Disaster Management

CONT.
 BY ERICK KEMBOI
 LECTURER KMTC ITEN CAMPUS
 BSc.N & PUBLIC HEALTH
Objectives
 By the end of this lesson, the learner
should be able to:
 Define disaster
 Describe the different types of disasters
 Describe the phases of disaster
 Describe the disaster management cycle
 Describe the role of a Community health

assistant in a disaster
 Definitions…..
 Emergency- is a state in which normal
procedures are suspended and extraordinary
measures are taken in order to avert a disaster
 It is a situation that poses an immediate risk to
health, life, property or environment and
requires urgent intervention to prevent a
worsening of the situation
 Definitions….
 It is a situation in which the community
affected is capable of coping
 Disaster- is an extreme disruption of
the functioning of a society that causes
widespread human, material, or
environmental losses that exceed the
ability of the affected society to cope
using only its own resources
Definitions….
 Any occurrence, that causes damage,
ecological disruption, loss of human life,
deterioration of health and health
services, on a scale sufficient to warrant
an extraordinary response from outside
the affected community or area” (WHO
definition)
 The community seeks the assistance of

government and international agencies

Definitions….
Hazard- refers to an event that has the
potential to adversely affect human, plant,
and animal life to the extent of causing a
disaster
 A hazard becomes a disaster when it

results in injuries, loss of life and

livelihoods, displacement and
homelessness and/or destruction and
damage to infrastructure and property
 E.g. Cyclone on an inhabited land vs.

populated island
Definitions….
• Hazards can have different origins:
 Natural–Geological,hydro
meteorological and Biological
Induced by human processes –
Environmental degradation and
technological hazards
• Each hazard is characterized by its location,
intensity and probability
Definitions
 Examples of hazards:
 Absence of rain (leading to drought) or the
abundance thereof (leading to flooding)
 Chemical manufacturing plants near
settlements
 Incorrect agricultural techniques will in the
long run lead to possible disasters

9
Definitions….
 Vulnerability- The degree to which people,
an area, physical structures and economic
assets are exposed to loss, injury and
damage caused by the impact of a hazard
 Risk- is the probability or likelihood of a
disaster happening
 It is expressed in terms of damage or loss
 RISK = HAZARD + VULNERABILITY
RISK
Risk is a measure of the expected
losses (deaths, injuries, property,
economic losses etc.) due to a
hazard of a particular magnitude
striking in a given area.
OBJECTIVES OF RISK
MANAGEMENT
 Reduce damage and deaths
 Reduce personal suffering
 Speed recovery
 Protect victims
Risk reduction

 Risk reduction can be done in two ways:

◦ A. Preparedness: Preparedness encompasses all those measures
taken before a disaster event which are aimed at minimizing loss of
life, disruption of critical services and damage when the disaster
occurs. Thus, preparedness is a protective process which enables
governments, communities and individuals to respond rapidly to
disaster situation and cope with them effectively. Preparedness
includes development of emergency response plans, effective warning
systems, maintenance of inventories, training of manpower etc.
◦ B. Mitigation: Mitigation encompasses all measures taken to reduce
both the effect of hazards itself and the vulnerable conditions in order
to reduce the losses in a future disaster. Examples of mitigation
measures include, making earthquake resistant buildings, water
management in drought prone areas, management of rivers to prevent
floods etc.
Definitions….
 Capacity- It is simply the ability, or
ableness to cope
 Refers to the internal and external
qualities and resources that individuals,
households, communities and countries
have to cope with a threat or resist the
impact of a hazard
Definitions….
 The capacity could be in terms of:
 material resources (i.e. food, animals,

cash, tools);
 social and organizational capacities

(i.e. leadership, previous organizing

experience, community based
organizations and networks);
 attitudinal capacities (i.e. beliefs,

motivations, work values, ideas, creativity,

efficacy).
Classification of disasters
 Disasters are classified according to:
 Cause-
 natural vs. manmade
 Speed of Onset-
 sudden vs. slow
Natural disasters
 These types of disaster naturally occur in
proximity to, and pose a threat to, people,
structures or economic assets
 They are caused by biological, geological,

seismic, hydrologic, or meteorological

conditions or processes in the natural
environment
 Examples include earthquakes, tsunami,

floods, landslides, and volcanic eruptions)

