Presentation on theme: "Disaster Preparedness Update"— Presentation transcript:
1Disaster Preparedness Update National Association of Perinatal Social WorkersCEU Module #1Lisa Baker, Ph.D., L.C.S.W.Department of Social WorkUniversity of Alabama at Birmingham
2Objectives What is a disaster? Effects on families Disasters and childrenPreparedness RecommendationsPreparing families with infants
3What is a Disaster?An event that exceeds the capabilities of the response – need exceeds resourcesLoss of life, property and livelihoodAlters lives of individuals, families and communitiesCreates hazardous conditions that exceed ability to endure and succeedIncreasing in both number and severity worldwide. Multifactorial – population growth with more people living on coastlines and hillsides, urbanization, environmental degradation, social unrest, increasingly complex technologies.
4Types of disasters Natural Man-made Tornados Hurricanes Earthquakes FloodsTsunamisLandslidesWildfiresVolcanic explosionsPandemic FluMan-madeBombingsArsonMass shootingsTerrorismNuclear emergenciesChemical emergenciesMass food & water contamination
5All-hazards Approach All-hazards All-hazards Preparedness Collection of man-made & natural events that have the capacity to cause multiple casualtiesAll-hazards PreparednessComprehensive preparedness required to manage the casualties resulting from all possible hazardsResponding Agencies need a management approach that can deal with whatever arises
6Potential impacts of disaster Immediate needsLong term needsCommunication/informationWater, food, shelterAccess to resourcesTransportationElectricity/power/gasHealth CareAcute issues/ injuriesExacerbation of chronic illnessRebuilding/relocatingInfrastructureFinancial/economicPsychosocialHealth, well-being, complicated loss issuesMental healthTime frame of impact can range from hours/days to months/years
7Psychosocial aspects Mental Health Needs PTSD, Depression, AnxietySubstance abuseSpecial concern about vulnerable populationsElderlyLow incomeChronic health care and mental health needsChildrenC-MIST (Kailes & Enders)Communication, Medical, Independence, Supervision, TransportationDisplaced persons after KatrinaDecrease in household incomeIncrease in mental health problemsTransportation issuesIncluding school and children’s health careInstitute of Medicine has issued recommendations regarding children mental health emergencies after a disaster: (10) MH and social services should be provided to children in disaster situations (2) Parents and children should be separated only when necessary, and methods for reuniting families should be designed into operational plans.
8Children in disasters Key issues include Children Mitigating factors Major determinants affecting susceptibilityDegree of exposure to eventParental response to eventPre-existing Mental health illnessesAgeSeparation from parentsMitigating factorsEarly support & interventionReturn to normalcy, especially schoolKey issues includeSchool readinessReunification
9Perinatal HealthEvidence that disasters impact maternal mental health and some perinatal health outcomesLow birth weightPreterm deliveryMaternal depressionAnxietyPost traumatic stress
10Children & Disasters Special challenges Dependent Non-communicative Physically and emotionallyNon-communicativeIncreased anxietyMore vulnerable to exposuresEspecially biological, chemical and radiological/nuclear agentsUnable to provide information in a crisisOften separated from caregiver
11Special health concerns of women and infants Disruption in clean water supply for drinking and bathingInadequate access to safe foodExposure to environmental toxinsCrowded shelter conditionsDisruptions of public health and clinical care infrastructureIncrease in psychosocial stressorsCallaghan, et. Al. (2007). Health concerns of women and infants in times of natural disasters: Lessons learned from Hurricane Katrina. Maternal Child Health Journal, 11
12Children with Healthcare Needs 20% of householdsMay includeHome Ventilator or other electrical deviceWheelchairs/equipmentChronic daily medsParents not always able to provide correct information47% 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 listCarracio et. Al (1998)
13Children with Special Healthcare Needs Present a challenge to EMS, non-children’s hospitalsCan place undue burden on medical needs sheltersMed refill – most common request in sheltersLoss of power in homeBasic suppliesVarying definitions on what constitutes Special Needs. At-risk individuals:Difficulty maintaining independenceDifficulty with communicationDifficulty with transportationSupervision required20 million SHCN children, 12 million if asthma is excluded.AAP – ACEP approved form.Case reports of children with home ventilators who had battery failure during transport after Hurricane Katrina.
14Current level of preparedness Campaigns primarily mass media – education based3 StepsBe informedHave a planHave a kitLess than 1/3 public has basic emergency planNat’l Ctr. Of Disaster Preparedness at Columbia Univ.Majority of Americans are unprepared for a major disasterCitizen Preparedness Survey Database Report (Dept. Homeland Security, 2007)Growing research base on level of preparedness
15Reasons why people are not prepared Lack of resourcesIncomplete knowledge about what to doCompeting prioritiesEspecially with complicated careImpedimentsBarriersLack of TransportationCaring for PetsLifeHow do the spare flashlight batteries end up in the Game boy?
