Disaster Preparedness Update

National Association of Perinatal Social Workers
CEU Module #1
Lisa Baker, Ph.D., L.C.S.W.
Department of Social Work
University of Alabama at Birmingham
[email protected]
 What is a disaster?
 Effects on families
 Disasters and children
 Preparedness Recommendations
 Preparing families with infants
What is a Disaster?
 An event that exceeds the capabilities of the response –
need exceeds resources
 Loss of life, property and livelihood
 Alters lives of individuals, families and communities
 Creates hazardous conditions that exceed ability to
endure and succeed
Types of disasters
 Natural
 Tornados
 Hurricanes
 Earthquakes
 Floods
 Tsunamis
 Landslides
 Wildfires
 Volcanic explosions
 Pandemic Flu
 Man-made
 Bombings
 Arson
 Mass shootings
 Terrorism
 Nuclear emergencies
 Chemical emergencies
 Mass food & water
All-hazards Approach
 All-hazards
 Collection of man-made & natural events that have the
capacity to cause multiple casualties
 All-hazards Preparedness
 Comprehensive preparedness required to manage the
casualties resulting from all possible hazards
Potential impacts of disaster
Immediate needs
Water, food, shelter
Access to resources
Health Care
 Acute issues/ injuries
 Exacerbation of chronic
Long term needs
 Rebuilding/relocating
Health, well-being,
complicated loss issues
Mental health
Time frame of impact can range from hours/days to months/years
Psychosocial aspects
 Mental Health Needs
 PTSD, Depression, Anxiety
 Substance abuse
 Special concern about vulnerable populations
Low income
Chronic health care and mental health needs
C-MIST (Kailes & Enders)
Communication, Medical, Independence, Supervision, Transportation
 Displaced persons after Katrina
 Decrease in household income
 Increase in mental health problems
 Transportation issues
Including school and children’s health care
Children in disasters
 Children
 Major determinants affecting susceptibility
Degree of exposure to event
Parental response to event
Pre-existing Mental health illnesses
Separation from parents
 Mitigating factors
Early support & intervention
Return to normalcy, especially school
 Key issues include
 School readiness
 Reunification
Perinatal Health
 Evidence that disasters impact maternal mental health
and some perinatal health outcomes
 Low birth weight
 Preterm delivery
 Maternal depression
 Anxiety
 Post traumatic stress
Children & Disasters
 Special challenges
 Dependent
Physically and emotionally
 Non-communicative
 Increased anxiety
 More vulnerable to exposures
Especially biological, chemical and radiological/nuclear
 Unable to provide information in a crisis
 Often separated from caregiver
Special health concerns of women
and infants
Disruption in clean water supply for drinking and bathing
Inadequate access to safe food
Exposure to environmental toxins
Crowded shelter conditions
Disruptions of public health and clinical care
 Increase in psychosocial stressors
Callaghan, et. Al. (2007). Health concerns of women and infants in times of natural
disasters: Lessons learned from Hurricane Katrina. Maternal Child Health Journal, 11
Children with Healthcare Needs
 20% of households
 May include
Home Ventilator or other electrical device
Chronic daily meds
 Parents not always able to provide correct information
 47% of caregivers bringing child to specialty care clinic were unable
to provide correct diagnosis (in non-crisis situation)
 29% were unable to provide correct medication list
 Carracio et. Al (1998)
Children with Special Healthcare Needs
 Present a challenge to EMS, non-
children’s hospitals
 Can place undue burden on
medical needs shelters
 Med refill – most common
request in shelters
 Loss of power in home
 Basic supplies
Current level of preparedness
 Campaigns primarily mass media – education based
 3 Steps
Be informed
Have a plan
Have a kit
 Less than 1/3 public has basic emergency plan
 Nat’l Ctr. Of Disaster Preparedness at Columbia Univ.
