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CHAPTER 16. Disaster Settings
CRITICAL INFO
• Nurses working in shelters must assess the needs of the shelter population and provide 24-hour health coverage for the residents.
OVERVIEW
Nurses provide care in many settings before, during, or after a disaster occurs. Frequently, it is an American Red Cross established shelter. Service centers are often opened after the disaster, but healthcare, first aid, and procurement of needed goods and equipment are provided in the shelter before service centers open. The following list provides other types of settings associated with the provision of disaster care:
• Emergency aid stations
• Emergency operations center (EOC)
• Family assistance centers (FACs)
• Home or hospital visits
• Outreach
• Phone banks and hotlines
• Points of dispensing (POD) centers
• Respite centers
• Reunification/family reception center
• Service centers
• Shelter
• Staging areas
• Temporary morgue
EMERGENCY AID STATIONS
Emergency aid stations are rapid-response, temporary, mobile or stationary units, often located in the heart of the disaster area. Emergency aid station teams frequently consist of a physician or emergency medical services (EMS) provider, a nurse, a case worker, and a mental health worker. Stabilization and basic first aid are provided, and triage and transportation to other healthcare facilities is arranged.
EMERGENCY OPERATIONS CENTER
Ongoing mental health support services may also be requested at the emergency operations center (EOC). In the aftermath of a large-scale disaster, the EOC is a chaotic and stressful environment as county and other organizational disaster planners and managers are preparing the disaster relief response.
FAMILY ASSISTANCE CENTERS
Family assistance centers (FACs) are commonly opened in the event of a disaster involving mass casualties or fatalities. These centers usually offer a range of services in an effort to meet the needs of individuals under these circumstances. Mental health services, spiritual care, mass care (feeding), and crime victims’ services, as well as the services of law enforcement, the medical examiner, disaster relief agencies, and other local, state, and federal agencies, are also offered on-site. Family assistance centers are usually located away from the immediate disaster site, though it is important to note that many times family members will request visits to the affected site or memorial services will be planned, and thus the FAC should be close enough to facilitate those activities.
HOME OR HOSPITAL VISITS
Visits are made to the home or hospital to provide assistance if a person(s) cannot come to a service center. Nurses evaluate living conditions, determine healthcare assistance needed, or provide support when a death is disaster related (condolence call).
OUTREACH
Similar to a home visit, the purpose of outreach is to meet victims/individuals in the affected area, provide needed goods and services, and make community assessments. Disaster response teams may be dispersed in communities to reach individuals who have not been able to come to a shelter or service center.