Disaster Nursing

MODULE 1: The Philippine Disaster and Risk Profile

The natural and man-made disaster is not region is affected by flooding caused by
new, but they are global in nature, rate, high rainfall brought by the southwest
type, and totality of the environment is monsoon and a low-pressure area, causing
increasing, there is a complex human damage to many livelihoods. Drought or El
emergency leading to population Niño caused roughly 12.8 trillion Philippine
migration violence, and infectious disease pesos in damage as a result of natural
outbreaks catastrophes or events in the Philippines/
The impact of disasters on healthcare Republic Act 10121
systems is immense, spanning all levels of
• An act strengthening the Philippine
society and the capacities of both official
disaster risk reduction and
and civilian response. Nurses play an
management system, providing for
important role in disaster management
the national disaster risk reduction
Disaster Nursing will contribute to the goal and management framework and
of ensuring that every nurse is prepared in institutionalizing the national
emergency. It is critical that all nurses are disaster risk reduction and
aware of the consequences of natural and management plan, appropriating
man-made disasters so that we are funds therefore and for other
prepared to respond if necessary purposes
The Philippines, with its 7,100 islands, is National Disaster Risk Reduction and
one of the countries that is most Management Council (NDRRMC)
vulnerable to natural disasters in the
• Highest organized and authorized
world. Earthquakes, typhoons, flooding,
body for Disaster Risk Reduction
volcanic eruptions, and landslides are all
and Management (DRRM) in the
common occurrences that pose a
Philippines
significant hazard to our fellow citizens.
• Established by virtue of Republic
Since the dawn of time, disaster has been
Act 10121 in 2010, the NDRRMC is
a part of the human experience, inflicting
composed of various government,
early death, diminished quality of life,
non-government, civil sector, and
dislocation, and altered health condition
private sector organizations
The Philippines is located inside the Pacific • The NDRRMC is vested with the
Ring of Fire, a 40-thousand-kilometer-long overall policy-making coordination,
horseshoe-shaped fault zone in the Pacific integration supervision, monitoring
Ocean that is prone to earthquakes and and evaluation functions focusing
volcanic eruptions. Aside from on DRRM
earthquakes and volcanic eruptions, the
CONCEPTS AND TYPES OF DISASTER 2 CATEGORIES OF DISASTERS
Disaster 1. Natural – caused by natural or
environmental forces
• A serious disruption of the
2. Man-made or anthropogenic –
functioning of the community or a
human generated
society at any scale due to
hazardous events interacting with Natural Disasters
conditions of exposure,
• A result of an ecological disruption
vulnerability, and capacity, leading
or threat that exceeds the
to one or more of the following:
adjustment capacity of the affected
o Human, material, economic,
community
and environmental losses, and
• Are the consequences of the
impact
intersection of natural hazards and
Health Disaster human activity
• Includes earthquakes, floods,
• A catastrophic event that results in
tornadoes, hurricanes, volcanic
casualties that overwhelm the
eruptions, ice storms, tsunamis,
healthcare resources in the
and other geological and
community and may result in a
meteorological phenomena
sudden surge of patients
Geophysical Disaster
Health care providers characterize
disasters by what they do to people - The • Tsunamis, volcanoes, landslides
consequences on health and health care and other mass movements
resources in the community • Floods (including glacial lake
outburst floods) and landslide dam
Hospitals and other health care facilities
may further classify disasters as: failures
Meteorological
External
• Caused by extreme weather such as
• Are those that do not affect the
rain, drought, snow, extreme heat
hospital infrastructure but tax
or cold, ice or wind. Violent, sudden
hospital resources due to numbers
and damaging alteration in the
of patients or type of injuries
atmosphere associated with,
Internal created by, or touching earth’s
atmosphere, particularly the
• Cause disruption of normal hospital
weather-forming processes
function due to injuries or deaths of
• Blizzards, cyclones, droughts,
hospital personnel or damage to
hailstorms, heat waves, hurricanes
the facility itself, as with a hospital
fire, power failure or chemical spill Hydrological

