MEDICAL FIRST AID,TRIAGE AND PSYCHOSOCIAL

CARE –DISASTER MANAGEMENT

PROFESSOR ANIL OHRI

DEPARTMENT OF ANAESTHESIA IGMC SHIMLA

INDIRA GANDHI MEDICALCOLLEGESHIMLA

INTRODUCTION:

Dr ANIL OHRIProfessor IN Anaesthesia

HEAD,Academics&researchChairman Disaster Cell

NODAL OFFICER IGMC SHIMLAState secretary indian

medicalassociation

WE CANT DO ANY THING

IMPORTANT BY SITTING HERE

PLEASE CONCENTRATE

SWITCH OFF YOUR MOBILE

WHAT TO DO……?

HELP YOURSELF BEFORE YOU HELP OTHERS………………………………………

PSYCHOSOCIAL CARE ASPECTS………………….. PSYCHOSOCIAL ASPECTS

SELF-STRESS RELEASERS

UMBRELLA AND BRAIN WORKS WHEN THEY ARE OPEN:

QUESTIONS…..? PLEASE NOTE ALL QUESTIONS AND I

ASSURE YOUR EVERY QUESTION ALL WILL BE CLEAR AT THE END OF SESSION

IF ANY THING LEFT CAN BE DISCUSSED IN QUESTION ANSWER SESSION

PSYCHOSOCIAL CARE RELATES TO MANY:

PSYCHO-SOCIAL CARE DEFINATION:

PSYCHOSOCIAL: TERM REFFERING TO: 

IT IS MIND ABILITYTO CONSCIOUSLY OR UNCONSCIOUSLY ADJUST AND RELATE BODY TO RELATE THE BODY TO SOCIAL ENVIRONMENT. A PART OF HOLISTIC APPROACH.

ALLOW PERSON TO SEEK BOTH INFORMATIONAL AND EMOTINAL SUPPORT FROM CARE-GIVERS TO MANAGE MENTAL TRAUMA

PSYCHOSOCIAL CARDINAL POINTS: “TIPS UMBRELLA”TO REMEMBER: LIFE CYCLE/MOTHER CHILD/DEATH 1942? I-I-R-R COUNSELLING CONTINUOUS

LONG DRAWN PROCESS ASSURANCE AVOID TRANSFERENCE DEAL INDIVIDUAL AS IT IS SELF CARE/DEBRIEFING

LIFE CYCLE……….?

?

DEATH IN A FAMILY…..RITUALS….?

?

MOTHER TEACHES US FIRST BASIC LOVE & AFFECTION:

MOTHER AND CHILD TOGETHER WONDERFUL:

MOTHER TERESA:

HISTORY OF PSYCHOSOCIAL CARE…………..

1942……….?

COCONUT GROOVE NIGHT CLUB FIRE-1944 Cocoanut Grove was BOSTON's premier NIGHT

CLUB during the post-Prohibition 1930s and 1940s. ON NOV. 28, 1942, DEADLIEST NIGHT CLUB

FIRE,[1] KILLED 492 (which was 32 more than the building's authorized capacity) and INJURED HUNDREDS

TRAGEDY SHOCKED NATION AND REPLACED HEADLINES OF WORLD WAR-II REFORMED SAFETY STANDARD CODES IN COUNTRY

MAJOR CHANGES IN TREATMENT AND REHABLITATION OF BURN VICTIMS.

SECOND SINGLE BUILDING DEADLIEST FIRE IN AMERICAN HISTORY; 1903 IROQOUIS THEATRE FIRE in CHICAGO KILLED 605. 1901- RYTHEM CLUB FIRE KILLED -209.[2]

COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-THE FRONT OF THE COCOANUT GROVE NIGHTCLUB AFTER THE FIRE

COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-III

TURKEY –MINE-RESCUE WORKERS TEAM-200 MINERS TRAPPED-1-12 MAY 2014

TAURKY MINE DISASTER FAMILIES WAITING OUT SIDE THE MINE/COLLEAGUES

TURKEY DISASTER-OUTSIDE HOSPITAL/OUTSIDE MINE:

THE NUCLEAR REACTOR AFTER THE DISASTER. REACTOR 4 (CENTER). TURBINE BUILDING (LOWER LEFT). REACTOR 3 (CENTER RIGHT)-26 APRIL 1986.

CHIRNOBYL DISASTER:II Time01:23 (MOSCOW TIME UTC+3) Date26 April 1986Location PRIPYAT,

(former UKARANIAN SSR,USSR) Cause:Inadvertent explosion of core

during emergency shutdown of reactor whilst undergoing power failure experiment

Deaths:31 (direct)

ABANDONED CITY OF PRIYAPET WITH CHIRNIBYL PLANT:

EFFECTS OF NUCLEAR DISASTER (20,000 YRS AFTER IT CAN BE USED AGAIN):

CHIRNOBYL DISASTER-IV April 26, 1986, explosions at a reactor at Chernobyl in Ukraine produced radiation effects almost

14 times greater than the 2011 Fukushima Daiichi disaster in Japan

400 times more powerful than the 1945 atomic bomb dropped on Hiroshima

DISASTERS AND PICS….