 Majority of Americans are unprepared for a major disaster
 Citizen Preparedness Survey Database Report (Dept. Homeland
Security, 2007)
 Growing research base on level of preparedness
Reasons why people are not
 Lack of resources
 Incomplete knowledge about what to do
 Competing priorities
 Especially with complicated care
 Impediments
 Barriers
 Lack of Transportation
 Caring for Pets
 Life
 How do the spare flashlight batteries end up in the Game
Steps to Personal Preparedness
(Red Cross, FEMA, AAP)
Most common recommendations
Get informed
Make a Plan
Assemble a Kit
Maintain the Plan
3-day rule
Get Informed
Community Hazards
Community disaster plans
Response plans
evacuation plans
Community warning systems
Make a Plan
 Meet with family members
 Choose “out-of-town” contact
 Designate a meeting place
 Complete a Family Communication Plan
 Plan escape routes
 Plan for those with special needs
 Emergency Information Form for Children with Special
 Plan for pets
 Prepare for different disasters
Especially critical when dealing with children
Assemble a Kit
 General Kit
Water & food
First aid supplies
Small tools
Personal items
Copies of ID and important
Insurance, passports, driver’s
 Money
 Store in large. waterproof
 Children
 Age-related supplies
 Diapers, wipes, bottles, powdered
 Activities
 Coloring books, crayons
 Extra “transition” objects
 Blankets
 Stuffed animals
 Copies of Guardianship related
 Current photos of children
 Emergency Information Form
for Children with Special Health
Care Needs
6 Key Elements for Every Disaster Plan
Designated shelters for pregnant women & families
Basic supplies & equipment for pregnancy women and infants
A plan to provide prenatal and well baby care
A plan to provide for access to safe environments for delivery
A plan to keep families together or reconnect families with
Specialized educational materials
March of Dimes
Preparedness considerations for evacuated
pregnant women and infants
 Ascertain pregnancy status as part of intake
 Make pregnancy tests available
 Consider contraceptive needs
 Promote continuation of breastfeeding (more on this later!)
 Recognize effects of exposures and provide information
 Determine feasibility of establishing a pregnancy registry to track
 Equip DMAT and other response teams with capacity for managing
pregnant and lactating women and their infants
Callaghan, et. Al. (2007). Health concerns of women and infants in times of natural disasters: Lessons
learned from Hurricane Katrina. Maternal Child Health Journal, 11
Infant Feeding
post disaster
 Breastfeeding
 Milk is nutritionally perfect
(even in cases of maternal
Readily available
Protective against infectious
diseases and respiratory
Always correct temp – can
prevent hypothermia
Hormone release in mother
provides stress relief – calming
for mother and infant
 Formula
• May not be available
• May require brand switch
• Errors in prep may occur
• Water may be contaminated
• Limited or no method of
sterilization for bottles &
• Limited electricity to cold store
opened formula
American Academy of Pediatrics
Ways to support breastfeeding
 Keep families together
 Provide supportive environment
 Assure mothers that human milk provides adequate
nutrition in absence of safe complementary foods
 Encourage re-initiation of breastfeeding if previously
 Recommend ready-to-feed formula if breastfeeding
not possible
Pregnant women and families with infants
Before a Disaster
 Complete general preparedness guidelines
 In addition:
 Let healthcare provider know where you will be
 List all prescriptions and prenatal vitamins
Take extras when available
 Get copy of prenatal records
 Give other providers contact numbers
Any special services or programs
During a Disaster
 Bring any prescriptions when evacuating
 Keep copy of prenatal records with you
 Get out and walk every 1-2 hours if driving
 Wear comfortable shoes
 Pack snacks
 Pack maternity clothes
 Use car seats and helmets for infants and young
If evacuated
 Keep informed
 Try to eat throughout the day
 Do not eat spoiled or questionable food
 Listen to and follow public announcements
 Drink bottled water or treated water
 Recognize symptoms of labor
 Take measures to reduce stress as much as possible
 Potential dangers
 Flood water in streets and buildings
Could be contaminated
Avoid contact/ wash after contact
 Toxic exposures
 Contact health provider if concerned
 Returning home
 Bacteria and mold
 Hard physical work
 Electrical shocks
 General safety issues
Care Providers
 Provide support for mothers and families
 Protect, Promote and Support
 Protect families
Create safe zones where families can stay together
 Promote breastfeeding
 Support breastfeeding and alternative feeding
Provide lactation consultants
Private spaces
 Provide multi-lingual materials
Take home message
 Preparedness saves lives
 Special considerations for pregnant women and
Research base is growing
Promote family-centered care during mass critical care
Medical setting is great for preparedness activities
Have the discussion 
Recent Recommendations for Perinatal Populations:
Pregnant Women and Infants
American Academy of Pediatrics
March of Dimes
Academy of Breastfeeding Medicine
American College of Nurse-Midwives
Centers for Disease Control
American Red Cross
 Be Prepared!!

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