Manmade disasters
• These are disasters of which the principal,
direct causes are identifiable human
actions, deliberate or otherwise
• It mainly involves situations in which
civilian populations suffer casualties,
losses of property, basic services and
means of livelihood
Manmade disasters
• In many cases, people are forced to leave
their homes, giving rise to refugees or
externally and/or internally displaced
persons
• Examples include an airplane crash, a
major fire, oil spill, terrorism, etc.
Disasters according to speed of
onset
 Sudden onset: little or no warning,
minimal time to prepare. For example, an
earthquake, tsunami, volcano, etc.
 Slow onset: adverse event slow to

develop; first the situation develops; the

second level is an emergency; the third
level is a disaster. For example, drought,
civil strife, epidemic, etc.
Vulnerability
 The degree to which people, an area,
physical structures and economic assets
are exposed to loss, injury and damage
caused by the impact of a hazard
Types of vulnerability:

 Structural/ physical vulnerability: is the

extent to which a structure is likely to be
damaged or disrupted by a hazard event
 Human vulnerability is the relative lack of
capacity of a person or community to anticipate,
cope with, resist and recover from the impact of a
hazard
Factors that increase human
vulnerability to disasters
 Rapid urbanization
 Lack of knowledge/ awareness about how

to effectively resist the effects of disasters

 Poverty
 Increased population density
 Environmental degradation
 War and civil strife
 Changes in way of life
Factors that increase human
vulnerability to disasters
 Rapid urbanization: It is characterized
by persons or civilians in an area of
conflict moving to metropolitan areas in
search of economic opportunities and
security
 As a result, fewer opportunities are

available and there is competition for

scarce resources, which can result in
human-made disasters
 E.g. sinai fire
Factors that increase human
vulnerability to disasters
 Lack of knowledge/awareness :
Disasters can also happen when people
who are vulnerable to them simply do not
know how to get out of harm’s way or
what protective measures to take e.g.
nakumatt fire
Factors that increase human
vulnerability to disasters
 There may be a lack of awareness about:
◦ what measures can be taken to build
safe structures on safe locations
◦ safe evacuation routes and procedures
◦ where to turn for assistance in times of
acute distress
Factors that increase human
vulnerability to disasters
 Poverty: studies show that the wealthiest
members of a population either survive a
disaster unaffected or are able to recover
quickly
 Generally poverty makes people

vulnerable to the impact of hazards

 Poverty explains why people are forced to

live on hills that are prone to landslides or

why people settle near rivers that
invariably flood their banks
Factors that increase human
vulnerability to disasters
 Increased population density:
population growth means more people will
be forced to live and work in unsafe areas
and more people are competing for a
limited number of resources (such as
employment opportunities and land),
which may lead to conflict
 If there are more people and structures

where a disaster occurs, then it is likely

there will be more of an impact.
Factors that increase human
vulnerability to disasters
 Environmental degradation: Many
disasters are either caused or exacerbated
by environmental degradation
 Deforestation leads to/contribute to

flooding
 Companies that engage in mineral

extraction often dispose toxic substances

which may lead to an increase in certain
diseases among the population
 E.g. global warming
Factors that increase human
vulnerability to disasters
 War and civil strife: these are regarded
as extreme events that produce disasters
 War and civil strife often result in
displaced people who are more vulnerable
as a result of their dislocation
Factors that increase human
vulnerability to disasters
 Changes in way of life: When people
move from rural to urban centers, they
may lose the social support system or
network that traditionally would have
assisted them in recovering from a
disaster
 Since these traditional coping mechanisms

may not exist in the new setting, the

population increasingly depends on
outside intervention to help in the
recovery process
Vulnerable groups
 Women and children
 Elderly persons
 Persons with disabilities
 Internally displaced persons
 Refugees
 Poor communities
VULNERABILITY ANALYSIS
 ASIGNMENT :
 DEFINE VULNERABILITY ANALYIS
 DESCRIBE STEPS IN

