak
inform medical & public communities about tx, health consequences, & preventive measures
response to bioterrorism
Push Package
1. oral abx & supplies
2. IV drugs & supplies
3. chemical antidotes & related supplies
4. airway supplies
5. pediatric supplies

Vendor Managed Inventory
--resupply push package
--supplement push package stock
--majority of SNS assets are in VMI Roles

coordinated by dept of homeland security, must have federal order

sufficient to vaccinate 6-7 mil in US
strategic national stockpike (SNS)