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April 2010, Volume 40 Number 4 , p 40 - 45


  • Janice S. Smith PhD, RN


THE CATASTROPHIC EARTHQUAKES in Haiti and Chile earlier this year remind us that disasters, whether natural or man-made, can strike anywhere at any time. By one estimate, at least one disaster or mass casualty event per week occurs somewhere in the world.1 When a mass casualty event occurs, nurses are called to action, no matter what their area of expertise in clinical practice. Standing on the front lines of the healthcare system, nurses make up the largest portion of the healthcare work force and are often referred to as the "first receivers" in the event of a disaster.Even though disaster preparedness is increasingly important to nursing practice, most nurses' knowledge and training in this field is limited. According to the American Nurses Association (ANA), "the responsibility of every professional is to maintain a state of professional readiness for emergency response."2 This article will discuss your nursing role in disaster management, beginning with how to prepare yourself before a disaster strikes. Let's start by clarifying some common terminology.Most disasters are mass casualty events. By definition, these are different from multiple casualty events, such as a multivehicle highway crash. In a multiple casualty event, the number of victims doesn't exceed the ability of local resources to provide treatment. In contrast, a mass casualty event quickly and suddenly overwhelms local resources with seriously injured or ill victims needing immediate care. Besides natural disasters, such as earthquakes, tsunamis, hurricanes, tornadoes, and epidemics, these may include acts of terrorism, including bioterrorism. In a mass casualty event, triage and initial care typically begin (and, in some cases, continue) outside a hospital.1,3In today's world, disaster preparedness is no longer the exclusive province of nurses practicing in EDs or community agencies, such as the American Red Cross and state public health agencies. Any mass casualty event will almost

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