National Center for Disaster

frizzflowerΠολεοδομικά Έργα

29 Νοε 2013 (πριν από 3 χρόνια και 7 μήνες)

57 εμφανίσεις


National Center for Disaster
Medical Response Webinar

March 29, 2011

The University of South Alabama

National Center for Disaster Medical Response


© University of South Alabama National Center for Disaster Medical Response. All Rights Reserved.

These slides are a part of the NCDMR program and cannot be reproduced for commercial purposes.


Presenters

Surge Capability in Complex Disasters


Carl Taylor, JD

Assistant Dean, USA College of Medicine

Director, USA Center for Strategic Health Innovation

Mobile, Alabama

Introduction to Radiological Agents


Craig Llewellyn, MD, MPH

Colonel, U.S. Army (Retired)

Center for Disaster and Humanitarian Assistance Medicine

Bethesda, Maryland

Meeting Mental Health Needs During and After Disasters


Carolyn Ross, RN, MSN, COHN
-
S

Assistant Director, Preparedness Training

USA Center for Strategic Health Innovation

Mobile, Alabama

Building Resiliency:


Meeting Mental Health Needs

During and After Disaster Events

The University of South Alabama

National Center for Disaster Medical Response


© University of South Alabama National Center for Disaster Medical Response. All Rights Reserved.

These slides are a part of the NCDMR program and cannot be reproduced for commercial purposes.


Introduction








Every affected individual will react and cope
with disaster and traumatic events with varying
skills and strengths based on their life experiences,
values, beliefs, cultural viewpoints, socio
-
economic
status and intellectual capability.


Normal and Abnormal
Stress Reactions


‘Fight or Flight’ response
is a physiological
response which ensures
safety and survival
during extreme events:


When stress reaction is
prevalent for a long
period of time or if it is
unresolved damage the
physical and mental
health of individuals.

Positive Stress



Negative Stress

Significant Traumatic
Events


Natural Disasters



Terrorism Events



Violent Events (such as war or civil unrest)



Small or large scale personal trauma, loss or
emergency



Any type of disaster or traumatic event which can
cause fear, trauma or loss


Disaster Phases and
Response


Warning and threat


Impact


Rescue or heroic


Remedy or honeymoon


Inventory


Disillusionment


Reconstruction and Recovery

Building Psychological
Resiliency During and After
Disasters

Mental health education and interventions will
be
necessary

for the following targeted groups:



Population of Affected Community



Responders


In
-
situ (hospital personnel, emergency responders)


Deployed disaster and emergency responders

Key Concepts of Disaster
Mental Health

Everyone who experiences
a disaster will be touched
by it!

There are 2 types of
disasters: individual
and community

People generally will
pull together during
and after a disaster

Stress and grief in
disasters are
normal reactions
to abnormal
situations

Most people
feel they do
not need
mental health
services

Survivors
respond to
active genuine
interest and
concern

Use an active
outreach approach
instead of
traditional methods

Social Support
systems are crucial
to recovery!

Disaster
Trauma Event

Signs and Symptoms of Short
and Long Term Reactions to
Stress/Trauma

Symptoms of Short Term Negative
Stress


Inability to concentrate


Changes in eating and sleeping habits


Tension headaches, lower backaches,
stomach aches, and other physical
ailments

Common Symptoms Short &
Chronic Term



Feeling depressed, helpless, sad and
lethargic


Memory problems


Fatigue


Feeling angry, irritable, lashing out
at others


Symptoms of PTSD/Chronic Stress



Nightmares related to event


Sleep disturbances


Changes in appetite


Situational anxiety and fear


Being on ‘edge’ or easily startled or being
‘over alert’


Inability to focus on work or daily activities


Difficulty in making decisions


Symptoms of PTSD/Chronic Stress



Feeling emotionally numb, withdrawn,
disconnected or different from others


Spontaneously crying, feeling a sense
of despair and hopelessness


Feeling extremely protective or fearful
for the safety of loved ones


Not being able to face certain aspects of
the trauma and avoiding activities,
places or even people that remind you of
the events

Interventions


Individuals/Responders


CISD (Critical Incident Stress
Debriefing)



Adequate rest, nutrition and
exercise



Return to normal routines



Focus on pleasant memories
and use relaxation techniques



Participate in a support group
or seek counseling



Keep a journal



Community


Recognize importance of culture and
respect diversity



Recruit disaster workers, community
leaders and organizations who are
representative of community



Ensure that services are accessible,
appropriate and equitable



Recognize cultural patterns that may
influence help seeking behaviors



Ensure that services and information
are cultural and linguistically
competent

Conclusion


Immediate Interventions and Preventive
Planning are key to successful interventions!



