❤️‍🩹First Aid Unit 19 – Disaster Preparedness and Triage

Key Concepts in Disaster Preparedness

• Disaster preparedness involves planning, training, and equipping individuals and communities to effectively respond to and recover from various types of disasters
• Includes developing comprehensive emergency response plans that outline roles, responsibilities, and procedures for different disaster scenarios
• Emphasizes the importance of risk assessment and mitigation strategies to reduce the potential impact of disasters on communities
• Focuses on building resilience through education, awareness, and capacity building initiatives that empower individuals and organizations to cope with and adapt to adversity
• Stresses the need for effective communication, coordination, and collaboration among various stakeholders (government agencies, non-governmental organizations, and the private sector) to ensure a cohesive and efficient response
• Recognizes the importance of regularly reviewing, updating, and practicing disaster preparedness plans to maintain readiness and incorporate lessons learned from previous incidents
• Addresses the unique needs and vulnerabilities of different populations (children, elderly, individuals with disabilities) in disaster preparedness planning to ensure inclusive and equitable protection

Types of Disasters and Their Impacts

• Natural disasters include earthquakes, hurricanes, floods, wildfires, and tsunamis, which can cause widespread destruction, loss of life, and displacement
• Technological disasters involve industrial accidents, chemical spills, and nuclear incidents, often resulting in environmental contamination and public health risks
• Biological disasters encompass outbreaks of infectious diseases, pandemics, and bioterrorism, posing significant challenges to healthcare systems and requiring specialized response measures
• Societal disasters, such as civil unrest, terrorism, and mass shootings, can lead to physical and psychological trauma, social disruption, and economic instability
• Cascading disasters occur when the impact of one disaster triggers or exacerbates another, creating complex and compounding effects that strain response capabilities
• The severity and scale of disaster impacts depend on factors such as population density, infrastructure vulnerability, and the effectiveness of preparedness and mitigation measures
• Disasters can have long-lasting consequences on affected communities, including:
  • Physical damage to homes, businesses, and critical infrastructure
  • Disruption of essential services (healthcare, education, transportation)
  • Economic losses and livelihood disruption
  • Mental health issues (post-traumatic stress disorder, anxiety, depression)
  • Social and cultural upheaval

Disaster Response Planning

• Disaster response planning is a proactive approach to organizing and coordinating actions taken before, during, and after a disaster to minimize its impact and facilitate recovery
• Involves conducting a thorough risk assessment to identify potential hazards, vulnerabilities, and capacities specific to a community or organization
• Develops a comprehensive emergency operations plan (EOP) that outlines roles, responsibilities, and procedures for various disaster scenarios
• Establishes a clear chain of command and communication protocols to ensure effective coordination and information sharing among response teams and stakeholders
• Identifies and secures necessary resources (personnel, equipment, supplies) to support response efforts and meet the needs of affected populations
• Includes provisions for evacuation, sheltering, and mass care to ensure the safety and well-being of individuals during and after a disaster
• Incorporates strategies for rapid damage assessment, search and rescue, and medical response to prioritize and allocate resources effectively
• Emphasizes the importance of regular training, drills, and exercises to test and refine response plans, build capacity, and foster collaboration among response teams

Triage Basics and Principles

• Triage is the process of quickly assessing and prioritizing patients based on the severity of their condition and the available resources in a disaster or mass casualty incident
• The primary goal of triage is to maximize the number of survivors by allocating limited resources to patients who have the greatest chance of benefiting from immediate medical intervention
• Triage is guided by the principles of doing the greatest good for the greatest number, providing the most efficient use of resources, and minimizing preventable deaths
• The triage process involves a rapid assessment of each patient's airway, breathing, circulation, and level of consciousness to determine their initial triage category
• Patients are typically assigned to one of four triage categories:
  • Immediate (red): Life-threatening injuries requiring immediate intervention
  • Delayed (yellow): Serious injuries that can wait for treatment without risk of death
  • Minimal (green): Minor injuries that can be treated later or by self-care
  • Expectant (black): Patients who are unlikely to survive due to the severity of their injuries or the lack of available resources
• Triage is a dynamic process that requires continuous reassessment and adjustment as patient conditions change and resources become available

