Physical effects of a catastrophic event can vary depending on the type of disaster. For example, explosive devices, transportation accidents, hurricanes, or floods might result in burns and crush injuries, release of chemical agents, or use of biological weapons/reemerging infections (e.g., pandemic influenza) causing mass infections that may result in various physical problems depending on the agent involved.
Disaster events can exacerbate any chronic condition, such as heart or lung problems, and/or precipitate emergent conditions such as premature births, seizures, and psychiatric conditions, panic disorders, and suicidal thoughts.
Following any disaster, those involved, victims, rescuers, and the surrounding community, suffer from a variety of responses. The bigger the disaster/catastrophe, the greater the number of people involved and the wider the effect. With the playing and replaying of the events, the effects can be magnified and people far removed from the scene may also suffer.
CARE SETTING
Wherever disaster occurs, to include triage areas, aid stations, hospital/emergency centers, shelters.
RELATED CONCERNS
Burns: thermal/chemical/electrical
Craniocerebral trauma
Fractures
Pneumonia, microbial
Sepsis/septicemia
Psychosocial aspects of care
Patient Assessment Database
Data depend on specific injuries incurred/presence of chronic conditions (refer to specific plans of care for data reflecting burns, multiple trauma, cardiac and respiratory conditions, etc.)
ACTIVITY/REST
May report: Sleep disturbances, recurrent intrusive dreams of the event, nightmares, difficulty in falling or staying asleep; hypersomnia (intrusive thoughts, flashbacks)
Fatigue, listlessness
CIRCULATION
May report: Palpitations or tachycardia
Sweating, hot flashes, or chills
May exhibit: Cold clammy hands
Increased blood pressure (anxiety), decreased blood pressure (dehydration/hypovolemia)
EGO INTREGRITY
May report: Excessive worry about events, avoidance of circumstances/locations associated with incident
Sense of inner turmoil
Dry mouth, upset stomach, lump in throat
Threat to physical integrity or self-concept
Questioning of God’s purpose/abandonment
May exhibit: Facial expression in keeping with level of anxiety (furrowed brow, strained face, eyelid twitch)
ELIMINATION
May report: Frequent urination; diarrhea
FOOD/FLUID
May report: Lack of interest in food; dysfunctional eating pattern
Nausea, vomiting
NEUROSENSORY
May report: Anticipation of misfortune to self or others, feeling stuck
Absence of other mental disorder
May exhibit: Motor tension; shakiness, jitteriness, trembling, easily startled
Apprehensive expectation; rumination
Excessive vigilance/hyperattentiveness; distractibility, difficulty concentrating, irritability, impatience, psychic numbing
PAIN/DISCOMFORT
May report: Muscle aches, headaches, chest pain (in addition to pain related to physical injuries/conditions)
RESPIRATORY
May report: Shortness of breath, smothering sensation
May exhibit: Increased respiratory rate
SEXUALITY
May report: Decreased libido
SOCIAL INTERACTIONS
May report: Concern for well-being of others
Questioning own actions/survival
Difficulty participating in social settings, reluctance to engage in usual activities/work
TEACHING/LEARNING
Discharge Plan
Dependent on individual situation, level of support, and available resources
DIAGNOSTIC STUDIES
Dependent on injuring agent/exposure and availability of resources for testing/procedures.
NURSING PRIORITIES
1. Prevent/treat life-threatening conditions.
2. Prevent further injury/spread of infection.
3. Support efforts to cope with situation.
4. Facilitate integration of event.
5. Assist community in preparing for future occurrences.
DISCHARGE GOALS
1. Free of preventable complications.
2. Anxiety/fear reduced to a manageable level.
3. Beginning to cope effectively with situation.
4. Plan in place to meet needs after discharge.
5. Community preparedness enhanced.
Disaster events can exacerbate any chronic condition, such as heart or lung problems, and/or precipitate emergent conditions such as premature births, seizures, and psychiatric conditions, panic disorders, and suicidal thoughts.
Following any disaster, those involved, victims, rescuers, and the surrounding community, suffer from a variety of responses. The bigger the disaster/catastrophe, the greater the number of people involved and the wider the effect. With the playing and replaying of the events, the effects can be magnified and people far removed from the scene may also suffer.
CARE SETTING
Wherever disaster occurs, to include triage areas, aid stations, hospital/emergency centers, shelters.
RELATED CONCERNS
Burns: thermal/chemical/electrical
Craniocerebral trauma
Fractures
Pneumonia, microbial
Sepsis/septicemia
Psychosocial aspects of care
Patient Assessment Database
Data depend on specific injuries incurred/presence of chronic conditions (refer to specific plans of care for data reflecting burns, multiple trauma, cardiac and respiratory conditions, etc.)
ACTIVITY/REST
May report: Sleep disturbances, recurrent intrusive dreams of the event, nightmares, difficulty in falling or staying asleep; hypersomnia (intrusive thoughts, flashbacks)
Fatigue, listlessness
CIRCULATION
May report: Palpitations or tachycardia
Sweating, hot flashes, or chills
May exhibit: Cold clammy hands
Increased blood pressure (anxiety), decreased blood pressure (dehydration/hypovolemia)
EGO INTREGRITY
May report: Excessive worry about events, avoidance of circumstances/locations associated with incident
Sense of inner turmoil
Dry mouth, upset stomach, lump in throat
Threat to physical integrity or self-concept
Questioning of God’s purpose/abandonment
May exhibit: Facial expression in keeping with level of anxiety (furrowed brow, strained face, eyelid twitch)
ELIMINATION
May report: Frequent urination; diarrhea
FOOD/FLUID
May report: Lack of interest in food; dysfunctional eating pattern
Nausea, vomiting
NEUROSENSORY
May report: Anticipation of misfortune to self or others, feeling stuck
Absence of other mental disorder
May exhibit: Motor tension; shakiness, jitteriness, trembling, easily startled
Apprehensive expectation; rumination
Excessive vigilance/hyperattentiveness; distractibility, difficulty concentrating, irritability, impatience, psychic numbing
PAIN/DISCOMFORT
May report: Muscle aches, headaches, chest pain (in addition to pain related to physical injuries/conditions)
RESPIRATORY
May report: Shortness of breath, smothering sensation
May exhibit: Increased respiratory rate
SEXUALITY
May report: Decreased libido
SOCIAL INTERACTIONS
May report: Concern for well-being of others
Questioning own actions/survival
Difficulty participating in social settings, reluctance to engage in usual activities/work
TEACHING/LEARNING
Discharge Plan
Dependent on individual situation, level of support, and available resources
DIAGNOSTIC STUDIES
Dependent on injuring agent/exposure and availability of resources for testing/procedures.
NURSING PRIORITIES
1. Prevent/treat life-threatening conditions.
2. Prevent further injury/spread of infection.
3. Support efforts to cope with situation.
4. Facilitate integration of event.
5. Assist community in preparing for future occurrences.
DISCHARGE GOALS
1. Free of preventable complications.
2. Anxiety/fear reduced to a manageable level.
3. Beginning to cope effectively with situation.
4. Plan in place to meet needs after discharge.
5. Community preparedness enhanced.
Chinese
French
German
Italian
Japanese
Korean
Russian
Spanish
