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Disaster Nursing and Emergency Preparedness, Fourth Edition

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Disaster Nursing and Emergency Preparedness, Fourth Edition

SKU# 9780826144171


  • Tener Goodwin Veenema PhD, MPH, MS, CPNP, FAAN

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“What a wonderful resource!"--Doody's Medical Reviews

“The 4th Edition is unique in recognizing the rapid changes in both the causes of crises and the latest attempts to provide timely multidisciplinary approaches to the practice of this growing specialty…Evident throughout this edition is the call to identify crisis leadership among the increasingly talented base of nurses who have responsibility to move the profession to recognize and accept that they can be advocates for better planning, coordination, education and training.”

- Frederick M. Burkle, Jr., MD, MPH, DTM, PhD(Hon.), FAAP, FACEP

Senior Fellow & Scientist, Harvard Humanitarian Initiative, Harvard University & T.C. Chan School of Public Health

From the Foreword

“This impressive edition builds upon the solid foundation of the first three award-winning editions with an expanded focus on climate change related disasters, globalization and its implications for emerging and re-emerging infectious diseases, the accommodation of high-risk, high-vulnerability populations, and the potential for disaster arising from a world witnessing increasing community violence and civil unrest.”

-Patricia M. Davidson, PhD, MED, RN, FAAN

Professor & Dean, Johns Hopkins School of Nursing

From the Foreword

“The contributing authors read like a “Who’s Who” of disaster leaders. They lend their special expertise and insights, which are supported and elucidated by cogent learning strategies in the use of case studies, student questions, and packed content in all areas of disaster participation, preparedness, policies, and research. For over 16 years [this book] has been the hallmark text in its field and this edition proves to be the best ever.”

-Loretta C. Ford, RN, PNP, EdD

Dean Emeritus, University of Rochester School of Nursing

Founder of the National Nurse Practitioner Program

Member, National Women’s Hall of Fame

Featuring the most current, valid, and reliable evidence-based content available, this three-time AJN winner once again presents an unparalleled resource for disaster and emergency preparedness. Disasters lay heavy burdens upon healthcare systems that stretch all levels of society. While natural and man-made disasters are not new, the global nature, rate, type, and totality of their impact has only increased. The fourth edition of this foundational text uniquely addresses the rapid changes in these crises and analyzes the latest attempts to provide timely, multidisciplinary healthcare.

Nurses consistently comprise seventy or more percent of responders to local, national, regional, and global crises, and represent a potentially untapped resource to achieve surge capacity goals and optimize population health outcomes. Considering recent world events and increasing geopolitical tensions, Disaster Nursing and Emergency Preparedness, Fourth Edition now features expanded content on the ubiquitous threat of terrorism, potential detonation of thermonuclear weapons, emerging and reemerging infectious diseases, and increasing frequency and intensity of natural disasters from climate change.

This text promotes competency-based expert nursing care during disasters and positive health outcomes for small and large populations consistent with the Federal Disaster Response Framework. Whenever possible, content is mapped to published core competencies for preparing health professions’ students for response to terrorism, disaster events, and public health emergencies. The fourth edition retains the clearly organized format in each chapter that includes an overview, learning objectives, a summary, and case study with reflective questions.

New to the Fourth Edition:

  • Addresses the most recent landmark agreements
  • Sendai Framework for Disaster Risk Reduction 2015–2030, the United Nations’ Sustainable Development Goals, and the Paris Climate Agreement
  • Covers public health emergencies involving community violence and civil unrest
  • Expands coverage of planning for and accommodating high-risk, high-vulnerability populations
  • Aligns with the U.S. National Health Security Strategy and the National Planning Frameworks
  • Provides focused content on medical countermeasures
  • Includes an improved instructor package with guide, PowerPoint slides, and case studies with questions for reflection in every chapter

Product Details 

  • Publication Date July 23, 2018
  • Page Count
  • Product Form Paperback / softback
  • ISBN 13 9780826144171

