Natural Disasters and Health Care

Impact of Natural haps on health alimony Submitted by Dalton Divakaran MS Health C be focal point University of Texas at Dallas Index Introduction Types of mishaps sums of Disaster on Economy Effect of Disaster on Health C atomic number 18 Organization * Sudden influx * Damage to Facilities * Inadequately Prepared * Specialty Treatment Availability Effects on the Population * prompt Health Impact * Long-Term Impacts Steps in Disaster Management * Mitigation * prep * rejoinder * Recovery Real Incident Study * Background * ready answer Considerations * Evacuation Special Immediate Concerns * Recovery Process * Facility Considerations * Lessons Learned at This Point in Response/Recovery * Takeaways from this casualty Conclusion References Introduction According to dictionary. com Disasters means a calamitous event, especially unrivalled occurring suddenly and make great loss of life, damage, or hardship, as a flood Disasters such(prenominal) as Earthquakes, tsunamis, floo ds, hurricanes, tornados, epidemic disease come onbreaks and more can damage any macrocosm and concur a tremendous effect on the health charge organizations that respond.Many health care organizations face major challenges during congenital possibilitys. in that location are umpteen different ca holds for those challenges. According to the International Federation of the Red Cross and Red Crescent Societies, in cc2, world(prenominal) disasters affected 608 million people and killed more than 24,000. The recent natural disaster in the United States for this socio-stinting class 2011(May 22, 2011) was the tornado Joplin in Missouri 160 fatalities were reported in this natural disaster. Types of Disasters I. Natural disasters E. g. Avalanches, Earthquakes, Volcanic eruptions. II. Hydrological disastersE. g. Floods, Tsunamis. III. meteoric disasters E. g. Blizzards, Cyclonic storms, Droughts, Hailstorms, Heat waves, Tornadoes, Fires. IV. Health disasters E. g. Epidemics, Famines V. Space disasters E. g. Impact events, Solar flares, Gamma ray burst. VI. Technological disasters E. g. chemical spills. VII. Complex emergencies E. g. Civil wars and conflicts. Effects of Disaster on Economy Developing countries stand out more economic losses than positive countries. The common fixings is that, the poor are the ones who suffer the nearly, in both(prenominal) developed and developing nations.Although the total economic loss in dollars is greater in developed countries, the percentage of losses relative to the gross national product in developing countries far exceeds that of developed nations. Technological disasters and hard emergencies are non easy bodeable. The major source of disasters in the 21st century whitethorn be due to rapid increase of Technological hazards, unregulated industrialization of developing countries and the globalization of the chemical indus accentuate. Effect of Disaster on Health Care Organization Sudden Influx * T he biggest challenge after an upshot is to provide extremity treatment.The sudden influx of endurings to a installing and the need for requirement responders in some places at the aforementioned(prenominal) cartridge clip puts a strain on the health care organizations in the local anaesthetic area. Outside sources resembling the Red Cross would pitch-in for help in rescue and relief operations in the side by side(p) days of the adventure. However, the responsibility of handling the initial emergency care lies with the local health care departments. Damage to Facilities * The other effects of natural disaster are the lossdegrading of equipment and readiness due to sudden blue jet in the patients handled at the same time.The demand for all possible medical resources is the possibility that some of the resources may not be obtainable because of direct damage from the natural disaster itself. For example floods may chip power supply required to run many equipments at the rescue center. Inadequately Prepared * stock-still though areas are more susceptible to certain natural disasters, such as earthquakes along a fault line or tornados in the South, they still strike with little or no warning. This throws the health cares schedule out of the ordinary routine. The facility may not be tout ensemble prepared for what comes next. destiny preparedness plans improve the chances that the organization leave be able to respond effectively in the event of a natural disaster, whatever said and make it is never a guarantee that when and what order a calamity occurs. Specialty Treatment Availability * Some disasters are not common like the storms, earthquakes and tsunamis. Epidemic outbreaks of infectious disease are something which needs utmost care to stop them from spreading to the others. It is not just to take care of emergency relief but also to quickly and efficiently harbor the rest of the population.It is more challenging when on that point is no e xisting vaccine or known treatment. At this instance the role of health care organizations becomes even more important. These organizations essential work to treat the patients and comfort themselves while labs attempt to figure out a way to stop the infection from spreading. Effects on the Population A populations vulnerability to all types of disasters depends on demographic growth, settlement in unsafe areas, environmental degradation, the pace of urbanization, unplanned development and climate change. Poverty thrives due to lack of addition to healthy and safe environment.Poor education and awareness also poises risk to population. The effects of disaster on population can be broadly categorized into 1. Immediate Health Impact 