VULNERABILIY ANALYSIS
 Vulnerability analysis involves

assessing the susceptibility of

the communities , infrastructure
and system to various hazards
Cont.
 It includes identifying factors such as
socioeconomic status, infrastructure
resilience, geographic location and
environmental conditions that contribute to
vulnerability .
 This analysis helps prioritize resources and

develop strategies to mitigate risks,

enhance preparedness and improve
response and recovery efforts in the event
of the disaster
Phases of disaster
 Include:
 Pre-event phase
 Emergency phase
 Intermediate phase
 Long term phase
Phases of disaster
 Pre-event
 Where action can be taken to prevent
disasters (e.g. Fire escape mechanisms,
plans aimed at mitigating the effects of
potential disasters)
Phases of disaster
 Emergency phase
 When the effects of the disaster have been felt
and action has to be taken to rescue people and
property
Phases of disaster
 Intermediate phase
 When the short-term needs of the people
must be dealt with, restoring utilities and
essential services.
 The objective at this point is to restore the
community to normality as quickly as
possible
Phases of disaster
 Long-term phase
 Continuation of the previous phase but

items that could not be addressed quickly

are attended to at this point (repair of
damaged infrastructure, correcting
environmental problems, counseling
victims, reinvestment strategies,
debriefings to provide input to revisions of
disaster strategies)
Implications of disasters
 Separation from home, property and
community resources
 Loss of familial support systems
 Loss of livelihood
 Loss of normal sources of food
 Lack of shelter and household necessities
 Lack of fuel for cooking and heating
 Lack of potable water
 Exposure to communicable diseases
 Injury, trauma during flight
Implications of disasters
 Infrastructure damage
 Telecommunication loss
 Power disruption
 Water problems
 Agricultural damage
 Family members killed, left behind or

missing
 Insecurity due to conflict, violence, human

rights abuse
 Psychological and emotional effects
Some disasters -
pictorial
IMPACTS
IMPACTS
Threat to Lives and Property - Floods
IMPACTS
Disruption of Lifestyles -
Floods
Floods in Kenya
Floods in Mozambique
FLASH FLOODS - TRANSPORT (Road
damage)
BUDALANGI FLOODS: PEOPLE
DISPLACED
RURAL HOUSES SUB-MERGED IN WATER
WIDESPREAD FLOODING
PARTIAL COLLAPSE/DAM BREAK
 WATER SCACITY/SHORTAGES

DOMESTIC REQUIREMENTS:

• 20 – 500 liters per capita

• 2 – 3 liters for drinking
Civil/political strive
Civil war
Child Soldier
Fire disaster
Disaster management
 Refers to administrative decisions and
operational activities that pertain to the
various stages of handling a disaster at all
levels i.e. international, regional, national,
community, household and individual
levels
 When an incident/ disaster occurs, there is

usually a well organized incident

command system in which the information
is relayed to the police, hospital,
ambulance crew etc
PRINCIPLES OF DISASTER
MANAGEMENT
 Organisations should function as an
extension of their core business.
 Individuals are responsible for their own

safety.
 Disaster management planning should

focus on large-scale events.

 Disaster management planning should

recognise the difference between incidents

and disasters.
PRINCIPLES OF DISASTER
MANAGEMENT
 Disaster management operational
arrangements are additional to and do not
replace incident management operational
arrangements
PRINCIPLES OF DISASTER
MANAGEMENT
 Disaster management planning must take
account of the type of physical environment
and the structure of the population.
 Disaster management arrangements must

recognise the involvement and potential

role of non-government agencies.
Disaster management
 Disaster management is a continuous process
 Often several phase take place concurrently
 Timely decision making during each phase
results in greater preparedness, better
warnings, reduced vulnerability and/or the
prevention of future disasters
Disaster Management
 Each country faces different types of
hazards
 Some countries are prone to floods, others
have histories of tropical storm damage,
and others are known to be in earthquake
regions
Disaster Management
 It is critical to know the types of hazards
likely to be encountered, how hazards
arise, probability of occurrence and
magnitude, physical mechanisms of
destruction, the elements and activities
that are most vulnerable to their effects,
consequences of damage
Disaster Management
 Seismologists, volcanologists,
climatologists, hydrologists and other
scientists study natural hazards and the
processes that cause it
 Engineers and risk specialists study the
effects of the natural hazards on
structures and the environment
Disaster Management
 Medical practitioners, economists and
social scientists study injury and death
caused by disasters and the consequences
of damage in terms of the disruption to
society and its impact on the economy
Disaster Management