FIRE DISASTERS AND VOLCANO:

FIRE CITY AND FOREST:

UPHAR CINEMA TRAGEDY -13TH JUNE-1993-59-DEAD-109 INJURED DECIDED-60 CRORES FINDED-COURT GREEN PARK

TSUNAMI JAPAN-26 NOVEMBER-2011

KEDARNATH DISASTER-25 JUNE 2013:

EFFCTS OF UTRAKHAND DISASTER:

NEPAL DISASTER-APRIL-25TH 7.8 MAGNITUDE-AB KYA HOGA….

NEPAL DISASTER:

HEY BHAGWAN SAB KHATAM HO GYA…AB…KYA?

COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-II TimeAround 10:15 P.M. Date-November 28, 1942Location BAY VILLAGE,BOSTON,

Massachusetts, United States Cause Ignition of synthetic palm tree Decorations

Deaths-492 Suspect-(s)Barney Welansky Charges-Manslaughter, numerous

building code and safety violations VerdictGuiltyConvictionsManslaughter

COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-IV

COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-V 1944, Lindemann published

psychological aftermath of the Coconut Grove nightclub fire in Boston. 

psychologists have attempted to relieve distress of victims, disasters RELATE TO several important psychological constructs. 

Disasters allowed psychologists the opportunity to observe how extreme stress impacts individuals and groups

COCONUT GROOVE NIGHT CLUB FIRE-1944-BOSTON-V11 The Cocoanut Grove. Erected by the Bay

Village Neighborhood Association, 1993. In memory of the more than 490 people that died in the Cocoanut Grove fire on November 28, 1942.

"Phoenix out of the Ashes“AS BROUGHT MAJOR CHANGES

"This plaque crafted by Anthony P. Marra, youngest survivor of the Cocoanut Grove fire".

PSYCHOSOCIAL ASPECTS: NO DISASTER MANAGEMENT IS COMPLETE WITHOUT PSYCHOSOCIAL RECOVERY PLAN

DISASTER DEVASTATING IMPACT ON INDIVIDUAL LIFE,STRUCTURES AND HEALTH CARE SYSTEM.

GEOGRAPHY,CULTURAL AND ECONOMICAL STRUCTURE

PSYCHOLOGICAL FIRST AID FOR STRESS AND TRAUMA-I: DEPENDS- STRENGTH AND REACTION -Prior Experience-INTENSIY OF DISRUPTION-EMOTINAL STRENGTH OF

INDIVIDUAL-FEELING OF NO ESCAPE-LENGTH OF TIME ELAPSED SINCE

DISASTER

AFFECTED PERSON FACES FOUR PHASES-II: IMPACT PHASE(NO RESPONE-FOCUS

ON SURVIVOR) INVENTORY PHASE(Immediate After

DISASTER-LOCATE SURVIVORS,ASSESS DAMAGE,SEEK MEDICAL HELP)

RESCUE PHASE(ACCEPTING HELP FROM HELP GROUP)

RECOVERY PHASE(FEEL OPERATION ARE NOT FAST ENOUGH,AGAINST THE HELP,LOOK FOR ACCOMMODATION,INSURANCE)

DURATION OF PASES AFTER DISASTER: Phases after a disaster- Duration -Characteristics Hours Apathy, Disorientation, wandering Surprise, Fear,

perplexity Anxiety,Helplessness Heroic Up to 1-2 weeks Strong, direct feeling Heroism,

Solidarity, Optimism Honeymoon 2 weeks to 3 to 6 months Great

solidarity,Eagerness to rebuild Sharing of common experience

Disillusionment 2months to 2 years Withdrawal, loneliness Anger, frustration Community disorganization Negativity, Hostility Impulsiveness, violence Alcohol and drug abuse R

Reconstruction A lifetime Acceptance of losses Realistic assessment of the situation Search for alternatives to rebuild

DISASTER INDUCED STRESS AND TRAUMA “NORMAL” TO “ABNORMAL” SITUATION:

Pschological Symptoms PhysiologicalSymptoms

Irritability Or Anger Self Blame or others Fear of Recurrence Feeling stunned or

numb Helplessness Concentraiton

Problems Sadness Denial Mood Swings

Loss of appetite Headache Chest pain Nausea,diaeehoea,st

omach pain Lack of sleep and

low energy Hyperactivity Increase in alchohol

or Drug consumption

HUMANISING RECOVERY Knowledge of Symptoms Be A Good Listener People are distressed as recovery-

people are same Recovery workers ouside have Distress

and Agonised Incorporate-Exercise,Meditation,Rest

Good Nutrition Long Term Assistance And Relief appeal Basic need are taken Care off Monitoring Of Symptoms, Medication if needed