2. Long-Term Impacts These are explained at a lower place Immediate Health Impact Short-term losses fall under three categories that have both direct and indirect effects I. Disability, Illness, and Death II. Direct losses in infrastructure and III. Lo ss or disruption in health care delivery. Long-Term Impacts It is primarily a matter of building institutional ability and human resources, and includes I.Identifying vulnerability to natural hazards or other calamities II. Building simple solutions for such particular in the future III. Initiating a changedevelopment among the main factors to develop a basic plan that outlines the responsibilities of each factor in the health sector, identifying possible overlaps or gaps and building a consensus to create an effective healthcare placement IV. Maintaining close collaboration with these main factors and V. Educating the first health responders and managers to face the special challenges of responding to disasters.Steps in Disaster Management * Mitigation To understate the effects of disaster. Examples Zoning Vulnerability analyses Public education. * Preparedness Planning how to respond. Examples Preparedness plans Emergency exercises/training Warning systems. * Response Effor ts in minimizing the hazards created by a disaster. Examples Search and rescue Emergency relief, conclusion alternative sources for relief. * Recovery Restore the community or organization to business as usual. Examples Temporary lodgment Grants Medical care. Mitigation Preparedness Response RecoveryFig Phases of Disaster Management Mitigation Mitigation is to strike down the devotion of a risk. Mitigation activity decreases the probably of the same disaster reoccurring. It includes vulnerability analyses updates zoning and land use management building use regulations and safety codes preventive health care and public education. Preparedness Preparedness is to have the health care crew on toes during an emergency situation. It is to achieve a level of deftness to handle any emergency situations. Preparedness can take form of education of rescue elief during emergencies.This may include rehearsals as well. besides it helps to ensure an optimum reserve of medicine, food, water, equipments and other essentials maintained for emergencies. Like moderateness activities, preparedness actions also depend on the appropriate measures in national and regional development plans. Response Response is to react to emergency situations to maintain life, sustain injuries and pay the morale of the affected. It also includes providing transport, fugacious cling to and food for the affected. Charitable organizations often play a major role in this phase of the disaster management cycle.Recovery Recovery is to bring back the affected population to normal life. Recovery measures both niggling and long term, include restoring life with minimum operating standard, temporary shelter, reconstruction and economic impact studies . This full stop brings many opportunities to boost prevention, increase vigilance and thus reducing helplessness. Real Incident Study overbearing 2, 2011 Medical Response to Joplin Tornado May 22, 2011 Background A tornado warning was issued by the topic Weather Services on May 22, 2011 at 517 p. m. The tornado was rated an EF-5 with winds exceeding 200 mph.It traveled from west to east along 32nd street cutting a path ? to 1 mile wide over 13. 8 miles. The tornado eye was approximately 300 yards wide. Mercy St. Johns infirmary took a direct hit, initial and secondary, on the west facade with duration of approximately 45 seconds. There was a pause as the eye passed through and through with(predicate) the facility. * 160 deaths in the community resulted from this storm. * 8000 structures were destroyed. 400 businesses destroyed, * 8 school buildings destroyed, * 18,000 vehicles destroyed and * 4,500 jobs displaced. When St.Johns took the direct hit from the tornado initially the generators were destroyed, the roof was destroyed and most of which get in the parking lots and on top of other facility equipment. All communications was nowadays disjointed. The facility fire prohibition sprinklers discharged and lines were br oken. Several walls and floors were damaged. Doors were torn from their hinges, all of the glass was blown out of the building except the mettlesome impact shatter resistant glass in the psychiatric ward, bumble lines were broken, sewer lines were destroyed with raw sewage projected throughout the facility, and 86 medical offices were destroyed.The oxygen armored combat vehicle was severely damaged and discharged all of the liquid oxygen. There was a strong smell of natural gas throughout the building and all over the campus. Water discharged by the fire suppression system left the rooms and hallways with 3 to 6 inches of standing water. The air evacuation helicopter was destroyed. typically the helicopter would have been moved to a local airport however, the storm track did not predict impact to the hospital and there hold up conditions prevented safe flight. All infirmarys vehicles, except a John Deere tractor, were destroyed and the emergency trailer was found in pieces sever al blocks away.Everyone in the facility panic that they were going to die, nurses evacuated patients to the hallways per their procedures and at the time of impact nurses covered patients with their bodies to offer as much protection as possible. IVs were ripped from patients arms, the IV poles became projectiles, and several patients were bleeding as a result. The ceilings collapsed, electrical, IT, and HVAC equipment dropped and littered the hallways. All emergency lights and exit signs