Develop Stress Management programs to
implement in order to effectively manage
stress!


Questions?

Introduction to Radiological
Agent Awareness



The University of South Alabama

National Center for Disaster Medical Response


© University of South Alabama National Center for Disaster Medical Response. All Rights Reserved.

These slides are a part of the NCDMR program and cannot be reproduced for commercial purposes.


Toxicity Basics:

Chemical or Radiological
Substances


Specific health effect characteristics of agent/chemical (localized versus
systemic)



Mode of entry (skin, lungs, eyes, GI tract)



Dose (how much, what concentration)



Duration of Exposure (how long)



Stress (anything that increases the heart rate can increase systemic absorption)



Personal physical condition (sick, anemic, impaired skin integrity,
drug/alcohol consumption)



Worldwide Nuclear

Conflict

Isolated Nuclear

Conflict

Single Detonation

Accident

Terrorists

Radiological Event:

The
higher the probability for an
incident, the lower the expected #’s
of casualties
.


Most Probable Incident Types:


Radiological:


-

Industry, medicine, research, teaching


or agriculture


-

Radioactive material or devices


generating ionizing radiation


Nuclear accidents:


-

nuclear facilities


Comparison of Radiation
Categories

Alpha


Beta

-
)

or


Gamma



Two protons

and two


neutrons bound together



se特rh楧h energy ve汳,


h楧h汹l楯n楺楮g



P牯瑥t瑩on 睩瑨


pT䅎䑁o䐠PPE


-

low penetration


(paper & cloth


adequate barriers)


-

short travel distance
-



centimeters (heavy)



Hazards: ingestion or


inhalation


-

deposits in organs


-

immediate damage


and ongoing chronic


exposure risk



Single electrons or positrons



䡩eh energyⰠh楧h 獰eed



pPEC䥁I PPE⁲敱 楲ed


-

T牡re氠d楳瑡湣t


10
-
15 feet


lighter weight


-

Penetrates skin
-

metal,


plastic, glass are adequate


barriers



Hazards: Contact, inhalation,


ingestion


-

Skin and eyes
-

burning w/


high levels


-

Deposits in organs
-



kidneys, liver, lungs, bone


-

Immediate and chronic


exposure risk



Electromagnetic radiation



(pass through)



sa特楮g⁥nergy ve汳

and


獰eed



Standard/Special PPE


provides NO protection


-

high penetration, travels


long distances


-

Time/Distance/


Shielding until gamma


rays pass
-

concrete,


steel dense barriers,


lead



Hazard: ionizing


penetrating rays


-

Immediate damage,


ends when rays pass


Radiological Event

PPE, Contamination Patterns
and Decontamination

Personal Protective

Equipment


Radiological

Contamination


Internal/External

Decontamination


Particulate Radiation Exposure


Contact, Inhalation, Ingestion
Risk


A high efficiency particulate
air (HEPA) filter


Standard universal
precautions clothing or
chemical suits (gown/suit,
gloves, goggles)


Electromagnetic Radiation
Exposure


No PPE needed after gamma
rays pass


To determine
radiation exposures
check individuals with a Geiger
Counter or other reputable
radiation measurement devices:



-

Before disrobement and


decontamination


-

After decontamination




Note: Decontamination is
95%


effective in contaminant


removal




t整 灡t楥湴 摯睮 t漠o敤畣攠


airborne particles




Remove clothing…
even


underwear!!




䑯 no琠牥ro癥 捬o瑨ing o癥爠


h敡d!




