disaster and its management

1. Disaster Management

2. Disaster plan at Hospital

3. Disaster plan
 Hospital disaster manual is the written statement of
disaster plan which need to be activated at the time of
disaster.
Aim
 To provide prompt and effective medical care to the
maximum possible in order to minimize morbidity and
mortality.

4. Objectives
 To optimally prepare the staff and institutional resources
for effective performance in disaster situations.
 To make the community aware of the sequential steps to
be taken at individual and organizational levels.

5. DISASTER DRILL
A disaster drill isan exercisein which
peoplesimulatethecircumstancesof a
disaster so that they havean opportunity to
practicetheir responses.

6. First Aid and sorting ( Triage )
Priority
level
Management Color of
ribbon
Action needed
1 Immediate
Rescuscitation.
Red Em.
OT/ICU/ICCU
2 Urgent surgery Yellow Em. Ward
3 First aid and
possible
surgery
Green First Aid
4 Brought dead Black Mortuary

7. Disaster plan
Drugs and equipments
 Air way devices
 Shock management
 Drugs, Blood
 Medical equipments
 Linen & blankets
 Stretchers & wheel chairs, O.T. tables
 Protective personal kit

8. Disaster plan
 The key should be available with the Sister- in charge
on duty and also with DNS & ANS of casualty.
 As an immediate measure buffer stock should be used.
 Medical & surgical stores should be opened immediately.
 Essential drugs , crystalloids etc should be issued.
 Medical supplies , basic equipments should be kept
prepared , and properly labeled and updated.

9. Disaster plan
 Operation theaters
 Emergency blood bank
 Clinical services ( lab, radiology )
 Linen stores
 Documentation center : special record for
each victim
 Information services
 General section ( CSSD, Ambulance)
 Maintenance service (Water, electricity)

10. Disaster plan-duties of staff
Chief Nursing Officer -CNO

In a major disaster she will do the Administrative
functions.
 Responsible for notifying all Dept. heads and alternates .
 Responsible to see that families of victims are notified as
soon as possible.
 She can take help from Social Worker .
Nursing supervisor
 Attempt to find out adequate number of nursing
personnel.
 Organization of medical and surgical items required for
the treatment.

11. Disaster plan – Pre Hospital
 Quick Response Medical Team ( QRMT)
Will be formed to be deployed in case of crisis situation
ranging from natural disaster to complex humanitarian
emergencies
Functions
 Primary first aid at the site
 Stabilization of the casualties
 Triage
 Casualty evacuation

12. Disaster plan – mitigation
 Physical aspect
Sanitation officer and the administrators ensure proper
sanitation and waste management .
 Psychological aspect
Psychiatrist and psychiatric nurses work to reduce the effect
of PTSD.

13. Internal Hospital disaster plan
Evacuation plan
 The evacuation of patients , visitors & staffs should be
made safely.
 All the fire escape routes & emergency exit doors should
be clearly marked with luminated paints.
 Keys of all emergency exit doors should be kept in the box
near the door. One key will be with sister on duty.

14. Internal Hospital disaster plan
 Large display boards will be placed at prominent places
showing display roots in case of fire.
 The locks of the emergency doors should open by one
master key which will be kept in the central fire control
room.
 Evacuation can have either vertical or horizontal flow to
move the patient to a safer area.
 Blankets can be used as improvised stretcher.
 Details of evacuation plan need to be discussed with fire
people.
 Activation of disaster plan as for external disaster.

15. Mental health services to victims
Critical Incident Stress Defusing
It is an abbreviated form of CISD and it takes place as soon as
possible after the critical incident is finished. The process
typically last for 1 hr.
 Problem solving : help to identify specific concerns,
problem solving and decision making
 Advocacy : Help the survivors in contacting appropriate
support services

16. Role of nurse in D.M
Planning
 Preparation of area for patient triage, morgue, relatives
and media .
 Provide current information regarding the number of
available beds, nursing staffs and locations & type and
quantities of supplies available.
 Assess the state of patients for potential discharge and
transfer .
 Arrangements for extra staffing and period of duty ( 12
hrs)
 Accurate inventories and supplies to be established.
 Activate a telephone cascade system.