• An extreme event associated with

water occurrence, movement and
distribution, hydrological hazards
 include droughts and flooding and existing, emerging or re-emerging
related events diseases and pestilences
• Hydrological hazards and their
Man-Made Disasters
impacts are associated with climate
variability, demographic trends, • Man-made disasters have an
land-cover change, and other element of human intent,
causative factors and could be negligence or error involving a
exasperated by global climate failure of a man-made system, as
change opposed to natural disasters
• The increase in greenhouse gases in resulting from natural hazards
the atmosphere will continue • Such man-made disasters are
leading to global warming and crime, arson, civil disorder,
intensification of the hydrological terrorism war, biological/chemical
cycle, making hydrological extreme threat, cyber-attacks
studies more complex and
Terrorism
challenging
• The use of force or violence against
Climatological
persons or property in violation of
• Events that are brought about by the criminal laws of the United
drastic fluctuations of climate States for purposes of intimidation,
states and variabilities coercion, or ransom
• Or these are phenomena that are a • Terrorist often use threats to create
result of climate functions that shift fear among the public to try to
outside of their normal state due to convince citizens that their
different factors that impact the government is powerless to
climate prevent terrorism and to get
immediate publicity for their
Biological
causes
• Are natural scenarios involving • Acts of terrorism range from
disease, disability or death on a threats of terrorism,
large scale among humans, animals assassinations, kidnappings,
and, plants due to microorganisms hijackings, bomb scares and
like bacteria or viruses or toxins bombings, and cyber arracks, to the
use of chemical, biological and
Biological Disasters may be in the form of:
nuclear weapons
1. Epidemic – affecting a
Technological
disproportionately large number of
individuals within a population, • Technological disaster is an event
community or region at the same caused by a malfunction of a
time, example cholera technological structure and/or
2. Pandemic – is an epidemic that some human error in controlling or
spreads across a large region, that handling the technology
is, a continent or even worldwide of
 • Examples of technological Planning/Preparedness
disasters, such as the case of the
• Preparedness refers to the
Fukushima Daiichi Nuclear Power
proactive planning efforts designed
Station in Japan and previous
to structure the disaster response
accidents in Chernobyl and Three
prior to its occurrence
Mile Island. Fireworks or explosion
• It encompasses evaluating
such as the Station Nightclub fire in
potential vulnerabilities and
Warwick, Rhode Island, which was
propensity for a disaster to occur
caused by pyrotechnics
malfunction Warning/Forecasting
Transitional Human Shelter • This is the process of monitoring
the situation or events to look for
• Which people can reside for up to
indicators that predict the location,
three years before moving into
timing, and magnitude of future
permanent housing
disasters
• They often consist of a
• In communities or areas known to
prefabricated house and have been
be vulnerable to slow-onset
criticized due to problems of
hazards, and passing the
sustainability and cultural
knowledge of the pending hazard
appropriateness
to people in harm’s way
TRENDS AND PATTERNS OF DISASTERS • To be effective, warnings must be
related to mass education and
Phases of Disaster
training of the population who
a. Pre-Disaster/Pre-Impact (before) know what actions they must take
b. Impact (during) when warned
c. Post Impact (After)
Impact (during)
Pre-Disaster/Pre-Impact (before)
Mitigation/Emergency Management or
• Before a disaster to reduce the Response
potential for human, material, or
Mitigation
environmental losses caused by
hazards and to ensure that these • Disaster mitigation measures are
losses are minimized when the those that eliminate or reduce the
disaster strikes impacts and risks of hazards
• Prevention and mitigation reducing through proactive measures taken
the risk of disasters involves before an emergency or disaster
activities, which either reduce or occurs
modify the scale and intensity of • Measures are taken to reduce the
the threat faced or by improving harmful effects of the disasters by
the conditions of elements at risk attempting to limit its impact on
human health community function
and economic infrastructure
Emergency Management or Response Evaluation

• Is the actual implementation of the • Is essential and must be conducted

disaster plan to determine what worked and
• Is the organization of activities used what did not work and what
to address the event, the response specific problems, issues and
phase focuses primarily on challenges were identified
emergency relief, saving lives,
Disasters are frequently categorized based
providing first aid, minimizing and
on their onset, impact and duration
restoring damaged systems such as
communications, transportation, Factors that influence the impact of the
electricity and providing care and disaster in the community include the
basic life requirements to victims nature of event, time of the day or year,
health and age characteristics of the
Post Impact (after)
population affected and availability of
Recovery resources

• Used to describe the activities that Classification of terms in the field of

encompass the three overlapping disaster science distinguishes between
phases of emergency relief, hazards, disasters and risk
rehabilitation, and reconstruction
Hazard – is a potential threat to humans
Rehabilitation/Reconstruction and their welfare. Presents the possibility
of the occurrence of a disaster caused by
• Are at the heart of the disaster natural phenomena
recovery phase
• The rehabilitation and Risk – is the actual exposure of something
reconstruction activities, which of human value and is often measured as
follow the disaster response stage, the product of probability and loss
aim at achieving long-term Disasters affect the health status of a
recovery community in the following ways
• Disaster recovery is a very
significant stage in the disaster o Disasters may cause premature
management cycle, as this is when deaths, illnesses and injuries in the
the support of governmental and affected community, generally
non-governmental agencies in the exceeding the capacity of the local
disaster aftermath usually starts healthcare system
receding and the affected o Disasters may destroy the local
community has to fend for itself health care infrastructures which
• At this stage, the role of the therefore will be unable to respond
community and self-help groups to the emergency
becomes paramount since they can o Disasters may create
make or mark the crucial link environmental imbalances
between disaster response and increasing the risk of
disaster recovery communicable disease and
 environmental air, soil, and water
hazards
o Disasters may affect the
psychological-emotional and social
well being of the population in the
affected community, depending on
the specific nature of the disaster,
the response may be fear, anxiety
depression, widespread panic or
exacerbation of pre-existing mental
health problems
o Disasters may cause shortages of
food and can cause severe
nutritional deficiencies
o Disasters may cause large
population movements (refugees)
creating a burden on the other
healthcare systems and
communities
o Disaster frameworks for response
are increasing shaped by
globalization , changing world
dynamics social inequality and
sociodemographic trends
 MODULE 3: DISASTER MANAGEMENT CONTINUUM
DISASTER MANAGEMENT CYCLE/ • The approach of delivering health
CONTINUUM care will need to switch from a
focus on the individual to that of
Disasters are often thought of as
population
happening in a cyclical manner, it is
important to note that the activities that Areas of focus within healthcare
take place within the disaster cycle are emergency management includes the
interrelated and may happen concurrently following:
Disaster management involves planning • Communication
what to do before during and after a • Surge capacity
disaster or emergency occurs. Through • Volunteer management
further understanding these hazards and • Security
assessing a structure’s behavior to them, • Hazard material and chemical
we can better prepare for disasters • Collaboration with public health
Goals of Disaster Management Hospital Preparedness
1. Reduce or avoid losses from • Must have adequate plans to
hazards handle both disasters and terrorism
2. Assure prompt assistance to • It must include
victims intercommunication system
3. Achieve rapid and effective
recovery Hospital Emergency Management Cycle