F汵獨⁷楴h

large
amounts of water



(
Soap and water to remove from


skin and hair.)



䵥慳畲M 牥獩r畡氠牡摩慴楯n

睩t栠a


G敩来爠䍯畮t敲




-
摲敳d


Patterns of Radiological
Contamination

Internal

External

Suspect

Internal Radiation:


-

If Geiger Counter readings are the


same on the front and back of person


after decontamination


-

If swab from nasal
turbinates

is


positive for radioactivity


*** Observe

closely for systemic effects of
radiation syndrome


Suspect External Radiation Only:


-

If Geiger counter shows no activity


after person has disrobed and been


decontaminated


-

If Geiger Counter registers positive
only


on front
OR

back of body (One side of


the body)


Important: Geiger Counter should be used to measure for radioactivity:


Scan body


front and back in systematic way


Before decontamination


After decontamination

Acute Radiation Syndrome

< 1
Gy

(100 RAD)
Survival Fairly Certain
No Treatment
Necessary

1
-
2.5
Gy

(100
-
250 RAD)
Survival Probable Treatment
for Infections, Fluids, Blood
System PRN

2.5
-

5
Gy

(250
-

500 RAD)
Survival Possible Treatment
for Infections, Fluids, Blood
System is Necessary

> 5
Gy

(500 RAD)
Survival Unlikely
Supportive Care with
Fluids and Electrolytes

0 RAD

> 500 RAD

Increasing Dose

Radiation Symptoms


Hematopoietic Disorders



Anemia


Bleeding


Infections


Delayed healing



Gastrointestinal Symptoms


Nausea/Vomiting **


Diarrhea


Mouth / Throat Sores


↓ Appetite & Weight Loss



Neurovascular Symptoms


Burning sensations


Poor balance


Confusion




Cutaneous Tissue Symptoms


Burns, blistering


Skin sloughing


Hair Loss


Sources: Environmental Protection Agency, Nuclear Regulatory Commission,: U.N. Scientific Committee on the Effects of Atomic

Ra
diation:
Canadian Nuclear Association.

New York Times , March 27, 2011

Health Effects from
High Radiation
Exposure

Questions?

Surge Capability In Complex Disasters

The University of South Alabama

National Center for Disaster Medical Response


© University of South Alabama National Center for Disaster Medical Response. All Rights Reserved.

These slides are a part of the NCDMR program and cannot be reproduced for commercial purposes.


What is Surge
Capacity?


The ability of a healthcare system to rapidly
expand beyond normal services to meet sudden or
sustained increased demand for medical care.






Surge Capacity vs.
Capability

Surge Capacity:



The ability to evaluate and care for a markedly
increased volume of patients
-

one that challenges or
exceeds normal operating capacity.

Surge Capability:


The ability to manage patients requiring unusual or very
specialized medical evaluation and care, e.g., infectious
disease or burn patients.


Key Principle



We
will work to maximize lives saved,
which must include our staff and our
patients


Planning For A Surge


Surge conditions may last for months
not just days


Your other patients have needs also


The usual scope of practice may not
apply


External events will impact internal
response

Planning Continued


The time of day or month may matter


Communication both internal and external
may be challenged


Staff challenges will create the need for
flexibility both during and after the event

Planning Continued


Some staff may not be yours


Supplies and supply chain disruption may
occur


Transportation and Fuel issues are
problematic


Alternate facilities and COOP planning a
new challenge

Planning Final


Leadership at every level will matter


Security of staff, patients and facility is
paramount


Cash and Financial Management may be
more damaging to the facility than wind
and water


There is no one size fits all response
-

the
nature of the event matters

Important Issues


Do we know our communities health?


Can we communicate with public health
and disaster leadership?


Who is making the decisions during a
disaster (and can we count on them)?


When we need help where does it come
from and do we know how to access it?


Resource and Contact
Information


National Center for Disaster Medical Response
Website:





www.ncdmr.org/




Contact Information:


Carl Taylor

email:
cwtaylor1@gmail.com


Carolyn Ross

email:
carolynross@usouthal.edu






Questions?