 Service industries depend on

manufacturing, which in turn relies on
supplies of raw materials, labor, power
and communications
 Disruption of any link in the chain makes
others vulnerable
Disaster Management
 Disaster management involves four
phases:
 Prevention/ mitigation
 Preparedness
 Response
 Rehabilitation/ reconstruction / recovery
Disaster Management
Cycle
Disaster Management
 Mitigation: Measures put in place to
minimize the results from a disaster
 Examples: building codes and zoning;

vulnerability analyses; public education

 Preparedness: Planning how to respond

to an emergency
 Examples: preparedness plans; emergency

exercises/training; warning systems

Disaster Management
 Response: Initial actions taken as the event
takes place; It involves efforts to minimize the
hazards created by a disaster
 Examples: evacuation; search and rescue;
emergency relief
 Recovery: Returning the community to
normal
 Ideally, the affected area should be put in a
condition equal to or better than it was before
the disaster took place
 Examples: temporary housing; grants; medical
care
Disaster Management
(Mitigation)
 Mitigation strategies:
 Risk identification and Analysis; this is a

thorough analysis of existing vulnerabilities,

location, severity and intensity of threat
 It also involves Identifying situations where a

combination of factors may pose a greater

risk e.g. a fire source, a dense residential
area and combustible houses
 Infrastructure planning, building

regulations and safety codes

Disaster Management (Mitigation)

 Environmental protection measures;

designed to protect existing, or
rehabilitate degraded, environmental
systems that have the capacity to reduce
the impacts of natural hazards e.g. Coral
reef protection
 Socio-economic measures- are aimed

at increasing the resilience of individuals

and communities to hazard effects
 Include raising awareness of hazards and

vulnerabilities
Disaster Management (Mitigation)
 Establish community and mutual
assistance networks and programs
 Back up: Ensure operations continue e.g.

Use of a backup generator

 Developmental programs e.g. Agricultural

and forestry programs

 Public education and awareness
 Protection of economy from disasters

through structural policies

Disaster Management
(Preparedness)
 Disaster preparedness involves the
preparation of people and essential service
providers in their communities for the
actions that they will take in case of
disasters
 Disaster preparedness strategies:
 Hazard data collection/ mapping, risk and

vulnerability assessments
 Response mechanisms and strategies

(Preventive technology)
Disaster Management
(Preparedness)
 Training & rehearsals/ drills before the
hazard Public education (Awareness
raising)
 Coordination
 Information management
 Early warning Systems
 Resource mobilization / inventory
 Community-Based disaster preparedness
Disaster Management
(Preparedness)
 Hazard data collection:
◦ Identifying hazards,
◦ estimating the likelihood of occurrence,
◦ the consequences if things go wrong and how
serious they would be
◦ How do we reducing the chances of things going
wrong and consequences?
◦ Getting things back on course
◦ Learning from the experience and feeding back
into the previous stages
Disaster Management
(Preparedness)
 Response mechanisms:
◦ evacuation procedures
◦ search and rescue teams (including plans for
training them)
◦ an assessment process and information priorities
for an emergency response
◦ measures to activate special installations, such as
emergency or mobile hospital facilities
◦ procedures for activating distribution systems
Disaster Management
(Preparedness)
 Response mechanisms:
◦ preparations for emergency reception centres and
shelters
◦ procedures for activating emergency programs for
airports, harbors and land transport
◦ preparations for storing or making arrangements
for rapid acquisition of emergency
◦ relief supplies and equipment
Disaster Management
(Preparedness)
 Coordination:
 Involves coordinating other agencies and

organizations that may be involved during

the disaster e.g.
 local population and local community

based organizations, Civil Defence and

government emergency structures, fire
brigades, health departments and clinics,
Red Crescent/Red Cross Societies,
international agencies, NGOs and others
Disaster Management
(Preparedness)
 Information Management:
 Involves gathering, analyzing and acting

on timely and accurate information before

(hazard and early warning information),
during (disaster needs assessment) and
after disasters (progress of post-disaster
recovery)
Disaster Management
(Preparedness)
 Early Warning signs:
 Purpose is to detect, forecast, and when