Table of Contents 




Foreword Frederick M. Burkle, Jr., MD, MPH, DTM, PhD(Hon.), FAAP, FACEP

Foreword Patricia M. Davidson, PhD, MED, RN, FAAN

Foreword Loretta C. Ford, RN, PNP, EdD


How to Use This Book

Editor’s Note



1. Essentials of Disaster Planning

Tener Goodwin Veenema

Chapter Overview

Definition and Classification of Disasters

Declaration of a Disaster

Health Effects of Disasters

The Disaster Continuum

Disaster Planning

All Hazards Disaster Planning

Disaster Planning and Public Health Preparedness

Hazard Identification, Vulnerability Analysis, and Risk Assessment

Evaluating Capacity to Respond

Core Preparedness Activities

Evaluation of a Disaster Plan

Situations Suggestive of an Increased Need for Planning


Disasters Within Hospitals and Healthcare Settings


Hazardous Materials Disaster Planning

Professional Nursing Mandate


Study Questions


2. Leadership and Coordination in Disaster Healthcare Systems: The U.S. National Preparedness System

Lynn A. Slepski, Mary Pat Couig, Roberta Proffitt Lavin, Susan M. Orsega, and Tener Goodwin Veenema

Chapter Overview

Federal Preparedness Planning and Emergency Response

National Planning Frameworks

National Response Framework

The NRF as It Relates to the NIMS

Implementation of the NRF

Roles and Responsibilities

ESF-8: Public Health and Medical Services

Federal Definition of a Disaster Condition

NRF Considerations

Federal Medical Response Resources

Federal Medical Stations

Medical Response Actions

Assessment of Health/Medical Needs

Health Surveillance

Medical Care Personnel

Health/Medical Equipment and Supplies

Patient Evacuation

In-Hospital Care

Food/Drug/Medical Device Safety

Worker Safety

Radiological/Chemical/Biological Hazards Consultation

Mental Healthcare

Public Health Information

Vector Control

Potable Water/Waste Water and Solid Waste Disposal

Victim Identification/Mortuary Services

Veterinary Services

A Blueprint for the Future for Disaster Nursing


All Disasters Are Local

Crisis Standards of Care for Use in Disaster Situations

Resources for Disaster Planning


Study Questions


3. Hospital and Emergency Department Preparedness

David Markenson and Sarah Losinski

Chapter Overview

Hospital Preparedness

Hazard Vulnerability Analyses

The Hospital Emergency Management Committee

Alliance Building and Community-Based Planning

Hospital Preparedness for Children

Phases of Emergency Planning

Mitigation Measures

Preparedness Efforts

The Response Phase

The Recovery Function

Disaster Standards of Care

Hospital Disaster Planning

Surge Capacity



Stockpiling and Logistics

Resource Inventories

Security Issues


Collaboration and Integration With Public Health

Equipment and Supplies


Facility Evacuation

Drills and Exercises

ED Disaster Operations

Trauma Centers

Alternate Care Sites

Incident Command System

Management of a Mass Casualty Situation

Initial Evolvement of MCI

Casualties Flow to the Hospital

Casualties Flow Within the Hospital

Patient Triage

Principles of Initial Hospital Management

Use of Radiology

Operating Room

Secondary Transport

Reassessment Phase

Communication and Manpower Control

Information Center and Public Relations

Communication and Information Technology Issues

Hospital-Based Decontamination and Pediatric Considerations


Study Questions


4. Emergency Health Services in Disasters and Public Health Emergencies

Jeremy T. Cushman, Manish N. Shah, and Mahshid Abir

Chapter Overview

The EHS System

EHS Components

Standard Operation of EHS

Current State of EHS

Major EHS Concepts Associated With Disasters

Resources for the EHS System

Regional and Federal Assets

Patients’ Access to EHS During a Disaster

Major EHS Issues

System Survey

Resource Availability

Communication and Coordination

How to Deal With the Influx


Critical Actions

Study Questions


5. Emergency Medical Consequence Planning for Special Events, Mass Gatherings, and Mass Casualty Incidents

Tener Goodwin Veenema, Paul Arbon, and Alison Hutton

Chapter Overview

Mass Gatherings and Special Events

Healthcare Emergency Management

Emergency Medical Consequence Planning


Goals of Emergency Care at Mass Gatherings

Predicting Patient Presentation Rates

Event Type



Heat Rash

Heat Cramps

Heat Syncope

Heat Exhaustion

Heat Stroke





Event Duration

Characteristics of the Crowd

Crowd Density

Crowd Mood

Alcohol and Drug Usage

