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Copyright © 2008 Delmar. All rights reserved.
Part V
Public Health Nursing in the 21st Century
Copyright © 2008 Delmar. All rights reserved.
Chapter 29
Disaster Preparedness and Public Health Nursing
Copyright © 2008 Delmar. All rights reserved.
3
Disasters
• Occur with little to no warning:– Avalanches– Fires– Explosions– Tsunamis– Hurricanes, floods– Winter storms, droughts
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4
Two Disaster Classifications
• Natural disasters (Table 29-1)– Hurricanes– Emerging diseases
• Avian influenza
• Man-made disasters (Table 29-2)– Accidental– Deliberate
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5
Terrorism
• Purpose: – Injure– Kill– Instill fear
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6
Terrorism
• Targeted sites:– Critical infrastructure systems– Public buildings or assembly areas– Symbolic or historic sites– Controversial facilities or businesses
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7
Terrorism
• Code of Federal Regulations
• Federal Bureau of Investigation (FBI)– Domestic – International
• Emerging threat– Cyber terrorism
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8
Weapons of Mass Destruction
• Categories of weapons of mass destruction:– Biological– Nuclear– Chemical– Incendiary/explosive
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9
Weapons of Mass Destruction
• Public health nurses should be: – Aware of guidelines for prophylaxis and
treatment of incidents– Prepared to develop and present information
to EMS, those on the front line, and the public
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10
Biological Weapons
• Categorized into three groups (Table 29-4)– Bacterial agents– Viral agents– Biological toxins
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11
Biological Weapons
• Three routes of exposure:1. Inhalation
2. Contact
3. Gastrointestinal
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12
Smallpox
• Smallpox– Isolation– Quarantine
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13
Smallpox
• Smallpox Vaccine Guidelines by CDC– Assess for contraindications– Choose site
• Deltoid
– Prepare skin• Do not use alcohol to prep skin
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14
Smallpox
• Administer vaccine with a bifurcated needle:– Absorb excess vaccine – Cover site until scab forms– Record vaccination– Educate the client
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15
Nuclear/Radiological Weapons
• Two types:1. Radiological dispersal device
• Dirty bomb
2. Radiation hidden in public place
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16
Nuclear/Radiological Weapons
• Most effective way to protect the public from exposure: – Time, distance, shielding
• Acute Radiation Syndrome
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17
Chemical Weapons
• Four categories:1. Nerve agents
2. Vesicant or blistering agents
3. Choking agents
4. Blood agents
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18
Incendiary/Explosive Devices
• Acts carried out by using:– Small arms– Explosives– Incendiaries
• Hazards are same as from fires:– Smoke inhalation, burns– High temperatures, dangerous fumes
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19
Effects of Disasters
• Affects individuals, communities, economic and productivity abilities
• Physical health effects– Preimpact, impact, post-impact
• May include bone, muscle, joint injuries, lacerations, rashes, burns, puncture wounds, death
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20
Effects of Disasters
• Mental health effects:– Depression– Post-traumatic stress disorder– Emotional disorders
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21
Effects on Responders
• Post-traumatic stress disorder
• Responders should have: – Limited on-duty work hours – Rotate from high to low stress functions– Adequate breaks and plenty of water– Nutritious meals– Debriefing
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22
Coping with Disasters
• Guidebook of Psychological Intervention, Coping with Disasters
– Four phases:1. Rescue
2. Honeymoon
3. Disillusionment
4. Reconstruction
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23
Public Health Role
• Community assessment
• Diagnosing and reporting
• Providing preventative measure
• Preventing spread of disease
• Assisting with outbreak investigation
• Discouraging inappropriate responses
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24
Public Health Role
• Disease surveillance– Public Health Information Network– National Electronic Disease Surveillance
System
• Strategic national stockpile– Technical Advisory Response Unit
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25
Public Health Role
• Disaster life cycle– Preparedness stage– Response stage– Recovery stage– Mitigation stage– Risk reduction– Prevention stage
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26
Disaster Response and Management
• National Response Plan
• National Incident Management System– Incident command structure
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27
Public Health Preparedness
• Eight domains of core competencies:1. Analytic/assessment
2. Policy development/program planning
3. Communication
4. Cultural competency
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28
Public Health Preparedness
• Eight domains of core competencies:5. Community dimensions of practice
6. Basic public health sciences
7. Financial planning and management
8. Leadership and systems thinking
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29
Public Health Nurse Practice Model
• Framework for developing a disaster plan:– Assessment– Diagnosis– Outcome identification– Planning– Assurance– Evaluation
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