DisasterManagement Assignment

Student Guidelines

Purpose:

Disasters are catastrophic events that often result in extensive property damage and loss of life. Extreme devastation can occur from both man-made and natural disasters. Nurses play a major role in responding to disasters to help ensure the best possible outcomes. 

Learning Objectives:

Upon completion of this activity, the learner will:

1. Understand the role of the Community Health nurse in disaster management.

2. Understand the principles of disaster management, including working within incident command structures.

3. Differentiate between the adult and pediatric triage algorithms (START and JumpSTART).

4. Apply triage algorithms to appropriately prioritize and treat victims.

5. Utilize principles of professional collaboration to assure for efficient and effective care of victims.

6. Utilize principles of professional collaboration to assure for efficient and effective care of victims.

Instructions:

Please complete all of the following assigned readings and viewings, answer the questions below.

Read: Association of Public Health Nurses “The Role of the Public Health Nurse in Disaster Preparedness and Response

http://nacchopreparedness.org/wp-content/uploads/2014/01/APHN_Role-of-PHN-in-Disaster-PRR_FINALJan14

Read: Demarco & Healey-Walsh: Chapter 20 pages 405-414 (Stop at Bioterrorism)

Read: ATI:  Chapters 2 & 3

Review:

https://www.aap.org/en-us/Documents/disasters_dpac_PEDsModule3

View:

Review: Triage algorithm:

https://chemm.nlm.nih.gov/startadult.htm

Please answer the following questions. Questions must be answered by individual students in narrative format. Turnitin® will be used to assess for integrity.

1. What disaster risks are present in the Chicagoland area (natural or man-made)?

2. Explain the disaster management cycle/plan/continuum. How do nurses participate at each step/phase?

3. What is an Incident Command System and why is it necessary?

4. What activities are prioritized at a disaster site? (p. 23-24 AAP article)

5. Explain the START (Field) Triage Model, including assessments critical for determining a victim’s condition.

6. What is the difference between START and JumpSTART Triage Models?

7. Fill in the boxes: Color coding for Triage (Table 20.2)

8. What Life Saving Interventions (LSI) should first responders/medical personnel be prepared to administer at a disaster site? What might they delegate to the “walking wounded”?

9. Mental health issues can emerge during and after disaster situations and could lead to permanent disability. What does the term “Psychological First Aid” mean and how might the nurse engage in this activity in a disaster situation?

10. Identify and prioritize three (3) nursing diagnoses related to this topic.

[This activity is worth 6 clinical hours]

Disasters

Objectives

Identify disaster types, planning and nursing participation.

Describe the public health response throughout the phases of an emergency response.

….Nurses at their Best
https://www.youtube.com/watch?v=JPSbDq2NjDg (13 mins)

Disasters
“A disaster is an event that causes human suffering and demands more resources than are available in the community. A disaster can be naturally occurring, man-made (accidental or terrorism types), or a combination of both, such as a natural disaster causing technological failures.” ATI p. 65
Phases:
Pre-impact
Impact
Post-Impact

Disaster Management Cycle

Effective emergency management includes a functional approach to all emergencies, cooperative planning, appropriate use of resources, and shared responsibilities among the three levels of government. 
Personal disaster preparedness is the first and most effective intervention to reduce the impact of disasters.

Levels of DM mitigation= prevention
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Disaster Prevention/Mitigation

Increased surveillance

Improved inspections at airports and other points of entry

Strengthening immunizations, isolation & quarantine

Strengthening flood barriers

Teaching methods of preventing communicable disease transmission

Assessment of the community’s threats, vulnerabilities, strengths

Levels of Prevention and Disasters:
Potential Roles for CPH Nurses

Level 1
1
Education in homes, work and schools

Serving on teams to develop disaster plans

Working with vulnerable populations (ex., “shelter-in-place”)

Participate in disaster training, including disaster drills

Immunizations

Level 2
2
Work on immediate response teams

Level 3
3
Work on teams to limit damage and disability (ex., mental health services)

Roles of Community Health Nurses
Risk Assessment

Populations at risk

History of prior disasters and responses

What is the community disaster plan?

What is the community warning system?

What response teams are already in place?

What other resources are already in place?

What type of evacuation measures will be needed?

What type of environmental dangers can be involved?