COMMON PROTECTIVE RESPONSES TO DISASTER: PANIC FACTOR SHOCK-INTENSE EMOTIONAL

FEELING-STUNNED / OR DAZED DENIAL-NOT ACKNOWLEDGING-

NUMB/DISCONNECTED FROM LIFE POST TRAUMATIC STRESS

DISORDER(SERIOUS EVENT AND MUST BE GIVEN DUE ATTENTION)

“TIPS UMBRELLA”TO REMEMBER: COUNSELLING CONTINUOUS LONG DRAWN PROCESS

ASSURANCE AVOID TRANSFERENCE DEAL INDIVIDUAL AS IT IS

NORMAL RESPONSE: REMEMBER NO STANDARD PATTERN ANXIOUS OR NERVOUS/DEPRESSED THOUGHTS AND

BEHAVOR ,EATING/SLEEP PATTERN TRIGGERING—FEAR THAT EVENT

WILL OCCUR INTERPERSONAL RELATIONS

STRAINED-ARGUMENTS SOME PHYSICAL SYMPTOMS

DISCUSSED ALREADY

RECOVERY PERIOD: PERSONS ABILITY COPE

EMOTIONAL TRAUMA DEGREE OF LOSS ANY ILLNESS BEFORE THE EVENT

WHAT NEXT……RECOVER-AS AFTER ANY DEATH ? HELP YOUR SELF AND YOUR

FAMILY.. GIVE TIME TO YOURSELF AND

FAMILY ALLOW UR-SELF MOURN ASK FOR HELP FROM PEOPLE YOU

KNOW COMMUNICATE WITH FAMILY

MEMBERS FIND OUT HELP TRY TO BE IN GROUP ENGAGE IN HEALTHY

CONVERSATION ESTABLISH YOUR ROUTINE AVOID MAJOR DECISIONS OF YOUR

LIFE

TAKING CARE OF YOUR FAMILY: INVOLVE YOUR CHILDREN AND FAMILY WITH YOU

COUNTERING THROGH COUNCELLING: KEEP FULL PRIVACY TIPS-HELP ARRANGING BASIC NEEDS INITIATE RETURN TO NORMAL,ROUTINE

AND ACTIVITIES ASSIST IN AVAILING BENEFITS FROM

GOVERNMENT HELP FILLING COMPENSATION FORMS INFORM AUTHORITIES –MENTALLY

ILL,FAMILIES,CHILDREN,PERSON WITH DISABILITIES ENSURE THERE RELIEF RE- SOURCES

BE A GOOD LISTENER

BEHAVIORAL REACTIONS EXAMPLES: Loss of interest in life A 65-year-old man, "Why

should I live anymore ? What is the vise of my life without my grandson and my granddaughter? The waves should have killed me also.''''

Reduced activity, no energy A 40-year-old man," There is nothing much to do here — just eat and then sit around. We have not started working. My days just pass by. I do not know what to do. Earlier I used to do a lot of work. Now without doing much I feel very tired and my body aches.“

Over activity and inability to rest (restlessness) A 25-year-old man, " I am unable to lie down, even for a minute. I need to do something or the other. My body is stiff. I am not able to sit or stand for a single minute.”

BEHAVIORAL REACTIONS-II Taking intoxicants or eating betel leaf 'paan' A 42-

year-old man, "I have nothing to do here in the relief camp. I sit idle all the time. If I sit idle, it reminds me of my two children whom I have lost. If I drink, I can atleast forget my sorrows for some time and get relief from the pain ".

Difficulty in concentration A 36-year-old woman, "I am not able to do any thing properly. I am forgetting to put salt while cooking. I keep looking at the sea and try to understand the sound, whether it is increasing".

Sleep disturbances and problem A 48-year-old woman, "During nights when I go to sleep, I get these images and thoughts of waves coming and destroying everything. I cannot sleep properly. I have to take sleeping tablets to get sleep, but then also, I get sleep only at around 3 o' clock at night."

COUNTERING TRAUMA :

AVOID TRANSFERENCE

WORKSHOP OF PSYCHOSOCIAL ASPECTS: NIDM MODULE ON PSYCHOSOCIAL ASPECTS

“FIRST AID” FOR OWN SELF:DEALING WITH STRESS CAN

STRESS THE MANAGER LEARN STRESS RELEASE EXERCISES-

PK-DANCE RELAX DURING WORKING ALOEVERA EYE SPECS MEDITATION SUPT- ASNA CLAP WHEN ALONE LISTEN MUSIC,DANCING-A GOOD

HABIT

THANK YOU VERY MUCH

THANK YOU VERY MUCH