• Pre-Disaster Risk Assessment

DISASTER • Issuance of advisories

q A serious disruption of the functioning of • Evacuation
society; • Relief Aid & Financial Assistance
q Causing widespread human, material or • Rescue Operations
environmental losses which exceed the ability
of the affected society to cope using its own Disaster Rehabilitation & Recovery
resources; • Restore & improve facilities and living
q Requires help from outside; conditions and capacities of affected
communities and reduce risks in accordance
with the “build back better” principle.
DISASTER RISK REDUCTION & MANAGEMENT o Reconstruction and improvement of
• the systematic process of using administrative houses, buildings, facilities (“Build
directives, organizations, and operational skills Back Better”)
and capacities to implement strategies, DISASTER CONTINUUM (BEFORE, DURING &
policies and improved coping capacities in AFTER)
order to lessen the adverse impacts of hazards
and the possibility of disaster.” BEFORE
1. Participate in the development of disaster
PHILIPPINE DISASTER RISK REDUCTION & plans.
MANAGEMENT ACT OF 2010 2. Participate in community risk assessment;
a. Elements of hazard analysis for all
REPUBLIC ACT 10121 hazards approach, hazard mapping,
• Known as the "Philippine Disaster Risk vulnerability analysis
Reduction and Management Act of 2010" 3. Initiate disaster prevention measures;
• Strengthening the Philippine Disaster Risk Prevention or removal of hazard, movement /
Reduction and Management System relocation of at risk populations, public
• Providing for the National Disaster Risk awareness campaigns, establishment of early
Reduction and Management Framework warning systems
• Institutionalizing the National Disaster Risk 4. Perform disaster drills and table - top exercises
Reduction and Management Plan, 5. Identify education and training needs for all
appropriating funds and for other purposes. nurses.
6. Develop disaster nursing databases for
DISASTER RISK REDUCTION & MANAGEMENT notification, mobilization and triage of
(DRRM) emergency nurse staffing resources.
• Disaster Mitigation & Prevention 7. Develop evaluation plans for all components of
• Disaster Preparedness disaster nursing response.
• Disaster Recovery & Rehabilitation
• Disaster Response DURING
1. Activate disaster response plan;
Disaster Prevention & Mitigation a. Notification and initial response,
• Avoidance of hazards and the attempt to leadership assumes control of event,
lessen the potential impacts hazards, by command post is established, establish
reducing vulnerabilities, exposure and communications, conduct damage and
enhancing of capacities. needs assessment at the scene,
o Vulnerability & Hazard Analysis search, rescue and extricate, establish
o Alarm and Early Warning Systems field hospital and shelters, triage and
o Flood Forecasting transport of patients.
o Geo-hazard mappings 2. Mitigate all ongoing hazards
o Policy & Safety Standards 3. Establish need for mutual aid relationships
o Engineering interventions 4. Integrate state and federal resources
o Flood control structures 5. Ongoing triage and provision of nursing care
6. Evaluate public health needs of the affected
Disaster Preparedness population
Establish and strengthen capacities of communities to 7. Establish safe shelter and the delivery of
anticipate, cope and recover from the negative adequate food and water supplies.
impacts of emergency occurrences and disasters. 8. Provide for sanitation needs & waste removal
• Contingency Planning 9. Establish disease surveillance (e.g. establish
• Prepositioning of Equipment vector control)
• Enhancement of Coordination 10. Evaluate the need for / activate additional
nursing staff.
• Training
AFTER
Disaster Response
1. Continue provision of nursing and medical care
Provide life preservation and meet the basic
2. Continue disease surveillance
subsistence needs of the affected population based on
3. Monitor the safety of the food and water supply
acceptable standards during or immediately after a
4. Withdraw from disaster scene
disaster.
 5. Restore public health infrastructure
6. Re – triage and transport of patients to
appropriate level care facilities
7. Reunite family members
8. Monitor long term physical health outcomes of
survivors
9. Monitor mental health status of survivors
10. Provide counselling and debriefing for staff
11. Provide staff with adequate time off for rest
12. Evaluate disaster nursing response actions
13. Revise original disaster preparedness plan.