16Steps to Personal Preparedness (Red Cross, FEMA, AAP) Most common recommendationsGet informedMake a PlanAssemble a KitMaintain the Plan3-day rule
17Get Informed Community Hazards Community disaster plans HurricanesTornadoswildfiresCommunity disaster plansResponse plansevacuation planssheltersCommunity warning systems
18Make a Plan Meet with family members Choose “out-of-town” contact Designate a meeting placeComplete a Family Communication PlanPlan escape routesPlan for those with special needsEmergency Information Form for Children with Special NeedsPlan for petsPrepare for different disastersEspecially critical when dealing with children
19Assemble a Kit General Kit Children Water & food First aid supplies MedicationsRadioSmall toolsClothingPersonal itemsCopies of ID and important papersInsurance, passports, driver’s licenseMoneyStore in large. waterproof containerChildrenAge-related suppliesDiapers, wipes, bottles, powdered formulaActivitiesColoring books, crayonsExtra “transition” objectsBlanketsStuffed animalsCopies of Guardianship related documentsCurrent photos of childrenEmergency Information Form for Children with Special Health Care Needs
206 Key Elements for Every Disaster Plan Designated shelters for pregnant women & familiesBasic supplies & equipment for pregnancy women and infantsA plan to provide prenatal and well baby careA plan to provide for access to safe environments for deliveryA plan to keep families together or reconnect families with infantsSpecialized educational materialsMarch of Dimes
21Preparedness considerations for evacuated pregnant women and infants Ascertain pregnancy status as part of intakeMake pregnancy tests availableConsider contraceptive needsPromote continuation of breastfeeding (more on this later!)Recognize effects of exposures and provide informationDetermine feasibility of establishing a pregnancy registry to track outcomesEquip DMAT and other response teams with capacity for managing pregnant and lactating women and their infantsCallaghan, et. Al. (2007). Health concerns of women and infants in times of natural disasters: Lessons learned from Hurricane Katrina. Maternal Child Health Journal, 11
22Infant Feeding post disaster Breastfeeding advantagesMilk is nutritionally perfect (even in cases of maternal malnourishment)Readily availableProtective against infectious diseases and respiratory illnessesAlways correct temp – can prevent hypothermiaHormone release in mother provides stress relief – calming for mother and infantFormula DisadvantagesMay not be availableMay require brand switchErrors in prep may occurWater may be contaminatedLimited or no method of sterilization for bottles & nipplesLimited electricity to cold store opened formulaAmerican Academy of Pediatrics
23Ways to support breastfeeding mothers Keep families togetherProvide supportive environmentAssure mothers that human milk provides adequate nutrition in absence of safe complementary foodsEncourage re-initiation of breastfeeding if previously stoppedRecommend ready-to-feed formula if breastfeeding not possible
24Personal Preparedness Pregnant women and families with infants
25Before a Disaster Complete general preparedness guidelines In addition:Let healthcare provider know where you will beList all prescriptions and prenatal vitaminsTake extras when availableGet copy of prenatal recordsGive other providers contact numbersAny special services or programs
26During a Disaster Bring any prescriptions when evacuating Keep copy of prenatal records with youGet out and walk every 1-2 hours if drivingWear comfortable shoesPack snacksPack maternity clothesUse car seats and helmets for infants and young children
27If evacuated Keep informed Try to eat throughout the day Do not eat spoiled or questionable foodListen to and follow public announcementsDrink bottled water or treated waterRecognize symptoms of laborTake measures to reduce stress as much as possible
28Post-disaster Potential dangers Flood water in streets and buildings Could be contaminatedAvoid contact/ wash after contactToxic exposuresContact health provider if concernedReturning homeBacteria and moldHard physical workElectrical shocksGeneral safety issues
29Care Providers Provide support for mothers and families Protect, Promote and SupportProtect familiesCreate safe zones where families can stay togetherPromote breastfeedingSupport breastfeeding and alternative feedingProvide lactation consultantsPrivate spacesProvide multi-lingual materials
30Take home message Preparedness saves lives Special considerations for pregnant women and newbornsResearch base is growingPromote family-centered care during mass critical care incidentsMedical setting is great for preparedness activitiesHave the discussion
31Recent Recommendations for Perinatal Populations: Pregnant Women and Infants American Academy of PediatricsMarch of DimesAcademy of Breastfeeding MedicineAmerican College of Nurse-MidwivesCenters for Disease ControlAmerican Red CrossBe Prepared!!