Disaster Preparedness:
Development of a Community Emergency Plan

Occurs at the national, state, and local levels

Individuals, families and professionals should be prepared

Preparations should be based on thorough assessment

A communication protocol is imperative to reach:

Red Cross

State and federal governmental agencies

Federal Emergency Management Agency (FEMA)

CDC

US Department of Homeland Security

Office of Emergency Management

Disaster drills are needed to rehearse responsiveness

https://www.youtube.com/watch?v=wTWOgBTuOoE (2 mins)

Disaster Preparedness:
Family Emergency Plan

https://www.beprepared.com/emergency-preparedness-plan-for-your-family

Personal Disaster Preparedness
Prep for individuals and families should include:
Action plan
Communication alternatives/options
Evacuation routes
Local and remote meeting places
Disaster kit or “go bag”

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Roles of Community Health Nurses:
Disaster Planning

Develop a plan based on the most likely disaster

Identify communication options: warning system, communication center, chain of command

Identify first responders plan

List agencies that are available (local, state, federal)

Define nursing roles in first-, second- and third-level triage

Locate necessary supplies

Check equipment function

Disaster Response

 Activate Disaster Plan

Immediate need for organization and management at the scene

Incident Command Center (ICS) 

Activate NIMS

Based on initial and follow-up assessments of:

How many people are affected?

How many people are injured or dead?

How much fresh water and food is available?

What are the areas of risk, including sanitation problems?

Mobilization is multidisciplinary, starting w/ law enforcement, fire and ambulance services.

Must restore communication and transportation early

TRIAGE
Communicate with potential responding agencies 
Disaster Response
Classified according to type, level and scope. If federal emergency is declared, National Response Framework (NRF) is activated.
Federal level agencies involved: 
Fed. Emergency Management Agency (FEMA)
CDC
U.S. Department of Homeland Security
American Red Cross (ARC)
Office of Emergency Management
Public Health System

https://www.fema.gov/media-library-data/1466014682982-9bcf8245ba4c60c120aa915abe74e15d/National_Response_Framework3rd  

FEMA
“FEMA’s mission is to support our citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards.” The Federal Emergency Management Agency.

Response: 
Incident Command System
National Incident Management System (NIMS) – Federal Level
Provides framework for local incident command structure
The Incident Command System (ICS) is a standardized approach to the command, control, and coordination of emergency response providing a common hierarchy within which responders from multiple agencies can be effective.

Nurses’ Duty to Respond to a Disaster
Are we ethically and legally bound to respond?
https://www.nursingworld.org/~4ad845/globalassets/docs/ana/who-will-be-there_disaster-preparedness_2017  

Class Activity: Read, Think Pair, Share

Mass Casualty Responses & Triage

Community trained pros triage @ ~ 6 min in
20

Simple triage and rapid treatment (START) is a triage method used by first responders to quickly classify victims during a mass casualty incident (MCI) based on the severity of their injury.

Stop, look, listen, think

Voice triage for walking wounded

Immediate care: difficulty breathing, bleeding, shock

START  Triage Model

21

START  Field/
Pre-Hospital Triage Model

Triage based on
Ambulation
Respirations
Circulation 
Mental status
Tags
Green—Minor injury(ies)
Yellow—Delayed (walking wounded; ill but stable)
Red—Immediate (unstable based on signs of shock)
Black–Deceased

Other Triage Tags

Immediate Care

Open airway—head tilt, chin lift

Control bleeding—pressure, elevation

Treat for shock

Re-establish blood volume

Give oxygen

Protect from complications

Disaster Recovery

Stabilization and Rebuilding phase

Lasts until the economic and civil life of the community are restored

At an individual level, it’s the time it takes to become functional again in the community

Communicable disease threats are controlled through sanitation, etc.

PTSD and other stress-related disorders are common

Phases of Emotional Reactions During Recovery:

Heroic-excitement and concern for survival

Honeymoon-affected people bond and relive experiences

Disillusionment-depression and disillusionment

Reconstruction-adjustment to a new reality; rebuilding of the area; hope.

Roles of Community Health Nurses:
Disaster Recovery

Re-assess population needs

Make home visits

Provide and coordinate care in shelters

Provide stress counseling and assess for PTSD

Make referrals prn

Evaluate disaster responses

Make surveillance reports

Evaluation of Disaster Response
Evaluate area, effect and level of disaster
Create ongoing assessments and surveillance reports
Evaluate efficiency of response teams
Estimate the length of time for recovery
Bahamas: Hurricane Dorian Recovery
https://www.supplychaindive.com/news/navigating-logistics-recovery-hurricane-dorian/563224/

Main Causes of Disaster in
Chicago Area
Tornadoes https://www.ready.gov/tornadoes

Floods https://www.ready.gov/floods

Fires https://www.ready.gov/home-fires

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Are YOU Prepared?
These slides were created as a collaborative effort between members of the Community Health team at Resurrection University 9/2019

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