necessary, issue alerts related to

impending hazard events
 Sources of early warning include:
◦ meteorological offices;
◦ Ministries of Health (for example, disease
outbreaks) and Agriculture (for example, crop
forecasts);
◦ local and media sources;
Disaster Management
(Preparedness)
 Resource Management:
 Involves developing strategies,

agreements and procedures for mobilizing

and acquiring emergency funds, supplies
and equipment in the event of a disaster
Disaster Management
(Preparedness)
 Community based disaster
preparedness:
 Disaster preparedness must be supported

by public education campaigns, training of

response teams and rehearsals of
emergency response scenarios
 The aim of public awareness and

education programs is to promote an

informed, alert and self-reliant community
Disaster Management
(Response)
 Involves putting all plans into action once
the disaster has occurred
 This phase is relatively short and includes

activities such as:

◦ search and rescue, evacuation,
◦ provision of shelters,
◦ first aid and emergency medical care,
◦ temporary restoration of transport and
communication
Disaster Management
(Response)
◦ Logistics and supply
◦ Communication and information management
(media)
◦ temporary restoration of transport and
communication
◦ Survivor response and coping
Phonetic Alphabet table
 Useful for spelling words and names over
the phone/ radio phone
 Mainly used by EMS
 Utilizes the 26 letters of the alphabet
Phonetic Alphabet table
A-alpha H- Hotel O- Oscar V- Victor
B-Bravo I- India P- Papa W-
Whiskey
C- J-Juliet Q-Quebec X- X ray
Charlie
D- Delta K- Kilo R- Romeo Y- Yankee
E- Echo L-Lima S-Sierra Z-Zulu
F- M- Mike T- Tango
Foxtrot
G- Golf N- U-
November Umbrella
Incident command system
(ICS)
• ICS is a standardized, on-scene all-hazard incident
management concept
• Its purpose is to ensure:
– Safety of responders and others
– Achievement of tactical objectives
– Efficient use of resources
History of ICS
Developed in the 1970’s
Firefighting
Resources of
California
Organized for
Potential
Emergencies
(FIRESCOPE)
 History of ICS
 Weaknesses in incident management
before ICS
◦ Lack of accountability
◦ Poor communication
◦ Lack of a planning process
◦ Overloaded Incident Commanders
◦ No method to integrate inter-agency requirements
 ICS provides an organized system to
manage incidents and addresses these
weaknesses
 Incident
Commander

Security Liaison
Officer Officer
Public Information
Officer

Operation Plannin Logistic Finance and

s g s administrati
on
Incident command system
• Incident commander- heads the command team
and makes decision in consultation with others
• Security officer- ensures safety of the responders,
public, e.t.c.
• Liaison officer- ensures inter agency
collaboration and harmony e.g. AP, military, NYS
• Public information officer- provide information,
warning to the public
• Operation section- Responsible for managing the
tactical objectives outlined by the Incident
Commander, e.g. medical care, transportation
 Key Benefits of ICS

 Manages routine or planned events

 Establishes a clear chain of command
 Provides a common structure
 Provides logistical and administrative
support to operational personnel
 Ensures key functions are covered and
eliminates duplication
Disaster Management
(Recovery)
 Activities at this phase are aimed at
restoring the “normal” conditions in the
affected areas and communities
 The activities are short term and long term
 Short term may overlap with response

stage
 Long term may take months to years
Disaster Management (Recovery)
 Activities include:
◦ Temporary repairs of housing, buildings and
infrastructure (transport and public utilities)
◦ help victims to return to work,
◦ create new job opportunities,
◦ mobilize financial resources (public, insurance and
multilateral)
◦ launch projects that deal with other consequences
of disasters
◦ Mobilizing, regulation and evacuation resources
for recovery
Key institutions in disaster
management
 The National Disaster Operations
Centre (NDOC) :
◦ Overall coordination and control of the disaster
response effort
◦ The command centre for all communications and
information relating to response operation
 Ministry of Provincial Administration
and Internal Security
◦ Responsible for coordination of disaster response
◦ Provide policy directive in National emergencies
Key institutions in disaster
management
 Ministry of State for Special
Programmes
◦ Responsible for coordination of disaster risk
reduction
◦ Provide policy directive in National emergencies
 The Police Department (Traffic, GSU,
AP)
◦ Maintenance of law and order situation in and
around the incidence scene
 The Fire Brigade
◦ Search and Rescue of trapped persons
Key institutions in disaster
management
 The National Youth Service
 Provide personnel and equipment to assist

