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CHAPTER 2. Weather-Related and Environmental Disasters
CRITICAL INFO
• The frequency and intensity of natural disasters are increasing.
• Awareness of the types of morbidity and mortality associated with each type of natural disaster can help the nurse be better prepared to respond.
• Natural disasters result in an increased workload and unsafe environment for nurses.
• Nurses should know how to treat injuries caused by natural disasters that are prevalent in their geographic region.
• Nurses who are not trained in search and rescue should not enter a disaster site alone, in order to prevent becoming a disaster victim.
• Stay safe! Secure the environment before entering.
• The Federal Emergency Management Agency (FEMA) is the lead federal agency for natural disasters—you can find more information at www.fema.gov.
OVERVIEW
The World Health Organization defines a natural disaster as the “result of an ecological disruption or threat that exceeds the adjustment capacity of the affected community” (WHO, nd). Natural disasters occur as many different types and have diverse characteristics.
Natural disasters can be categorized as having an “acute” or “slow” onset. Examples of disasters with an acute onset include blizzards, cyclones and hurricanes, earthquakes, extreme heat waves, floods, tornadoes, tsunamis, volcanic eruptions, and wildfires; examples of disasters with slow onsets include drought. Natural disasters are unpreventable and uncontrollable; yet, they are predictable in that they occur in approximately the same geographic region. They result in long-term effects such as transportation problems and structural damage.
Natural disasters differ from environmental disasters because they are directly the result of Mother Nature, whereas environmental disasters may be human-caused. Examples of environmental disasters that can be caused either by nature or by humans include building or structural collapse, fires, food-drink poisoning, and power outage.
TYPES OF WEATHER-RELATED AND ENVIRONMENTAL DISASTERS
BLIZZARD/EXTREME COLD
A blizzard is a winter storm that is characterized by low temperatures (usually below 20° F) accompanied by high winds (at least 35 miles per hour [mph] or greater) and blowing snow that reduces visibility to a quarter mile for at least 3 hours. A severe blizzard is considered to have temperatures near or below 10° F with winds exceeding 45 mph and visibility reduced to near zero. Extreme cold is a natural disaster in which the air temperature drops to a level significantly below the usual low temperature for a specific area of the country. The exact temperature is variable, depending upon the geographic area. Because of poor visibility and hazardous road conditions, there may be an increase in motor vehicle accidents or falls.
The elderly and technology-dependent patients are particularly vulnerable during a blizzard if there is a concurrent power outage. The elderly who are without heat may require special accommodations to prevent hypothermia as well as homebound patients or patients receiving oxygen therapy. Given these considerations, surge capacity issues may arise.
Environmental Effects
• Avalanche
• Erosion
• Communication disruption
• Damage to transportation systems
• Household fires
• Snow melt and flooding
• Loss of plant/animal life
• Power/utility failures
• Heating system failure
• Healthcare system failure and overcapacity
Transportation accidents are the leading cause of death during winter storms. Preparing vehicles for the winter season and knowing how to react if stranded or lost on the road are the keys to safe winter driving. Morbidity and mortality associated with winter storms include frostbite and hypothermia, carbon monoxide (CO) poisoning, blunt trauma from falling objects, penetrating trauma from the use of mechanical snow blowers, and cardiovascular events usually associated with snow removal. Frostbite is a severe reaction to cold exposure that can permanently damage its victims. A loss of feeling and a light or pale appearance in fingers, toes, nose, or earlobes are symptoms of frostbite. Hypothermia is a condition that results when the body temperature drops to less than 90° F. Symptoms of hypothermia include uncontrollable shivering, slow speech, memory lapses, frequent stumbling, drowsiness, and exhaustion.
Nursing Implications
• Prepare to administer cardiopulmonary resuscitation (CPR) and respond to trauma injuries.
• Recognize and treat hypothermia, frostbite, falls, and miscellaneous injuries.
• Ensure safe environment for clients, adequate heat, and emergency supplies.
• Monitor protective clothing of those patients most at risk.
• Prepare to treat inhalation injuries caused by fires.
• Be aware of alternative sites with electrical power (e.g., schools, churches, hotels) in order to shelter individuals who are technology dependent.
CYCLONE, HURRICANE, AND TYPHOON
A cyclone is a large-scale storm characterized by low pressure in the center and surrounded by circular wind motion. A hurricane is a cyclone that develops in the Atlantic Ocean, while a typhoon originates in the Pacific Ocean and the China seas. Typhoon winds range from 64 to 170 mph while hurricane winds range from 74 to 175 mph. Both have five classification categories. In addition to high winds, torrential rains and storm surges can result.
Environmental Effects
• Epidemics
• Flooding
• Landslides
• Mudslides
• Erosion
• Water contamination
• Loss of plant/animal life
• Building/structural damage
• Communication disruption
• Power/utility failures
• Healthcare facility damage
• Healthcare system failure and overcapacity
• Damage to transportation systems
Nursing Implications
• Prepare to assist with timely evacuation or find shelter for affected populations.
• Prepare for traumas, injuries, and long-term illnesses from water contamination.
• Be familiar with your facility’s disaster plan and any annual updates.
• Be ready to respond as soon as watches or warnings are issued.
• Social work and psychiatric referrals may be necessary.
DROUGHT
A drought is a transient, prolonged period (at least one season) of the absence of adequate precipitation that results in a shortage of water in a particular geographic area, thereby affecting the water needs of plants, animals, and humans. A drought may occur in any geographic area but may manifest in different ways. A drought may occur even when rainfall is normal but when the use of water increases or when the water supply becomes contaminated.
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