were ripped from their mounts and were useless. Both incident command centers were destroyed and Emergency Operations Plans (EOP) lost in the debris.The facility was filled with hazardous waste and the radioactive material was unsecured. Outside debris was mixed and power lines were down. advert If the tornado had moved just two blocks south Freeman would also have been destroyed. Freeman did suffer some animal(prenominal) damage that resulted in internal evacuation of at to the lowest degree 6 patient rooms. Immediate Response Considerations There were many immediate considerations that had to be made. If the generators were started, then there was an extremely high probability of electrocution and possible explosion from natural gas.Various ways for communication should be arranged. Communications is not yet interoperable. Security forces and public safety could not communicate with each other due to edition is radio systems. Ambulance radios became the communication infrastructure during the initial response. Staff management is vital. Sufficient lag should be available for relief. Drug dispensing machines are useless in this type of a disaster. Staff had to break into the machines to gain recover to life saving drugs. ID badges need to be backed up with wallet identification cards for employees.Several round members lost their homes and automobiles and the badges went with them in many cases. National Guard troops ref apply to allow staff into the area because of n o identification. Pharmacies need to be guarded with armed shelter system. Have strong security so that people wont run away with cars they do not own. The hospital needs access to several public utility company terrain vehicles (UTV) for equipment and patient transport. Same uniform, common identification and common radio frequencies are required for the security team up for easy identity. Remember that even the staffs require food, water and rest.Evacuation Within a few hours St. Johns evacuated 183 patients, completed one surgical case while the storm was in progress, had 1 patient in the PACU, 24 ED patients and 28 critical care patients were among the evacuees. Evacuation was a tough job. This rescue team used what is depict as the reverse START process found in our evacuation plan. The team discharged most of the patients they could. Some had no home to go to and opted to stay in the health care system as long as possible. Patient tracking was a nightmare. It took about 4 days to positively come on all of the evacuated patients.Many were sent to hospitals a great distance from St. Johns. The usage of heliport was not practicable and two temporary heliports were constructed in the parking lot. Anything that could be used to move a patient was used. Hospital evacuation sleds, mattresses, doors, wheelchairs, and mattresses were used to move patients down 9 flights of stairs that were dark and littered with debris. The Hospital had three predetermined hookup points (muster stations) to evacuate to. This helped them to identify the patients and giving accountability for staff. Special Immediate ConcernsStaffs and physician homes were looted while they were stressful to save other. There were attempts to loot property and drugs from the hospital and physicians offices. Hospitals need deployable incident command centers rather than fixed. Intra-operation communications was an immediate and continuing concern. Security forces could not be identified since they came in variety of uniforms. There was no common identification and no common radio frequency. Hospitals need the ability to install at to the lowest degree a 6 steel chain link fence around the perimeter as in brief as possible following the initial event.Know your staff was personally affected by the storm, many lost family members and homes. Many were not prepared to see the level of trauma and had difficulty dealing with the reality of this event. well-nigh all required debriefing and employee support services. Special equipments are required for immediate rescue. Know whom your local, state, and federal response partners are and have an established relationship with them prior to any event. In an event of this magnitude, if you try to survive in your facility you cannot do it. You will need to evacuate the facility as presently as safe to do so.Everyone should be included during the planning process. It is important to acknowledge that although a habituated natural di saster may last for only a short period survivors can be involved with the disaster aftermath for months or even years. Recovery Process The first step is security of the facility and campus. The next morning after the event the mass evacuation was complete and the facility was cleared. As stated earlier, contracted security forces need to be in the same uniform and on the same radio frequencies as the Hospital security forces so that the recovery process goes smooth.Arrangement for vehicles and fuel should be done and agreements must be in place to have them delivered from locations outside the affected area. The types of vehicles needed should be predetermined. The delivery mechanism should be established very effectively to even work without any phone service. inhabit operations became the first means of providing medical services followed by portable facilities. Facility Considerations During Disasters even emergency power outlets may not operate. Assuming you can use a power g enerator, consider the following facilities * Cameras intended for security purpose should be on power generator. Lighting on emergency power needs to be evaluated. * Exit signs, stairs should be marked with photo light tape or