for quick and effective search and rescue

coverage, protection and operation in case
of any other disaster
 Other departments/ ministries
◦ Kenya Meteorological department, KPLC, RED
cross
Role of the media in disaster
management
 Aid prioritization of Disaster Risk Issues
 Facilitate creation of Early Warning Systems
 Increase lobbying for political commitment,

to make national leaders more responsive to

the unique needs of vulnerable communities
 Increase international donations
 improve the coordination of risk-assessment

activities between policymakers and donor

communities
Role of the media in disaster
management
 Positive effects of the media:
 They inform the public about disasters

and therefore heighten awareness; which

influences public opinion about how the
disaster is being managed
 The media provides instantaneous

information and are considered to be

trusted sources especially at the local
level
 The media disseminate information about

public safety e.g. impassable roadway

Role of the media in disaster
management
 Negative effects of the media:
 The media may exaggerate some

elements of the disaster and create

unnecessary panic.
 Influential politicians may manipulate the

media for personal or political gains

 News reporters may provide biased

coverage for purposes of sensationalism

by capturing horrific devastation on a
street
Role of the media in disaster
management
 Negative effects of the media:
 Media representatives often cause

“congestion” in the affected area

 This influx of individuals with needs into

an already burdened area can be

overwhelming, which may:
◦ hinder or compromise search and rescue
operations,
◦ jeopardize rescuer safety
◦ hamper the provision of care needed by the
critically ill and injured
Incident Notification
• Incident notification refers to communication to
relevant personnel of important information
regarding an actual or potential hazard impact and
the response status of the organization
• Categories of communication may be:
– Advisory: Potential need for a response
– Alert: Elevated preparedness required as
response is likely or imminent
– Activation: Response action is required
Incident Notification
 Critical information to obtain
◦ Type of incident, including specific hazard/agent
◦ Location of incident
◦ Numbers and types of injuries
◦ Special actions being taken (e.g.,
decontamination)
◦ Estimated time of arrival of first EMS units
Management of mass
casualties
 A mass casualty incident (MCI) is any
event producing a large number of victims
such that the normal capacity of local
health services is disrupted
 Common causes of an MCI include floods,

fires, explosions, industrial accidents, or

conflict situations
Triage
 Triage is defined simply as sorting and
prioritising patients for medical attention
according to the degree of injury or illness
and expectations for survival
 Triage is carried out to reduce the burden

on health facilities and it is normally done

by the most experienced health worker
assisted by competent staff on the triage
team
Triage
 The goal of managing a mass casualty
incident is to minimise the loss of life or
disability of disaster victims through:
 Priority of care
 Priority of transportation to the hospital
Triaging at the incident
scene
 Immediate (Red) = victims needing the
most support and emergency care (0 min)
 Delayed (Yellow) = victims less critical

but still in need of transport to emergency

centers for care(15-30min)
 Ambulatory (Green) = victims who have

minor injuries and may not warrant

transport to an emergency center (30
mins-3 hrs)
 Expectant (Black) = victims who are least

likely to survive or are already deceased

Triaging at the incident
scene
• Red: sucking chest wounds, airway obstruction,
shock, hemothorax, tension pneumothorax,
unstable chest and abdominal wounds, open
long bone fractures, 2nd/3rd degree burns

• Yellow: stable abdominal wounds without

hemorrhage, soft tissue injuries, facial injuries
without airway compromise, genitourinary tract
disruption, fractures requiring open reduction,
most eye and CNS injuries
Triaging at the incident
scene
• Green: upper extremity fractures, minor burns,
sprains, small lacerations without major bleeding,
behavioral or psychological disturbances

