The Traditional Role of Emergency Nurses Facing A Disaster in Mexico Gerardo Jasso Ortega, RN (Mex), CEN (Mex) Emergency Nurse Manager Instituto Mexicano del Seguro Social Mexican Association of Emergency Nurses gerardo.jassoo@imss.gob.mx ameu_presidente@yahoo.com.mx Disclosure(s) Conflict of Interest: None Commercial Support: None The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Emergency Nurses Association is approved by the California Board of Registered Nursing, Provider 2322. Learning Outcomes − Identify the opportunities to improve the Mexican emergency care system to supports the larger disaster response. − To discuss professional and social responsibility of the nurses in the provision of emergency care to local, national, and international communities in need. − Describe the benefits to develop emergency response teams to disasters with the participation of the emergency nurses. What is a disaster? Disasters worlwide • Between 1994 and 2013, EM-DAT recorded 6,873 natural disasters worldwide, which claimed 1.35 million lives or almost 68,000 lives on average each year. In addition, 218 million people were affected by natural disasters on average per annum during this 20-year period. The Human cost of Natural Disasters 2015, A global perspective: CRED https://www.cred.be/node/1355 The Human cost of Natural Disasters 2015, A global perspective: CRED https://www.cred.be/node/1355 • Earthquakes are large-scale, sudden-onset disasters, which cause widespread damage. Between 2000 and 2018, there were 520 earthquake events with relevant human impact worldwide, with nearly two thirds having occurred in the Asian continent. • Health impacts of earthquakes depend not only on their magnitude and potential secondary effects, such as tsunamis or landslides, but also on characteristics of the community: built environment, time to rescue, availability of physicians and hospital beds, and prior training of lay uninjured survivor Why Mexico Is So Prone to Strong Earthquakes? Mexicotenochtitlan • The city was originally built on an island of Lake Texcoco, which was downright destroyed in the 1521 siege of Tenochtitlan, and subsequently rebuilt in accordance with the Spanish urban standards. Mexico • Mexico City population is 21.2 million people, making it the largest metropolitan area of the world’s western hemisphere and tenthlargest agglomeration and world’s largest Spanish-speaking city. After quake • Some emergency departments received a radio notification from the emergency medical services (EMS) providers before patients began to arrive, but several emergency departments received NO notification of the extent of the damage by the earthquake or the number and types of patients they could expect to receive. After quake • Hospitals were unable to know about the status of other emergency departments and how many patients were being treated at any facility. After quake • The public, as well as health care workers, law enforcement, and rescue workers relied on social media, such as Facebook and Twiter, and Internet-based communication tools, such as WhatsApp, to communicate during the initial hours. Mexican Red Cross Leads Response Following Deadly Quakes • The Mexican Red Cross teams led emergency response and relief efforts: searching for survivors, transporting the injured to hospitals and providing immediate first aid in the hardest hit areas.. Rescue • Rescue workers, especially the volunteers who were not wearing adequate protective gear, also sustained similar injuries in the course of their efforts. After earthquake Around Mexico City, unaffected buildings became gathering places for families and friends near sites where efforts to locate survivors. After quake The Mexico City hospitals were not immune to the damaging effects of the earthquake. Some facilities lost power, and evacuations were carried out if the building was deemed unsafe to occupy. Traditional role of nurses in disasters Traditional role of nurses in disasters Unfortunately, in Mexico, registered nurses are not considered as part of team of “first responders” Nursing response Nurses set up sidewalk clinics to attend to the needs of those assembled, providing care and comfort as best they could. Nursing response • Emergency departments were set up outside in large open spaces away from the risk of falling buildings . • Outdoor makeshift nursing units with rudimentary equipment and supplies provided ongoing care. Nursing Response • The Neonatal Intensive Care Unit nurses at Centro Medico la Raza, located on the 12th floor of that facility, alternated 5-minute shifts to ventilate fragile infants manually until electrical power was restored. Traditional role of nurses in disasters Irrational and unorganized evacuation, due to lack of emergency preparedness plan on place What have we learned Social media Goal and Objectives • Goal: Safe hospitals continue to provide health-care services in times of emergencies and disasters. • Objectives: The objectives are: • to enable hospitals to continue to function and provide appropriate and sustained levels of health-care during and following emergencies and disasters; • to protect health workers, patients and families; • to protect the physical integrity of hospital buildings, equipment and critical hospital systems; • to make hospitals safe and resilient to future risks, including climate change. REEDA-Emergency and Disasters Nursing Network https://www.observatoriorh.org/enfermeria/red-de-enfermeria-en-emergencias-y-desastres-reeda REEDA-Emergency and Disasters Nursing Network https://www.observatoriorh.org/enfermeria/red-de-enfermeria-en-emergencias-y-desastres-reeda Traditional role of nurses in disasters Conclusions Earthquake Plan for Mexico: An Example to Follow • The Mexican authorities have worked for several decades in developing disaster risk reduction and preparedness measures to face disasters such as the one caused by the 1985 earthquake, when dozens of thousands of people died and the referral hospitals collapsed in Mexico City Preparedness and Mitigation in the Americas –OPS-News and Information for the International Community The New York Times | Fuente: Víctor Cruz-Atienza, Universidad Nacional Autónoma de México The focus of emergency preparedness in Mexico has been on densely populated urban areas; however, there is a danger associated with neglecting rural or unpopulated areas. Emergency preparedness plan Seismic alert Thank you