Hospital Emergency Management • Consists of clinical, support,

operational and financial units
• Must have a comprehensive
• Committee chairperson
emergency management planning
o Fluency in emergency
process for all health hazards
management principles and
• Engage in community stakeholders practices
• A common cornerstone of • Members represent all hospital
emergency management is to including at a minimum of senior
protect life leadership, legal, environmental
• Education and training health, security, laboratory, ED,
• Equipment and supplies chaplaincy, public affairs, clinical
• Worker safety and academic affairs, HR, OH, IC,
• Drills and exercises engineering, life safety and
• Emergency department disaster housekeeping
operations • Representatives from local and
• Trauma center role national agencies involved in
• Health and medical needs of emergency management BFP, PNP,
population are priority includes RHU’s
shelter, sanitation, food and water • Its responsibilities – overseeing and
and other essential services/needs guiding the hospital mitigation,
 preparedness, response and Recover Function
recovery efforts
• To restore core services and normal
Phases of Emergency Planning operations
• Recovery actions and
Mitigation Measures
implementation activities for its
• Ensure a well-defined command core financial, human resources
structure and support services should be
• Make structural and non-structural addressed
sustained efforts to lessen the
likelihood and impact of hazards
• Structural Mitigation – Detection
Systems
• Non-structural Mitigation
o Human behavior modification
examples: staff awareness
and educational programs
• Mitigation
o Should meld into the other
phases of the plan
Preparation
International Strategy for Disaster
Hospitals must develop and maintain a Reduction (UNISDR) / Hyogo Framework
comprehensive effective emergency plan for Action
- The core of the hospitals The Hyogo Framework for Action 2005-
emergency preparedness activities 2015:
Preparedness Effort range from developing • Building the resilience of nations
a resource inventory and conducting and communities to disasters, was
institution wide emergency management adopted by the World Conference
trainings, drills and exercises for Disaster Reduction Kobe, Japan
Response Phase in January 2005
• The framework offers guiding
• Measures taken when an principles, priorities for action and
emergency incident occurs that practical means for achieving
may involve care of patients, staff disaster resilience for vulnerable
and visitors; to limit injuries, loss of communities
life and damage to physical
environment Priorities for action include:
• Response phase commence as soon 1. Ensure that disaster risk reduction
as the incident is apparent and is a national and a local priority with
conclude when the leader declares a strong institutional basis for
it over implementation
 a. Countries that develop dissemination of relevant
policy, legislative and knowledge and information
institutional frameworks for on hazards, vulnerabilities
disaster risk reduction and and capacities
that are able to develop and 4. Reduce the underlying risk factors
track progress through a. Disaster risks related to
specific and measurable changing social, economic,
indicators have greater environmental conditions
capacity to manage risks and land use and the impact
and to achieve widespread of hazards associated with
consensus for engagement geological events, weather,
in and compliance with water, climate variability
disaster risk reduction and climate change, are
measures across all sectors addressed in sector
of society development planning and
2. Identify, assess and monitor programmes as well as in
disaster risk and enhance early post-disaster situations
warning 5. Strengthen disaster preparedness
a. The starting point for for effective response at all levels
reducing disaster risk and for a. At times of disaster, impacts
promoting a culture of and losses can be
disaster resilience lies in the substantially reduced if
knowledge of the hazards authorities, individuals and
and the physical, social, communities in hazard-
economic and environmental prone areas are well
vulnerabilities to disasters prepared and ready to act
that most societies face and and are equipped with the
of the ways in which hazards knowledge and capacities
and vulnerabilities are for effective disaster
changing in the short and management
long term, followed by action
Hazard Risk and Vulnerability Analysis
taken on the basis of that
(HRVA)
knowledge
3. Use knowledge, innovation and Hazard
education to build a culture of
- Any source of potential damage,
safety and resilience at all levels
harm or adverse health effects on
a. Disasters can be
something or someone
substantially reduced if
- Basically, a hazard is the potential
people are well informed
for harm or an adverse effect; for
and motivated towards a
example, to people as health
culture of disaster
effects, to organizations as
prevention and resilience,
property or equipment losses or to
which in turn requires the
the environment
collection, compilation and
6 Main Categories of Hazards office, poor posture and
manual handling
1. Biological Hazards
6. Psychosocial Hazards
a. Include viruses, bacteria,
a. Include those that can have
insects, animals, etc., that
an adverse effect on an
can cause adverse health
employee’s mental health
impacts
or well-being
b. For example, mold, blood
b. For example, sexual
and other bodily fluids,
harassment, victimization,
harmful plants, sewage,
stress and workplace
dust and vermin
violence
2. Chemical Hazards
a. Are hazardous substances HRVA
that can cause harm
• Hazard vulnerability analyses tool
b. These hazards can result in
to screen for risk and plan for the
both health and physical
strategic use of limited resources
impacts such as skin
• It helps entities focus on work in
irritation, respiratory
which hazard would likely to yield
system irritation, blindness,
the maximum adverse
corrosion and explosions
consequence
3. Physical Hazards
• It does create an organized
a. Are environmental factors
framework to direct where an
that can harm an employee
institution’s emergency
without necessarily
management committee’s energy
touching them, including
heights, noise, radiation and effort should go
and pressure • An HVA provides the hospital with
4. Safety Hazards a basis for determining the most
a. These are hazards that likely standards and potential
create unsafe working demands on emergency services
conditions and other resources that could
b. For example, exposed wires occur during a crisis so that
or a damaged carpet might effective preventive measures can
result in a tripping hazard be taken and a coordinated disaster
c. These are sometimes response plan can be developed
included under the category Steps in Conducting HVA
of physical hazards
5. Ergonomic Hazards 1. Identify the specific tasks that must
a. Are a result of physical be completed to reach your project
factors that can result in goals
musculoskeletal injuries 2. Determine if there are hazards
b. For example, a poor associated with completing these
workstation setup in an tasks
3. Identify the risks connected with
the hazards
 4. Develop a list of controls (things • The most common type of work to
you can do) to eliminate or result in an electrocution is routine
minimize the risks work involving repair and
5. Create a safe working procedure maintenance
that describes how you will safely
Workplace Hazard #5: Repetitive Motion
complete each task
Injury