17. Guidelines for hospital nursing
personnel
 Remain calm .
 Inform patients and family of disaster situation & request
co-operation.
 Notify on – duty staff & call off – duty staff as needed.
 Obtain initial account of available beds.
 Reallocate the resources to the treatment areas.
 Conserve supplies and resources left on the unit.
 Avoid use of lifts and telephone except for disaster activities.

18. Rehabilitation
Physical Rehabilitation

A disaster can leave many people handicapped amidst the
panic and fear, many of the victims either loose any of
their limbs or sight or may go for severe forms of
handicaps.
 The nurse can teach such people to return to their normal
life style by using prosthesis and cope with it for the rest
of the life.
 The victims should be encouraged
to go on with life.

19. Rehabilitation
Social rehabilitation
 Explain them that all others are in the same situation.
 Help the individual to identify his roles in the society and
indulge in him a spirit of well being by encouraging him
often of the potentials he has.
 Discuss with the victim, how he can create a normal life
again, how to use his potential.
 Educate about the community sources which are available.

20. Rehabilitation
Vocational rehabilitation
 Assess the physical strength attention, and concentration.
 Make them to perform various activities like weaving, basket
making, stitching ,gardening and sell these products to earn
their living.

21. HISTORY OF DISASTER
MANAGEMENT IN INDIA
1. High Powered Committee set up in August 1999.
2. Until 2001 – Responsibility with Agriculture
Ministry,
3. Transferred to Ministry of Home Affairs in June
2002.
4. National Disaster Management Authority
established.
5. Disaster Management Act passed in December 2005

22. Central
Government
National Disaster
Management
Authority
Chairman: PM
State Disaster
Management
Authority
Chairman: CM
State
Government
District
Administration
Panchayats
s
Municipalities
MHA
District Disaster
Management
Authority
Co-Chairmen
DM/Chairman ZP
DMD
National
Executive
Committee
State
Executive
Committee
NIDM NDRF
Disaster Management Act 2005

23. VISION
 To build a Safe and Disaster Resilient India by
developing a holistic, proactive, multi-disaster and
technology-driven strategy through a culture of
prevention, mitigation, preparedness and efficient
response.

24. D.M in India
 State Crisis Management Group: This is chaired by
the state relief commissioner or chief secretary.The
committee develops various contingency plan to deal with
various types of disasters .
 District administration : Revenue department and the
Relief department are responsible.District collector, SDO,
Tehsildar and village officers are involved.

25. Role of various agencies in D.M
 The central Government plays a supportive role in terms of
provision of financial and other resources.
 The Ministry of Home affairs is the nodal agency for
disaster management.
 The Central Relief Commissioner in the DAC coordinates
the relief operations.

26. Various agencies in D.M
 National Disaster Management Authority
 National Centre for D.M
 Ministry of Agriculture.
 Disaster Risk Management Programme
 National Disaster Management Framework
 Calamity Relief Fund
 National Calamity Contingency Fund(NCCF)

27. International agencies
Every country is a potential source of health humanitarian
assistance for some other disaster striken country.
 United Nations Office for the Co ordination of
Humanitarian Affairs(OCHA)
 World Health Organization (WHO)
 Food and Agricultural Organization
 International Committee of Red Cross
 International Council of Voluntary Agencies.

28. Recommendations
 Enactment of Disaster Management policy and Act
 Undertake large scale awareness measures/campaigns
 Review and amendment of existing building codes and by
laws
 Inclusion of DM elements in school curriculum
 Safe housing atlas (earth quake
resistant reconstruction in J&K).
 Seismic zoning map
 National core group for disaster
mitigation

29. Recommendations
 Decentralization of the disaster management process
 Development of warning manual
 Faculty members of civil engineering to undergo 6
week course in earth quake engineering
 Special training in IPS,IAS…..
 Special training for women in first aid, shelter,
management, water, sanitation, rescue and
evacuation.

