Role of Community Health Nurse in Disaster Management
The community health nurse has a play vital role in each phase or preventing, preparing for responding to and supporting recovery from a disaster. After a thorough community assessment for risk factors, the community health nurse may initiate the formation of multidisciplinary taste force to address disaster prevention and preparedness in the community.
Preventation of disasters :-
There are 3 levels, primary, secondary, tertiary levels. There are applied to natural disasters in the levels of prevention display.
Primary Preventation :-
It means keeping the disasters from ever happening, taking action to completely eliminate its occurrence.
Although, it is obviously the most effective of intervention both in terms of promoting clients.
When possible, primary prevention of disaster can be practiced in all settings – in the work place and home with programs to monitor risk factors, reduce pollution, and encourage non violent conflict resolution.
Secondary prevention :-
It focuses on earlist possible detection and treatment eg. A mobile home community is devastated by a tornado. And local health department community health nurses work with the American Red Cross to provide emergency assistance. Secondary Preventation can responds to immediate and effective response.
Tertiary Preventation :-
It involves reducing the amount and degree of disability or damage resulting from the disaster. Although it involves rehabilitate work, it can help a community recover and reduce the risk of further disasters. In this sense there all the preventive measures.
Steps Involved in Disaster Management
On receipt of information about disaster following steps are taken.
1.Informing disaster protocol officer :-
It is desirable that the hospital administrator. Their responsibility is assigned to the person who is efficient, effective and willing on receipt of information the protocol officers informed to enable him to initiate necessary action.
2.Immediate communication and alert:-
- Alert within the institution :
using public address system, pages, alarm, siren, telephone, the protocol officer nursing director , chief security officer, blood bank officer and other staff on emergency duty are informed by the telephone operator.
B.communication outside the institution:
– Regional police station
– Police control room
– Site of disaster
– Ambulance services
– Other nearby hospitals are contacted and alert .
3.TRANSPOTATION OF VICTIMS:-
- Site of disaster:-
Victims are transported to the hospital from the site of disaster using
- Ambulance
- Mobile care units
- Flying squarch
- Police van
- Any other available mode of transport.
b.within the hospital :-
After implementing triage system, patients are shifted to the desired areas for investigations, or observations, using trolleys and wheel chairs. It is essential to mobilize trolleys from other areas f the hospital and keep them ready at the entrance of hospital.
4.TRIAGE SYSTEM:-
Victim triage tag is recommended by the California fire chiefs association. There are four basic categories.
1.RED:– urgent/critical:
Victims in this category have injures or medical problems. That wills likely leads to death if not treated immediately.
2.YELLOW:– delayed
Victims in this category have injuries that will require medical attention; however time to medical treatment is not yet critical.
3.GREEN:– minor/ walking wounded.
Victims in this category have sustained minor injury or at presenting with minimum signs of them. Prolonged delayed in care most likely will not adversely affect their long time outcome.
4.BLACK: – dead / non- salvageable.
Victims in this category are obviously dead or have suffered mortal wounds because of which death is imminent.
- CONTROL OF CROWD:-
During any unusual event a looker and members of the public unsounded with the patient tend to cool around. Anxious relatives of the victims also assemble. Crowing by too many persons interferes in proper management of the victims. For controlling crowd the steps are
- Maxing repeated announcements in cool languages giving details of the situation and proper guidance’s to prevent unnecessary crowding at work place.
- It is desirable to set up a separate inquiry counter.
- All the available information about the victims must be displayed on the board.
- Local security staff, police, volunteers; particularly local community leaders are adequate to control the large group.
- IDENTIFICATION OF VICTIMS:-
Identification of conscious victims accompanied by relatives does not pose problems.
If unconscious victims are brought either by the police,
Well wishers. Social worker they need to give temporary identification using arbitrary alphabets and numerical…eg.x22, Yty .act. The same identification code must be used while requisitioning x-ray, blood group etc.
After emergency call is over and once victim is stable a search for proper identification can be made. I.e. railway pass, I’d card etc…
- SEGREGATION OF VICTIMS:-
- critically at patient’s needs life support system and continuous monitoring are sent to intensive care of critical care units.
- patients who have been stabilized and those who are improving should be sent to intermediate care ward.
- patients who have been treated and do not need to stay in the hospital can send home.
- dead bodies are collared, labeled, photo graphed and they sent – to mortuary. No of photographs can be displayed at specific, prominent place like waiting hall or near mortuary
- ENSURING ADEQUATE AND UNITERUPTED SUPPLIES:-
The stock may be grossly insufficient during mass casually situation of required additional supply from the gift shop, situated in the hospital and nearby stockiest may be obtained telephonic odors to the bulk supplies may also become necessary.
The items commonly required are
- Drugs
- IV fluids
- Blood units
- Dressing material
- Drainage tubes, catheters, I.v sets, intracaths..Etc…
- FACILITIES FOR THE STAFF :-
- for duty a different sites like acute care areas, operating rooms, wards, causality..Etc… Specific team/ persons need to be listed.
- place for the rest of the staff is required because additional stand by staff would act as receiving team. Those who have completed their duties may not be able to go home due to likely transport disruption to come back to hospitals.
- supply of drinking water , tea , coffee , snacks and meals to all the categories of staff essential to enable them to work without breaks.
10.DISPOSAL OF DEAD BODIES:-
- setting up satellite coroner’s counter near mortuary. This will preventer minimize hardships faced by the relatives to get no objection statements from police station , coroner court ect. Bodies need to be shower to the relatives after primary identification of the photograph taken prior to staring the body in this mortuary.
If the face has been completely disfigured or not identification circumstantial evidence eg. Scale on any particular part of body, tattoo marks .ect. Lastly DNA analysis also performed.
- HANDLING MEDIA :-
One responsible staff members should be given the responsibility to handle media. Photography or video shooting should be allowed only after prior permission from management and also the relatives of they are present.
- HANDLING VISITS OF DIGNITARIES :-
Dignitaries to visit site of disaster and also visit the hospitals managing them almost all the dignitary’s first land in or near the office. They can by suitably guided after showing due courtesy ,visits of this VIP category also need to observe discipline as regards visiting – rather not visiting no entry area.
13.CONTINUOUS MONITORING OF ACTIONS :-
Protocol officer should be free to take and implement the decisions after using his judgment, including purchases of essential items without following the procedure.