• Eliminating repetitive work so that

workers can rotate between
different tasks and use different
muscle groups is the ideal
preventative measure
• Temporary or permanent injuries
to muscles, nerves, ligaments and
tendons caused by performing the
same motion over and over again

5 Major Hazards in the Workplace

Workplace Hazard #1: Falls and Falling
Objects

• Slips, trip and fall injuries

Workplace Hazard #2: Chemical Exposure

• Breathing of contaminated air is

the most common way that
workplace chemicals enter the
body
Workplace Hazard #3: Fire Hazards

• Extinguishing systems are

mandatory, but if you expect your
workers to use firefighting
equipment, you must give them
appropriate equipment and train
them to use the equipment safely
Workplace Hazard #4: Electrical Hazards

• Engineers, electricians and

overhead line workers are at the
top of the list of professionals who
are most exposed to electrical
hazards
 MODULE 3: DISASTER PREPAREDNESS
PREPAREDNESS • Evacuation plans and training
• Resource inventories
Disaster preparedness consists of a set of
• Emergency personnel contact lists
measures undertaken by governments,
organizations, communities or individuals • Mutual aid agreements and;
to better respond and cope with the • Public information/education
immediate aftermath of a disaster, As with mitigation efforts, preparedness
whether it be human-made or caused by actions depend on the incorporation of
natural hazards appropriate measures in national and
The goal of emergency preparedness regional development plans
programs is to achieve a satisfactory level In addition, their effectiveness depends on
of readiness to respond to any emergency the availability of information on hazards,
situation through programs that emergency risks and the countermeasures
strengthen the technical and managerial to be taken, and on the degree to which
capacity of governments, organizations government agencies, non-governmental
and communities offices
These measures can be described as PREPAREDNESS/RISK ASSESSMENT
logistical readiness to deal with disasters
and can be enhanced by having response • Evaluates the facility’s
mechanisms and procedures, rehearsals, vulnerabilities or propensity for
developing long-term and short-term disasters
strategies, public education and building • Issues to consider include
early warning systems o Weather patterns
o Geographic location
Preparedness can also take the form of o Expectations related to the
ensuring that strategic reserves of food, public events and
equipment, water, medicines and other gatherings
essentials are maintained in cases of nation o Age, condition and location
or local catastrophe of the facility
During the preparedness phase, o Industries in close proximity
governments, organizations and to the hospital (nuclear
individuals develop plans to save lives, power plant or chemical
minimize disaster damage and enhance factory)
disaster response operations • Preparedness plans should be
developed based on the
Preparedness measures include: identification of potential disasters
• Preparedness plans and the related risks associated
• Emergency exercises/trainings with those disasters
• Warning systems • This phase includes an inventory of
• Emergency communications available resources to respond to a
systems potential disaster
According to CDC, there are 6 domains of A large earthquake will always be followed
preparedness by a sequence of aftershocks that normally
aggravates its effect on human and
1. Community Resilience
material elements like buildings and
a. Preparing for and recovery
infrastructure. The following are the
from emergencies
different hazards that normally result from
b. Health education, role of
the occurrence of an earthquake:
nurses is to be an educator
2. Incident Management • Ground shaking or ground motion
a. Coordinating an effective • Ground or surface rupture
response • Liquefication
3. Information Management • Earthquake induced ground
a. Making sure people have subsidence and lateral spreading
information to take action • Tsunami
4. Countermeasures and Mitigation • Earthquake induced landslides
a. Getting medicines and
supplies when they are Types of Earthquakes
needed 1. Volcanic – earthquake produced by
5. Surge Management movement of magma beneath
a. Expanding medical services volcanoes
to handle large events 2. Tectonic – earthquake produced by
6. Biosurveillance sudden movement along faults and
a. Investigating and plate boundaries
identifying health threats
Effects of Earthquake

