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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
events that require a swift, intense response on the part of existing community resources; personal
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
disaster medical assistance teams (DMAT)
in a federal disaster, ________________ supplement local & state medical care needs & can be activated
preventing occurrence of disaster or limit consequences
occurs in nondisaster & predisaster stages
search, rescue, & triage of victims
assessment of destruction & devastation
implemented once disaster occurs
recovery & restoration of community to previous level of functioning
aimed at preventing a recurrence or minimizing effects of future disasters
initiates proactive mitigation activities, trains 1st responders, manages National Flood Insurance Program & US Fire Administration
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...
analysis of vulnerability
predicts who will be affected the most & identifies community resources that are available for a response
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
initiate measures to limit damage, disease, disability, & loss of life among members of a community
how does mitigation work?
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
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
American Red Cross responsibilities in disaster (7)
provides emergency energy assistance to elderly & disabled in peak winter & summer months for Alabamians
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
transfer those requiring immediate attention to medical facilities
give tetanus shots, first aid, & medical attention to victims
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?
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
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
moderately easy to disseminate, moderate morbidity rate, low mortality rates
typhus, cholera, salmonella, shigella, e.coli
emerging pathogens that can be engineered for mass dissemination bc they are easily produced
hantavirus, tickborne viruses, yellow fever, multi-drug resistant TB
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
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
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
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)
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
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)
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