PANDEMIC RESPONSE
Mass Casualty Incidents (MCI)
Pandemic Problems • Any call involving three or more patients
1. Lack of Training (protocols on handling • Any situation that requires a mutual aid
patients, documentation) response
2. Improper donning and doffing of PPEs • Any incident that has the potential for one of
3. Lack of supplies (alcohol, disinfectant and etc.) these situations
4. Lack of Isolation Facilities • an incident where the number of patients
5. Lack of oxygen supplies exceeds the amount of healthcare resources
6. Lack of Manpower, benefits for the available.
Responders
7. Lack of Transportation (Public transport, Triage
ambulances) • “Triage” means “to sort” patients based on the
8. Lack of Testing Facilities severity of their injuries.
9. Border Control
• Assessment is brief and patient condition
10. Policies and Guidelines Implementation
categories are basic.
11. Leadership
• Primary triage is done in the field. Secondary
12. Disconnect between managers and public
triage is done as patients are brought to the
13. Communication
treatment area.
14. Malversation of funds
15. Recognition of the possibility of a Pandemic • Preliminary assessment of patients in order to
determine the urgency and nature of
INCIDENT COMMAND SYSTEM (ICS) treatment.

Incident Command System (ICS)

• 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.
Initially developed to address problems of inter-
agency response
Use in all-hazards situations, ranging from active
shootings to hazmat scenes

The purpose of the ICS is to:

• Ensure responder and public safety Triage System
• Achieve incident management goals 1. Simple Triage and Rapid Treatment (START)
• Ensure the efficient use of resources 2. S.A.L.T.
a. Sort, Assess, Lifesaving interventions,
transport/treatment.
Key Concepts of the ICS 3. Jump START Triage
1. Unity of Command a. pediatric version of START
2. Flexible and Modular Organization 4. Canadian Triage and Acuity Scale (CTAS)
3. Common Terminology
4. Management by Objective
5. Span of Control
6. Coordination
7. Incident Action Plans / Emergency Plan
8. Resource Management
9. Integrated Communications

Sample Command Structure

TRIAGE TAPES / TAGS

MCI Basics
• During a large scale incident such as a mass
casualty, it is important to have a MCI
notification system. Successful MCI
notification systems will:
o Internally: alert staff to activate MCI
protocols and prepare for a potential
surge of patients
o Externally: increase community
awareness
• Some patients may arrive to the hospital
without having been assessed/ triaged at the
scene
• MCI response requires efficiency and
coordination
• Non-clinical personnel (including hospital
volunteers) can assist in moving patients to
designated areas based on level of care
• Help gather patient information in the
emergency treatment area
• Staff should review patients in clinical
assignment for any potential discharges/
transfers to make room for potential MCI
admissions, a process known as “surge
discharge”

Role of a Triage Nurse

• Assessment of patients and determining
• acuity
• Communicating with other healthcare
professionals
• Determines treatment location
• Initiating treatment protocols
• Monitoring and reassessment
• Participating in patient flow
• Documenting
After a major disaster, health personnel are often
called up to participate in a coordinated response to
save lives and prevent unfavorable outcomes to
community especially in vulnerable populations.
They are responsible for initiating the public health
response during the first 24 hours of an emergency or
disaster and coordinating with the existing emergency
response structure in specific types of incidents such
as floods, earthquakes and other calamities.

Collaboration between emergency managers,

community planners, and public health officials
can lead to:
• Identifying toxic sites within the flood plain or near
potable and well water sources.

DEPARTMENT OF SOCIAL WELFARE AND

DEVELOPMENT (DSWD)
• It is the primary government agency mandated
to develop. implement, and coordinate social
protection and poverty-reduction solutions for
and with the poor, vulnerable, and
disadvantaged.
• Its role and function is to assist families in
rebuilding their homes and livelihoods through
its rehabilitation programs. In times of disaster
and calamities, the DSWD mobilizes its
resources to provide relief assistance and
rehabilitation support to affected communities
in any crisis situations like floods, typhoons,
earthquake, volcanic eruptions and others.
• DSWD's response cluster provide immediate
relief assistance such as in the form of food,
water, shelter materials like tent. clothes, and
hygienic materials, medical assistance and
psychological support.