Disaster Preparedness Update
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Transcript Disaster Preparedness Update
National Association of Perinatal Social Workers
CEU Module #1
Lisa Baker, Ph.D., L.C.S.W.
Department of Social Work
University of Alabama at Birmingham
[email protected]
Objectives
What is a disaster?
Effects on families
Disasters and children
Preparedness Recommendations
Preparing families with infants
What is a Disaster?
An event that exceeds the capabilities of the response –
need exceeds resources
Loss of life, property and livelihood
Alters lives of individuals, families and communities
Creates hazardous conditions that exceed ability to
endure and succeed
Types of disasters
Natural
Tornados
Hurricanes
Earthquakes
Floods
Tsunamis
Landslides
Wildfires
Volcanic explosions
Pandemic Flu
Man-made
Bombings
Arson
Mass shootings
Terrorism
Nuclear emergencies
Chemical emergencies
Mass food & water
contamination
All-hazards Approach
All-hazards
Collection of man-made & natural events that have the
capacity to cause multiple casualties
All-hazards Preparedness
Comprehensive preparedness required to manage the
casualties resulting from all possible hazards
Potential impacts of disaster
Immediate needs
Communication/information
Water, food, shelter
Access to resources
Transportation
Electricity/power/gas
Health Care
Acute issues/ injuries
Exacerbation of chronic
illness
Long term needs
Rebuilding/relocating
Infrastructure
Financial/economic
Psychosocial
Health, well-being,
complicated loss issues
Mental health
Time frame of impact can range from hours/days to months/years
Psychosocial aspects
Mental Health Needs
PTSD, Depression, Anxiety
Substance abuse
Special concern about vulnerable populations
Elderly
Low income
Chronic health care and mental health needs
Children
C-MIST (Kailes & Enders)
Communication, Medical, Independence, Supervision, Transportation
Displaced persons after Katrina
Decrease in household income
Increase in mental health problems
Transportation issues
Including school and children’s health care
Children in disasters
Children
Major determinants affecting susceptibility
Degree of exposure to event
Parental response to event
Pre-existing Mental health illnesses
Age
Separation from parents
Mitigating factors
Early support & intervention
Return to normalcy, especially school
Key issues include
School readiness
Reunification
Perinatal Health
Evidence that disasters impact maternal mental health
and some perinatal health outcomes
Low birth weight
Preterm delivery
Maternal depression
Anxiety
Post traumatic stress
Children & Disasters
Special challenges
Dependent
Physically and emotionally
Non-communicative
Increased anxiety
More vulnerable to exposures
Especially biological, chemical and radiological/nuclear
agents
Unable to provide information in a crisis
Often separated from caregiver
Special health concerns of women
and infants
Disruption in clean water supply for drinking and bathing
Inadequate access to safe food
Exposure to environmental toxins
Crowded shelter conditions
Disruptions of public health and clinical care
infrastructure
Increase in psychosocial stressors
Callaghan, et. Al. (2007). Health concerns of women and infants in times of natural
disasters: Lessons learned from Hurricane Katrina. Maternal Child Health Journal, 11
Children with Healthcare Needs
20% of households
May include
Home Ventilator or other electrical device
Wheelchairs/equipment
Chronic daily meds
Parents not always able to provide correct information
47% of caregivers bringing child to specialty care clinic were unable
to provide correct diagnosis (in non-crisis situation)
29% were unable to provide correct medication list
Carracio et. Al (1998)
Children with Special Healthcare Needs
Present a challenge to EMS, non-
children’s hospitals
Can place undue burden on
medical needs shelters
Med refill – most common
request in shelters
Loss of power in home
Basic supplies
Current level of preparedness
Campaigns primarily mass media – education based
3 Steps
Be informed
Have a plan
Have a kit
Less than 1/3 public has basic emergency plan
Nat’l Ctr. Of Disaster Preparedness at Columbia Univ.
Majority of Americans are unprepared for a major disaster
Citizen Preparedness Survey Database Report (Dept. Homeland
Security, 2007)
Growing research base on level of preparedness
Reasons why people are not
prepared
Lack of resources
Incomplete knowledge about what to do
Competing priorities
Especially with complicated care
Impediments
Barriers
Lack of Transportation
Caring for Pets
Life
How do the spare flashlight batteries end up in the Game
boy?
Steps to Personal Preparedness
(Red Cross, FEMA, AAP)
Most common recommendations
Get informed
Make a Plan
Assemble a Kit
Maintain the Plan
3-day rule
Get Informed
1.