• Serious disruption of life, probably

EARTHQUAKE PREPAREDNESS arising with no warning, that causes
Earthquake or threatens death or injury on a
large scale and/or with destruction
• It is a weak to violent shaking of the of property and disruption of
ground produced by sudden communication system
movement of rock materials below
the earth surface Before an earthquake
• The perceptible shaking of the • Review family preparedness plan
surface of the earth, resulting from • Establish a family communications
the sudden release of energy in the plan
earth’s crust that creates seismic • Assemble earthquake kit
waves • Prepare your home
Geologists explain that an earthquake is a o Store breakable items in
type of hazard that depends on the low, closed cabinets and
strength of seismic activity, along with such fasten shelves securely to
factors as local topographic and built walls
features, subsurface geology and
groundwater
 o Hang heavy items, such as anything that could fall and
pictures and mirrors away break
from beds and couches • If outdoors
o Secure and brace overhead o Move into the open, away
light fixtures from buildings, street lights,
o Repair any deep cracks in poles and utility wires
walls, ceilings and o Get down low and stay
foundations there until the shaking
o Store pesticides and stops
flammable products in • If in a moving vehicle
closed cabinets and on o Stop quickly and stay in the
bottom shelves vehicle
o Repair defective electrical o Move to a clear area away
wiring, water or gas from building, trees, utility
connections wires and overpasses
• Identify safe places in each room of o Once shaking has stopped,
the house proceed with caution,
o Under sturdy furniture, avoiding bridges or ramps
such as heavy table or desk that might have been
o Against an inside wall or damaged
under a door frame • If in mountainous area, keep in
o Away from glass or where mind the possibility of landslides
heavy furniture could fall and debris flow
over • Similarly, if you are on the coast, be
• Locate safe places outdoors aware that tsunamis are often
o In the open, away from associated with earthquakes
buildings, retaining walls,
After an earthquake
trees, overpasses and
power or telephone lines • Be prepared for aftershocks,
although smaller than the main
During an earthquake
shock, aftershocks can cause
• If inside additional damage and bring
o Drop down onto your hands weakened structures down
and knees • Aftershocks can occur in the first
o Take cover in a safe place hours, days weeks or even months
and hold on after the quake
o If you are in bed, stay there • Listen to a radio or tv for updated
and cover your head and information
neck with a pillow • When the shaking stops, look
o If you are in the kitchen, around. If there is clear path out,
quickly try to turn off the leave the building and head for an
stove if possible open area
o Stay away from pictures,
windows, light fixtures or
 • Avoid making phone calls except in medical care may be more difficult than
serious emergencies usual during the pandemic
• Help injured or trapped people. Do
VOLCANIC ERUPTIONS
not move seriously injured people
unless they are in immediate A volcano is a mountain that serves as a
danger of death or further injury. vent through which a molten rock and
Call for help other gases escape. When pressure from
• Stay out of damaged homes, and the gas and molten rock becomes too
follow the directions of emergency great, an eruption occurs
officials
Volcanic eruptions may be subtle or
• Inspect your home explosive and can produce dangerous lava
o Check for damage to the flows, poisonous gases and flying rocks and
walls, roof, foundation, ash
electrical system and water
lines Many volcanic eruptions are also
o Clean up spilled medicines, accompanied by other natural hazards,
bleaches or other such as earthquakes, landslides, debris
flammable liquid flows, flash floods, fires and tsunamis
immediately If you live near a volcano, active or
• Leave the house if you smell gas or dormant, be prepared to act on short
chemical fumes notice
• Notify your insurance company if
your home is damaged Before a volcanic eruption:
• Do not return home until officials • Review your family preparedness
declare it safe. If the house plan
presents major structural damages • Establish a family communications
or is partially destroyed, evacuate plan
Dealing with disasters can cause stress and • Assemble a disaster supply kit
strong emotions, particularly during the • Have a family evacuation plan in
COVID-19 pandemic. It is natural to feel place
anxiety, grief and worry. Coping with these
Additional considerations for COVID-19
feelings and getting help when you need it
will help you, your family and your • Unless you live in a mandatory
community recover evacuation zone, it is
recommended that you make a
People with preexisting mental health
plan to shelter-in-place in your
conditions should continue with their
home, if it is safe to do so
treatment and be aware of new or
• If you live in a mandatory
worsening symptoms
evacuation zone, make a plan with
If you are injured or ill, contact your friends or family to shelter with
medical provider for treatment them where you will be safer and
recommendations. Keep wounds clean to more comfortable
prevent infection. Remember, accessing
 • Only evacuate to shelters if you are • When outside, avoid volcanic ash
unable to shelter at home or with fall. Cover your skin, noes, eyes and
family or friends. Note that your mouth
regular shelters may not be open • Clear roofs of ash fall. Ash can be
this year. Check with local very heavy and cause roofs to
authorities for the latest collapse
information about public shelters • Avoid making phone calls except in
serious emergencies
During a volcanic eruption
• If you are injured or ill, contact your
• Listen to radio or TV for updated medical provider for treatment
information recommendations.
• Be prepared to evacuate and do so • Keep wounds clean to prevent
immediately if necessary infection
• Avoid areas downwind and river
Floods, Tornadoes, Typhoons, Cyclones
valleys downstream from the
and Tsunami Preparedness
volcano
• Close all windows and doors, and
bring any pets or livestock into
closed shelters
If outdoors:

