Types of disaster and medical care
Natural disasters: earthquake, tsunami, flood, cyclone, landslide, heat wave. Human-made disasters: large fire, building collapse, transport accident, chemical or radiation leak, conflict. Each causes different injuries: earthquakes cause crush injuries, floods cause drowning and infections, fires cause burns and smoke harm.
Disaster medical care is organised: rescue at the site, a first-aid post, transport to hospitals, and hospitals that expand their beds. Teams include doctors, nurses, paramedics and volunteers working under one command system.
Features of disaster nursing
Normal nursing aims to give the best care to each patient. In a disaster, resources are too few, so the aim becomes the greatest good for the greatest number. Features: quick decisions, triage, working with little equipment, teamwork across agencies, and care for stressed survivors and for the helpers themselves.
Triage colours: Red (immediate, life-threatening but treatable), Yellow (urgent, can wait a short time), Green (minor injuries, can walk), Black (dead or cannot be saved with the resources). Patients are re-checked because their state can change. Nurses also keep records so families can be found and care continues.
Nursing in each disaster phase
Preparedness (calm period): learn risks, practise drills, store supplies, teach the community, plan for people who need extra help (old people, babies, disabled people).
Acute phase (hours to about 3 days): rescue, triage, treat life threats, stop bleeding, keep warm, find people.
Sub-acute phase (days to weeks): shelter health, clean water and toilets, stop infections, give medicines for long illnesses, prevent blood clots from sitting still, watch for stress.
Recovery (chronic) phase (weeks to years): support life rebuilding, long-term mental care, prevent loneliness, restart usual health services. Each phase then feeds back into preparedness for the next event.
Key formulas and definitions
- Aim: greatest good for the greatest number
- Triage colours: Red = immediate, Yellow = urgent, Green = minor, Black = expectant or dead
- Phases: preparedness, acute, sub-acute, recovery
- Re-triage: check again as the patient changes
Worked examples
1. A building collapses. A man is trapped with heavy bleeding but conscious, a woman has a small cut and is walking, a child is not breathing and has no heartbeat for long. Give triage colours.
Man with heavy bleeding: Red (life threat but treatable). Woman with small cut: Green. Child not breathing with no heartbeat in a mass event with few resources: Black, though teams re-check and follow local rules.
2. Which phase: the shelter has 200 people, many with diarrhoea, and old people ran out of blood pressure tablets.
Sub-acute phase. Nurses focus on clean water, toilets, infection control and medicines for long illnesses.
3. Name three things a school should do in the preparedness phase.
Hold drills, mark safe exits and the assembly point, keep a first-aid kit and a contact list, and teach students what to do.
Common mistakes
- Treating the loudest patient first. Triage is by need, not by noise.
- Thinking disaster care ends after the first week.
- Forgetting stress care and old people with long illnesses.
- Not re-checking triage colours as patients change.