Triage Systems and Methods

• Various triage systems and methods have been developed to standardize the process and improve the accuracy and efficiency of patient prioritization in disaster settings
• The Simple Triage and Rapid Treatment (START) system is a widely used method that assesses patients based on their ability to walk, respiratory rate, and perfusion
• The JumpSTART pediatric triage system is an adaptation of START that accounts for the unique physiological characteristics and needs of children
• The Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT) triage system is a more comprehensive approach that incorporates lifesaving interventions and patient reassessment into the triage process
• Triage tags or colored ribbons are often used to visually identify a patient's assigned triage category and facilitate their movement through the treatment and transport process
• Electronic triage systems and mobile apps have been developed to improve the speed, accuracy, and documentation of triage decisions in the field
• Mass casualty incident (MCI) triage algorithms and decision-support tools assist responders in making consistent and evidence-based triage decisions under high-stress conditions

On-Scene Assessment and Action

• On-scene assessment is the process of rapidly evaluating the scope, severity, and resource needs of a disaster or mass casualty incident to guide response efforts
• Involves establishing scene safety and security to protect responders and prevent further harm to patients or bystanders
• Conducts a rapid size-up of the incident to determine the number and types of casualties, the extent of damage, and the presence of hazards (chemical, biological, radiological)
• Establishes a command structure and assigns roles and responsibilities to response personnel based on their training and expertise
• Sets up a triage area and treatment stations to facilitate the efficient flow of patients through the care continuum
• Initiates patient triage using a standardized system or method to prioritize care and allocate resources based on clinical need
• Provides lifesaving interventions (airway management, hemorrhage control, decontamination) to stabilize patients and prevent further deterioration
• Arranges for the transport of patients to appropriate healthcare facilities based on their triage category and the availability of resources
• Documents patient care, triage decisions, and resource utilization to support continuity of care and post-incident analysis

Resource Management in Disasters

• Resource management is the process of identifying, acquiring, allocating, and tracking the personnel, equipment, supplies, and facilities needed to effectively respond to a disaster
• Involves conducting a pre-incident inventory of available resources and identifying gaps or shortfalls that need to be addressed through mutual aid agreements, stockpiling, or procurement
• Establishes a resource requesting and allocation process to ensure that critical resources are distributed equitably and efficiently based on the needs of the incident and the priorities of the response plan
• Implements a resource tracking system to monitor the location, status, and utilization of personnel, equipment, and supplies throughout the response
• Coordinates the deployment of specialized resources (search and rescue teams, medical strike teams, decontamination units) to support specific operational needs
• Manages the logistics of resource transportation, staging, and distribution to ensure that resources are available when and where they are needed
• Addresses the needs of response personnel (food, water, shelter, rest) to maintain their health, safety, and operational effectiveness during extended deployments
• Develops demobilization plans to ensure the orderly and efficient return of resources to their original location or status when no longer needed

Post-Disaster Recovery and Evaluation

• Post-disaster recovery is the process of restoring and rebuilding communities affected by a disaster to a state of normalcy and resilience
• Involves conducting a comprehensive damage assessment to determine the extent of physical, economic, and social impacts and prioritize recovery efforts
• Develops a recovery plan that outlines short-term and long-term goals, strategies, and resources needed to support the restoration of housing, infrastructure, and essential services
• Coordinates the provision of financial assistance, case management, and social services to help individuals and families recover from the disaster and meet their basic needs
• Implements mitigation measures (building codes, land-use planning, early warning systems) to reduce the risk and impact of future disasters on the community
• Engages in community-driven planning and decision-making processes to ensure that recovery efforts are inclusive, equitable, and responsive to the needs and priorities of affected populations
• Conducts after-action reviews and evaluations to assess the effectiveness of response and recovery efforts, identify lessons learned, and make recommendations for improvement
• Incorporates lessons learned into future disaster preparedness and response plans to enhance organizational learning and resilience