• Seek shelter indoors immediately

• Avoid low-lying areas and streams
• If caught in a rock fall, roll into a ball
to protect your head
• Wear long-sleeved shirts and pants
and if necessary, along with goggles
and a mask
After a volcanic eruption

• Continue listening to PAGASA

weather radio or TV for the latest
information
• Remain inside your home until
officials declare it safe to leave
Inspect your home:

• Check for damage to walls, roof,

the foundation, electrical system
and water lines
• Notify your insurance company if
your home is damaged
 COMMUNICATION PLAN
An emergency communications plan (EC management organizations and
plan) is a document that provides disaster responders as well as
guidelines, contact information and disaster information created and
procedures for how information should be shared by journalists and the public
shared during all phases of an unexpected
Top 10 Communication Method in Disaster
occurrence that requires immediate action
1. Social media
The key functions for emergency
2. Mobile applications
communications are the declaration of an
3. Mobile phones
emergency and the communication with
4. Landline phones
the people concerned
5. Satellite phones
Communication during and immediately 6. Two-way radio
after a disaster situation is a vital 7. Citizen band radio
component of response and recovery 8. Amateur radio
9. Police radio/scanner
Effective communication connects first
10. Word of mouth
responders, support systems and family
members with the communities and How to Build an Emergency Preparedness
individuals immersed in the disaster Communications Plan
Effective Communication during Disasters: 1. Form an emergency
communications plan
• Making use of technology, media
2. Invest in emergency
and human resources is an
communication technology
informative, multi-faceted
3. Implement a threat monitoring
resource on preparedness planning
system
for effective communication
4. Coordinate your emergency
before, during and after a disaster
notification plan
occurs
5. Reach your people over all
Purposes of Disaster Communication communication channels
6. Understand your audience
• Preventing panic
7. Script messages for various
• Promoting appropriate health incidents
behaviors
• Coordinating response among
stakeholders Universal Emergency Code System
• Advocating for affected Emergency codes are color-coded
populations indicators used in healthcare facilities to
• Mobilizing resources alert all staff members of potential issues
Communication in Disaster arising in a facility

• Information disseminated to the Hospital emergency and disaster codes are

public by governments, emergency being used in hospitals worldwide to
convey essential information quickly to
staff while preventing stress or panic of the disaster committee of the
among patients and visitors in the hospitals hospital emergencies within their
catchment area
Hospital emergency and disaster codes are
• Chiefs of hospital/medical center to
being used for two purposes
automatically declare code white
1. To convey need to be alert or ready during national events and
2. To convey type of emergency or activities especially with the
disaster occurring in the hospital potential of an MCI
that needs a corresponding • Each hospital shall prepare its own
response procedures in declaring and lifting
the code
The first code alert system provided by the
• The alert level is raised, lowered or
Administrative Order 182 S. 2001 was
suspended by the secretary of
directed to the DOH hospitals given that
health, director of HEMS for
“most emergencies and disasters are
external emergencies and national
unpredictable”
events, the respective medical
The code alert system of DOH is a center, chiefs of hospital or their
mechanism for the provision of health designates for emergencies within
services during emergencies and disasters their catchment area
which describes the conditions that govern
Conditions to raise or suspend the alert
the expected levels of preparation and the
level depends on the threat whether it is
most suitable response by all concerned,
increased or is no longer present
particularly during mass casualty situations
Arrival of patients in the hospitals warrants
There is a standardized code alert system
the raising of the alert level; likewise alert
which consists of code white, code blue
can be suspended when no significant
and code red
incident is monitored and the hazard or
The Integrated Code Alert System of 2008 condition
(A.O No. 2008-0024)
Codes allow trained hospital personnel to
• Describes the conditions for respond quickly and appropriately to
adopting the alert status, the various events. The use of codes can also
human resource requirements and help prevent concern or panic by visitors
other requirements with the and people being treated at the hospital
procedure in implementing the
The most common hospital codes are code
code alert
blue, code red, and code black, though the
Guidelines in Implementing the Code Alert use of these codes is not standardized in
the country
• The hospital code alert shall be
declared by the secretary of health Critical Medical Emergency
or by the director of HEMS for
Code Blue
external emergencies; by the
medical center chiefs; chiefs of • Code Blue is the most universally
hospital; HEMS coordinator or head recognized emergency code
 • Code Blue means there is a medical differing or conflicting meanings at
emergency occurring within the different hospitals
hospital
Some of the more widely used codes in
• The team is comprised of:
hospitals include:
o Doctors
o Nurses • Code Pink – infant or child
o Respiratory therapist abduction
o Pharmacist • Code Orange – hazardous material
• Common reasons for activating a or spill incident
code blue: • Code Silver – active shooter
o Cardiac arrest, heart attack • Code Violet – violent or combative
or dangerous arrhythmia individual
o Respiratory arrest • Code Yellow – disaster
o When someone becomes • Code Brown – severe weather
severely confused, not alert • Code White – evacuation
or shows signs of stroke • Code Green – emergency activation
o Sudden and severe drop in
blood pressure Benefits to the Public