paint. * Knowledge on how to shut down utilities and medical gases quickly and establish a protocol for this procedure. * Proper lightning should be maintained in parking lots and facility areas during recovery phase. * The facility should be considered unstable until cleared by structural engineers. * Secure wiring, HVAC components, piping and light fixtures correctly preceding(prenominal) ceilings. * Plan for rapid deployment and connection trailer mounted equipment, portable buildings, and portable equipment. Debris removal is prolonged and complex. Lessons Learned at This Point in Response/Recovery * Intra department communication is a must. If the Hospital and response partners are not on common frequencies then effective communication will not be pos sible. * Purchase solar charging stations for cellular phones and radio batteries. * Social networks or texting services may not be available during disaster. Effective alternative ways to communicate should be taught to the staffs. * Telephone landlines and support from IT are vital. Electronic Medical Records were essential to the continuum of patient care and for identification of practitioners who were in the facility at the time of impact. * Know that your reserve supplies will be inadequate or may be lost. A 96 hour cache of supplies may last as few as 4 hours because of the out of the blue(predicate) demand. * If the generators operated the potential exists for several deaths by electrocution or explosion. * Stairwell sack will be lost. JCMH egress lighting is all generator fed with no battery emergency lighting. * Manage staff and provide staff support, including mental health services.This will help them in taking quick decision. * Security of the building is critical. Yo u have to protect your resources. * Badges will be lost during this type of event. Have wallet identification cards for your staff. Takeaways from this incident * What you practice is what you do. * Knowledge of response partners, local, state, and federal. * Rehearsals with your community partners for rescue related activities. * Add patient slippers/shoes to your weather plan. Have on bed during Code Grey Level I. * Warehousing emergency supplies and to make it easily accessible even without transport facility. Have emergency kits throughout the facility with pens, pencils, paper, and medical record forms. Also include gloves, masks, flashlights, and batteries. * Develop a common triage tag and process. It is best to have a standard triage system. voice and follow it with all of the hospitals in your region. * You need to develop a rapid response team for security and a component of the security team will need to be armed. * Staff adequately during such events. * Efficient disbur sement of supplies (Medicines, food etc) among staff for patient care and personal use. Consider staff physical and psychological needs shift relief, food, rest, and debriefing. * Many storms usually have a follow- up storm and to be ready to minimize damage caused to structure and building (eg Glass debris)during such events.. * The Joint Commission will arrive on site to assist with reestablishment of services and they proved to be a valuable resource. * test Scrub Racks with many sizes of scrubs to keep staff in suitable clothing. Conclusion Natural disasters are crisis situations. However, with planning, costly and ineffective interventions can be avoided.Improvisation and rush inevitably come with a high price, and there are many things health officials ought to avoid preferential use of expatriate health professionals emergency procurance and airlifting of food, water, and supplies that often are available locally or that remain in storage for long periods of time the tende ncy to adopt dramatic measures all contribute to making disaster relief one of the least cost effective health activities. . The occurrence of a major disaster can be the initial catalyst that helps health authorities recognize that disasters are a public health risk that must be addressed in an organized manner.Yet, preparedness cannot wait. A continual effort is needed to reduce possibility, by decreasing weakness through elimination and minimization and by increasing potential through ability methods. There needs to be a continuum between normal development, preparedness, and disaster response activities. Disasters are not likely to decrease in the foreseeable future. A sustained effort is needed to minimize risk, by reducing vulnerability through prevention and mitigation and by increasing capacity through preparedness measures.Disasters need to be addressed on a long-term and institutionalized basis through an established ministry of health program or department for prevention, mitigation, preparedness, and response for all types of disasters. References * Environmental health in emergencies and disasters A practical guide. WHO, 2002. * Disaster Help, US Department of Homeland Security. * Green Paper on Disaster Management, Department of Provincial and Local Government, South Africa * http//www. ehow. com/list_6847852_effects-disasters-health-care-organizations. tmlixzz1epfIqgRL * Guide to Emergency Management Planning in Health CareBy Joint Commission Resources, Inc * http//www. scsrc. org/wp-content/uploads/2011/08/Joplin_Tornado_Trip_Report. pdf * http//www. himss. org/content/files/ambulatorydocs/BridgeheadWhitePaper_HealthcareDisasterRecovery. pdf * http//www. healthcaredisasterplanning. org/ * http//www. sans. org/reading_room/whitepapers/hipaa/disaster-recovery-healthcare-organizations-impact-hipaa-security_1336 * http//pandemic. wisconsin. gov/docview. asp? docid=14447 * http//www. dcp2. org/file/121/