• Black: unresponsive patients with penetrating

head wounds, high spinal cord injuries, multiple
system injuries, 2nd/3rd degree burns over 60%
of the BSA, profound shock with multiple injuries,
agonal respirations, no pulse and fixed, dilated
pupils
Hospital response to
disaster
 The hospital’s incident management team
should have a pre-determined area to
convene and coordinate response activities,
resources, and information
 The Incident Commander (IC) is the first to
respond
 IC determines level of staffing according to
the functional needs of the hospital
response
 Positions might be filled initially by in-house
mid-level staff until senior personnel arrive
Hospital response to
disaster
 Identified personnel with decision making
authority include
◦ Administrator on call/CEO/MD
◦ Nursing supervisor/DNS
◦ Senior emergency department physician/Registrar
◦ Senior emergency department nurse
Hospital response to
disaster
 Some individuals might function in
multiple positions simultaneously
throughout the entire response or until
additional personnel become available
 All departments are notified
 Once patients arrive, ID them (name, age,

description of injuries)
 Triage patients; if not already done at the

accident scene
 Use SAMPLE acronym for history taking
Hospital command center
 Primary and secondary assessment of
victims
 Treatment is initiated on the basis of

injuries
 Decisions are made on the likelihood of

surviving and how many resources will be

consumed in the process
 There should be designated triage officers

at the triage spot and they should be

outside or at the door to the ER
Communication and
coordination
 There should be a clear spokesperson for
the Health care facility to speak to the
press
 Security shouldn’t allow the press into the

patient care areas

 Updates should be given on regular

intervals
 Families of victims should be taken to an

appointed area staffed by therapists,

counselors and clergy
Hospital response to
disaster
 Groups to be given information
include:
 Information exchange within the hospital

and/or healthcare system

 Information for patients and visitors
 Information exchange with external

response partners e.g. EMTs, police,

security
Role of the nurse
The role of the nurse will fall into the 3
categories:
 Caring for patients
 Triage
 Bereavement
Role of the nurse
 Assess the situation calmly
 Protect your self and the casualties from danger
 Identify the injury or the nature of illness
affecting a Casualty
 Give early and appropriate treatment, treating
the most serious condition first
 Give consideration of victims’ abilities, deficits,
culture, language, or special needs
 Prevent cross – infection between you and your
patient
Role of the COMMUNITY
HEALTH OFFICER
 Assist in the mobilization of healthcare
personnel, food, water, shelter,
medication, clothing, and other assistive
devices
 Continue educating self on various types

of disasters and appropriate response

Primary assessment
Primary Assessment – rapid initial
assessment of the symptoms to determine life
threatening conditions while simultaneously
intervening
Include:
 Airway- with C spine immobilization, patent

airway, ability to speak, foreign body, chest

expansion
Breathing- effectiveness of breathing and

ventilation ability
Circulation- adequate circulation to maintain

cellular tissue perfusion

Primary assessment cont;
 Disability – complete a brief neurological
assessment to determine baseline
functioning, potential life
threatening complications, LOC
 Expose- remove all clothing from the client

to facilitate a thorough complete secondary

assessment examination
Secondary Assessment
 A brief, systematic head to toe
assessment that identifies all injuries
 Get vital signs – other assessment aids :

cardiac monitor, pulse oximeter, urinary

catheter, NGT, lab. studies: CBC,
electrolytes, Fibrin degradation products
(coagulation), amylase, lactate, renal
studies, blood type and cross-match,
toxicology studies
System Recovery
 Return to routine patient care activities
 Return of extra equipment, supplies and

medications
 Return to normal or “new normal”

operational levels
 Formal debriefing of hospital personnel

with others and appreciation gifts

Principles of managing casualties
and other emergencies
1. Always explain procedures to be done to patients
2. Handle each patient as a unique individual
3. Always save life with or without money
4. Respect and dignity
 All human beings have a right to be respected
whether ill or well irrespective of their color or
race or social class
5. Consent
• Patients have a right to accept or decline medical
care being offered to them
• If the patient declines medical attention the
patient should sign against medical advise
Principles of managing casualties
and other emergencies
 If the patient is a child and the parents do
not consent then the hospital authority
should seek
6. Privacy
 All information about a patient should only

be shared between medical staff on grounds

of helping the patient
 Those not concerned with care of the

patient should not be allowed to access the

patients documents
7.Deaths in casualty should be reported to
the police
Summary
 Defined disaster
 Described the different types of disasters
 Described the phases of disaster
 Described the disaster management cycle
 Described the role of a community health

assistant in a disaster
QUESTIONS……….