Code Red • Hospital emergency codes are

extremely important to the safety
• Code red typically means there is a of people inside a hospital
fire or smoke within the hospital • Hospital employees, including
• A code red may be activated if doctors, undergo extensive training
someone smells or sees smoke or to respond to each of these events,
flames allowing them to save lives
Code Black • One of the primary benefits of a
code system is that trained hospital
• Code black most often indicates a employees know to respond to any
bomb threat given emergency without alarming
• Code black may be activated if those being treated and hospital
there has been a threat made to visitors. Panicked bystanders can
the facility from an internal or hinder the response efforts of
external source, or if staff or law emergency responders
enforcement officials have
identified a possible bomb in or Benefits of Standardized Communications
near the facility • Emergency codes are extremely
Events needing an immediate response important for the safety of
everyone inside a hospital
There are a number of other codes hospital • They allow doctors and
may use to indicate emergency situations. administrative employees to
These codes can vary more widely from respond quickly and effectively to
facility to facility, so one color may have save lives in emergency situations
FAMILY COMMUNICATIONS PLAN Texts can often get aroubd network
disruptions when phone calls
Before A Disaster
cannot
• Have a list of emergency contacts
During A Disaster
(fire, police, ambulance) in your
cellphone and near your home • If you have a life-threatening
phone emergency, call 911
• Agree on a family meeting place • Avoid making phone calls except in
both in your neighborhood and out serious emergencies. If you must
of town, in case you cannot get in make a call, keep the conversation
touch or are unable to go home brief
• Program I.C.E (in case of • For non-emergency
emergency) numbers into your communication, use text messages,
phone and family member’s email and social media instead of
phones. If someone is injured, making phone calls. Too many
emergency personnel can use phone calls can cause network
these numbers to notify friends and congestion, meaning people in real,
family life-threatening emergencies
• Prepare a family contact sheet with cannot get help
the names, addresses and phone • Keep your out of town contact
numbers of important contacts. updated on your location and
Include an out of town contact for condition
family members to get in touch
After A Disaster
with when they are unable to
contact other family members. • After a disaster, call and message
Often, during disasters, it is easier the family members that you are
to make long-distance calls than safe and well update any contact
local calls information as needed
• Create a contact card for each
PERSONAL AND HOME DISASTER
member of the family. Keep these
PREPAREDNESS PLANNING
cards in a purse, wallet or child’s
backpack. Include an emergency Personal preparedness includes being
contact name and number, out of ready for emergencies at home, in your car
town contact name and number, a or anywhere else you may spend time
neighborhood meeting place and
Being prepared can reduce fear, anxiety
any other important information
and losses that accompany disasters
• Be sure every family member has
emergency phone numbers and a - Better respond to and recover from
cellphone any disaster or emergency as well
• Teach children how and when to as contribute to the overall
call 911 for help readiness of your community
• Make sure everyone in your family
knows how to send a text message.
A. Assembling Emergency Kit B. Make a plan
• Make a kit • Before any emergency happens,
o You may need to survive on make a plan
your own after an • To start, sit down as a family and
emergency. This means create a communications plan
having your own food, • Make sure everyone has each
water and other supplies in other’s phone numbers and also
sufficient quantity to last has numbers for other family or
for at least three days friends nearby who can help relay
o The following items are information
recommended for a basic • Decide on a good safe location you
emergency supply kit: can all meet at If you are unable to
▪ One gallon of water return home right away, a friend,
per person per day family member or local landmark
for at least three • Write it all down and make copies
days, for drinking for everyone. Keep a copy in your
and sanitation emergency supply kit
▪ At least three-day • Remember to check the plan
supply of non- periodically to make sure it is
perishable food always up to date
▪ Battery-powered or
hand crank radio C. Be informed
▪ Wrench or pliers for • There are important differences
turning off, can between potential emergencies
opener for food that can impact the decisions you
▪ Local maps, make and the actions you take
cellphone with
chargers, inverter or D. Get Involved
solar charger lights • Getting involved, comes as a result
▪ Flashlight and extra of successfully completing the first
batteries three. Once you are confident that
▪ First aid kit you and your family are ready for
▪ Whistle to signal for an emergency, helping others do
help the same, especially in your area
▪ Dust mask to help • Building a community will also help
filter contaminated build strength and resiliency and
air and plastic help a community recover and
sheeting and duct rebound quickly following any
tape to shelter in emergency
place, moist
towelettes, garbage
bags
LEARNING PREPAREDNESS SKILLS Considerations during an MCI Response
Survival preparedness is being able to cope • Supply vs demand
in situations where your safety is not • Resource allocation
automatically assured by the resources to • Coordination
which you are accustomed • Medical management
Patterns of Survival • Ethics