Community Hazards
2.
Community disaster plans
3.
Hurricanes
Tornados
wildfires
Response plans
evacuation plans
shelters
Community warning systems
Make a Plan
Meet with family members
Choose “out-of-town” contact
Designate a meeting place
Complete a Family Communication Plan
Plan escape routes
Plan for those with special needs
Emergency Information Form for Children with Special
Needs
Plan for pets
Prepare for different disasters
Especially critical when dealing with children
Assemble a Kit
General Kit
Water & food
First aid supplies
Medications
Radio
Small tools
Clothing
Personal items
Copies of ID and important
papers
Insurance, passports, driver’s
license
Money
Store in large. waterproof
container
Children
Age-related supplies
Diapers, wipes, bottles, powdered
formula
Activities
Coloring books, crayons
Extra “transition” objects
Blankets
Stuffed animals
Copies of Guardianship related
documents
Current photos of children
Emergency Information Form
for Children with Special Health
Care Needs
6 Key Elements for Every Disaster Plan
1.
2.
3.
4.
5.
6.
Designated shelters for pregnant women & families
Basic supplies & equipment for pregnancy women and infants
A plan to provide prenatal and well baby care
A plan to provide for access to safe environments for delivery
A plan to keep families together or reconnect families with
infants
Specialized educational materials
March of Dimes
Preparedness considerations for evacuated
pregnant women and infants
Ascertain pregnancy status as part of intake
Make pregnancy tests available
Consider contraceptive needs
Promote continuation of breastfeeding (more on this later!)
Recognize effects of exposures and provide information
Determine feasibility of establishing a pregnancy registry to track
outcomes
Equip DMAT and other response teams with capacity for managing
pregnant and lactating women and their infants
Callaghan, et. Al. (2007). Health concerns of women and infants in times of natural disasters: Lessons
learned from Hurricane Katrina. Maternal Child Health Journal, 11
Infant Feeding
post disaster
Breastfeeding
advantages
Milk is nutritionally perfect
(even in cases of maternal
malnourishment)
Readily available
Protective against infectious
diseases and respiratory
illnesses
Always correct temp – can
prevent hypothermia
Hormone release in mother
provides stress relief – calming
for mother and infant
Formula
Disadvantages
• May not be available
• May require brand switch
• Errors in prep may occur
• Water may be contaminated
• Limited or no method of
sterilization for bottles &
nipples
• Limited electricity to cold store
opened formula
American Academy of Pediatrics
Ways to support breastfeeding
mothers
Keep families together
Provide supportive environment
Assure mothers that human milk provides adequate
nutrition in absence of safe complementary foods
Encourage re-initiation of breastfeeding if previously
stopped
Recommend ready-to-feed formula if breastfeeding
not possible
Pregnant women and families with infants
Before a Disaster
Complete general preparedness guidelines
In addition:
Let healthcare provider know where you will be
List all prescriptions and prenatal vitamins
Take extras when available
Get copy of prenatal records
Give other providers contact numbers
Any special services or programs
During a Disaster
Bring any prescriptions when evacuating
Keep copy of prenatal records with you
Get out and walk every 1-2 hours if driving
Wear comfortable shoes
Pack snacks
Pack maternity clothes
Use car seats and helmets for infants and young
children
If evacuated
Keep informed
Try to eat throughout the day
Do not eat spoiled or questionable food
Listen to and follow public announcements
Drink bottled water or treated water
Recognize symptoms of labor
Take measures to reduce stress as much as possible
Post-disaster
Potential dangers
Flood water in streets and buildings
Could be contaminated
Avoid contact/ wash after contact
Toxic exposures
Contact health provider if concerned
Returning home
Bacteria and mold
Hard physical work
Electrical shocks
General safety issues
Care Providers
Provide support for mothers and families
Protect, Promote and Support
Protect families
Create safe zones where families can stay together
Promote breastfeeding
Support breastfeeding and alternative feeding
Provide lactation consultants
Private spaces
Provide multi-lingual materials
Take home message
Preparedness saves lives
Special considerations for pregnant women and
newborns
Research base is growing
Promote family-centered care during mass critical care
incidents
Medical setting is great for preparedness activities
Have the discussion
Recent Recommendations for Perinatal Populations:
Pregnant Women and Infants
American Academy of Pediatrics
March of Dimes
Academy of Breastfeeding Medicine
American College of Nurse-Midwives
Centers for Disease Control
American Red Cross
Be Prepared!!