Disaster Management Assignment
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.
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.
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.pdf
Read: Demarco & Healey-Walsh: Chapter 20 pages 405-414 (Stop at Bioterrorism)
Read: ATI: Chapters 2 & 3
Review: Triage algorithm:
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]
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)
“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
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
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
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
Work on immediate response teams
Work on teams to limit damage and disability (ex., mental health services)
Roles of Community Health Nurses
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?
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:
State and federal governmental agencies
Federal Emergency Management Agency (FEMA)
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)
Family Emergency Plan
Personal Disaster Preparedness
Prep for individuals and families should include:
Local and remote meeting places
Disaster kit or “go bag”
Roles of Community Health Nurses:
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
Activate Disaster Plan
Immediate need for organization and management at the scene
Incident Command Center (ICS)
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
Communicate with potential responding agencies
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)
U.S. Department of Homeland Security
American Red Cross (ARC)
Office of Emergency Management
Public Health System
“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.
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?
Class Activity: Read, Think Pair, Share
Mass Casualty Responses & Triage
Community trained pros triage @ ~ 6 min in
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
Pre-Hospital Triage Model
Triage based on
Yellow—Delayed (walking wounded; ill but stable)
Red—Immediate (unstable based on signs of shock)
Other Triage Tags
Open airway—head tilt, chin lift
Control bleeding—pressure, elevation
Treat for shock
Re-establish blood volume
Protect from complications
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:
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
Main Causes of Disaster in
Are YOU Prepared?
These slides were created as a collaborative effort between members of the Community Health team at Resurrection University 9/2019