S – size up the situation, size up your Objective

equipment, size up your physical condition, Casualties = Resources
size up your surroundings
Mass Casualty Incident:
U – use all your senses, undue haste makes
waste • Transportation accident
• Fire
R – remember where you are • Hospital overloading
V – vanquish fear and panic • Hospital evacuation
• Sporting event
I – improvise
• Hazmat incident
V – value living • Loss of power
• Severe weather
A – act only after thinking
Managing Mass Casualty Incidents
L – live by your wits, but for now, learn
basic skills • Would any of those situations lead
to shortage of personnel and
equipment resources?
PACE PLANNING • Would decisions and changes need
to be made in how you do
PACE is an acronym for:
business?
• Primary o Altered standards of care
• Alternate
Hospital Considerations
• Contingency
• Emergency • Transition from the EMS patient to
hospital patient
Bugging in simply means sheltering in
• Dealing with self-presenting
place, likely at home, while bugging out
patients
means leaving your home

DISASTER TRIAGE
Goal of MCI Management

• To save the largest number of

survivors from a multiple casualty
incident
Incident Command System Types of Triage

• Primary
o On scene prior to movement
or at hospital (self-transport)
• Secondary
o Incident dependent, probably
prior to or during transport or
upon arrival to hospital

Triage Coding

Priority Treatment Color

Immediate 1 Red
Aims of Triage Urgent 2 Yellow
Delayed 3 Green
1. To sort patients based on needs for Dead 0 Black
immediate care
2. To recognoze futility
3. Medical needs will outstrip the Primary Triage
immediately available resources,
• The first attempt at balancing
additional resources will become
resources and casualties/injured
available given enough time
Priority 3
Prinicples of Triage
• Not injured or “walking wounded”
The main priniciple of triage are:
• Have motor, respiratory, mental
1. Every patient should receive and function
triaged by appropriate skilled • Delayed
healthcare professionals • Example
2. Triage is a clinic-managerial decision o Patient walks over to you and
and must involve collaborative has an obvious broken arm
planning o Respirations are 22, pulse is
3. The triage process should not cause a 124
delay in the delivery of effective o Awake alert and crying
clinical care

Advantages of Triage

1. Helps to bring order and organiation to

a chaotic scene
2. It identifies and provides care to those
who are in greatest need
3. Helps make the difficult decisions
easier
4. Assure that resources are used in the
most effective manner
5. May take some of the emotional
burden away from those doing triage
 Priority 2

• Did not move out, when asked

• Airway OK
• Breathing within 11 and 29
• Capillary refill less than 2 seconds
or radial pulse present
• Can follow instructions to move
unaffected limb
• Urgent
• Example
o Patient states he cannot
move or feel his legs
o Respirations are 26, pulse is
110
o Awake and oriented
Circulatory Check
Priority 1
• If you are unable to obtain capillary
• Opening airway, starts to breathe
refill, check the radil pulse, if absent
• Breathing is greater than 30 or less
then control any bleeding and
than 10
prioritize the patient priority 1
• Delayed capillary refill time
• Absent radial pulse
• Bleeding that needs to be
controlled
• Does not follow instructions
• Immediate
• Example
o Patient has open head
wound, bleeding controlled
o Respirations are 16, pulse is
88, unconscious
Expectant/Dead SMART Triage Pack Contents

• Still require resources • Dynamic tags (20)

• Focus of care is comfort • Dead tags (10)
• Psychologically most challenging • Pencils
for healthcare providers • Cylume sticks
• Patient count card/protocol
• SMART pediatric tape
Secondary Triage
Goal of Disaster Triage Training?
• Generally used when there is an
• Increase familiarity/proficiency of
extended duration event
the START and Jump START triage
• After initial color coding triage
methodologies
• Healthcare professionals who
• Increase familiarity with the SMART
respon to the scene or hospital
tag Triage System
response teams may be utilized to
• Train with a standardized
further determine who gets
methodology and system
transported from scene first

Pediatric Triage

• Children are involved in mass

casualty incidents
• The over prioritizing of children will
take valuable resources away from
more seriously injured adults
• Triage systems based on adult
physiology will not provide
accurate triage