30. Recent advances
 Thermal imaging : This is a sophisticated sensor with
wires are pushed into the rubble. Body temperature of humans
provides thermal images of survivors caught under the rubble.
 Sniffer dogs : Trained to bark when they detect any living
person.
 Multiple sensors : These sense very low sound waves
from the rubble and hence spot trapped people.
 Electronic resources of information : Internet
connectivity and web utilization enhance resource availability.

31. Promoting Global and Regional
Cooperation in disaster Reduction
 India worked closely with International Strategy for
Disaster Reduction in developing the Asian Strategy for
Disaster Reduction at the Beijing Conference.
 India took proactive role in developing SAARC Regional
Framework for Disaster Risk Reduction in South Asia
 India is hosting SAARC Disaster Management Centre at
New Delhi.

32. Some recent disasters…..
 Earthquake in Pakistan – 2005
 Earthquake and tsunami in the
Indian coast - 2004
 Gujarat Earthquake - 2001
 Floods in Mumbai, West
Bengal
 Flash flood in Uttrakhand
 Cyclone: Rita, katrina , phalian
etc…..
 Fire: Kumbakonam, Dabwali
 Terrorist attack: Mumbai
And the list goes on and on……………

33. Government of India initiatives:
1) Inclusion of disaster management in school
curriculum
 Introduction of DM in Class VIII, IX and X as part of
the frontline curriculum by CBSE.
 Many of the state Boards have already introduced DM
in school syllabi.

34. Disaster management bill -2005
 Disaster management bill 2005 under the article 51( A)
of the constitution has been put up for implementation.
 In this, mandatory training for all youth above 18 years
to be implemented by training institutes like Panchayats,
Municipal bodies .
 All organizations and hospitals should have Disaster
Management plan for managing all type of casualties.

35. Challenges ahead…
 Recent disasters like Tsunami and Mumbai floods
have demonstrated that much needs to be done.
 Growing economy and urbanization have exposed
more areas, assets and people to risks.
 Enforcement of building codes and zonal regulations
in rural and urban areas still a huge task.
 Communicating early warning to the last mile.
 Diversifying livelihood opportunities in disaster
prone areas.

36. Indian aspect
 Every year 2nd
October has been designed as world Disaster
Reduction Day as part of International Decade for Natural
Disaster Reduction activities.(1980-1990)
 Indian Meteorological Department (IMD) plays a key role in
forewarning the disaster. Disaster warning System receivers
have been installed primarily in the coastal areas of Tamil
nadu and A.P.
 The Snow and Avalanche Study Establishment(SASE) in
Manali has been issued warning to people about
avalanches 24 to 48 hours in advance.

37. Research inputs
Dr. R.B Mathur “Disaster preparedness of major Delhi
hospitals” (2001,AIIMS)
 No written disaster plan in major hospitals except for some
few .
 No written plan for evacuation during internal disasters in
hospitals other than AIIMS.
 No plan for creating extra beds during disasters in many
hospitals except for AIIMS and Delhi Govt. Hospital.

38. Summarization
 Disaster – introduction
 Types
 Disaster management
 Triage
 Disaster plan at hospital
 Disaster management act 2005
 Resaerches

39. References
 P.K .Dave et al .Emergency Medical services & Disaster
Management - A holistic approach,Jaypee,2001
 S.Seliger et al .Emergency Preparedness -Disaster planning
for health facilities,Aspen,1986
 Peter Basket et al Medicine for disasters.Wright,1988
 David E et al Disaster Medicine ,LWW,2002
 Stanthope et al Foundations of community health Nursing
,Mosby,2002
 Suzane C Smelter et al Medical surgical Nursing
 K. Park. Preventive and social medicine,2004
 Disaster management plan – AIIMS ,2006

40. ThankThank
YouYou