Medical Aid Stations

Transportation Considerations

Communication Systems



Mass Casualty Incidents

Practice Parameters for Nursing Care

Nursing Assessments

Nursing Therapeutics and Core Competencies


Study Questions


Appendix 5.1 No-Notice Incidents: Hospital Triage, Intake, and Throughput

6. Legal and Ethical Issues in Disaster Response

Eileen M. Amari-Vaught, Marilyn M. Pesto, and Kevin D. Hart

Chapter Overview

Legal and Ethical Framework and Background

Introduction to the Legal System

Effect of Law on Nursing Professionals

Relationship Between Ethical and Legal Obligations

Proposed Model State Acts

The Role of Government in a Public Health Crisis

Local Government

State Government

Federal Government

Law and Ethics

Specific Legal and Ethical Issues

Privacy Issues

Reporting of Diseases

Disclosure of Health Information

Quarantine, Isolation, and Civil Commitment


Treatment for Diseases

Screening and Testing

Professional Licensing

Resource Allocation

Professional Liability

Provision of Adequate Care

Selected Ethical Issues


Study Questions




7. Identifying and Accommodating High-Risk, High-Vulnerability Populations in Disasters

Elizabeth A. Davis, Rebecca Hansen, Lori Peek, Brenda Phillips, and Sarah Tuneberg

Chapter Overview

Defining and Understanding Vulnerability

Models for Understanding Vulnerability

Medical Model

Functional Model


Understanding Vulnerability Systematically as a Basis for Intervention

Using an Equity and Empowerment Lens

The Life Cycle of Disasters



Response Activities


Recovery Programs


Guiding Principles

Conditions Fostering Change

Examples Organized Around the Ecosystem Model

Microlevel Example: Personal Preparedness

Meso-Level Example: Safe Centers in Alabama

Exo-Level Example: FEMA Trailers and Housing Policy

Macro-Level Example: Muslim Americans—Targeting and Tolerance After 9/11



Additional Resources

Case Study 7.1

Case Study 7.2

Case Study 7.3

Appendix 7.1 The Post-Disaster Personal Assessment Tool

Appendix 7.2 Think Before You Speak or Write: Polite Communication

8. Human Services in Disasters and Public Health Emergencies: Social Disruption, Individual Empowerment, and Community Resilience

Juliana Sadovich and Jonathan D. White

Chapter Overview

Human Services “Under Clear Skies”

Human Security

What is Social Well-Being?


Human Services in Disaster Response and Recovery

Theories Supporting the Role of Nurses in Human Services

The Role of Nurses in Human Services

Case Management in Disasters


Study Questions


Case Study 8.1

9. Understanding the Psychosocial Impact of Disasters

Susan M. S. Carlson, Kathleen Coyne Plum, and Elizabeth C. Meeker

Chapter Overview

Bioterrorism and Toxic Exposures

Community Impact and Resource Assessment

Normal Reactions to Abnormal Events

Resiliency in the Face of Disaster

Special Needs Populations

Children and Youth

Older Adults

The Seriously Mentally Ill

Cultural and Ethnic Subgroups

Disaster Relief Personnel

Community Reactions and Responses

Mourning, Milestones, and Anniversaries


Study Questions

Internet Activities

Useful Links


Case Study 9.1

Case Study 9.2

10. Management of the Psychosocial Effects of Disasters

Susan M. S. Carlson, Elizabeth C. Meeker, Kathleen Coyne Plum, and Tener Goodwin Veenema

Chapter Overview

The Mental Health Response Team

Recruitment, Screening, and Training

Disaster Mental Health Interventions

Psychological First Aid

Crisis Intervention

Social Support

Psychological Triage

Mental Health Referrals

Acute Stress Disorder

Posttraumatic Stress Disorder

PTSD in Children

Interventions With Special Populations

Children and Youth

Children’s Disaster Mental Health Concept of Operations Model

Older Adults

Individuals With Mental Illness

Cultural, Ethnic, and Religious Subgroups

Disaster Relief Personnel

Fatigue Management

When Grief and Stress Go Awry

Traumatic Grief (Complicated Bereavement)

Evidence-Based Practices in the Treatment of ASD and PTSD

Utilizing Technology as an Adjunct to Intervention and Treatment

Critical Incident Stress Management

The Debriefing Controversy


Study Questions

Internet Activities

Useful Links


11. Unique Needs of Children During Disasters and Other Public Health Emergencies

Michael Beach and Patricia Frost

Chapter Overview

Epidemiology of Pediatric Injuries and Illnesses During Disasters and Public Health Emergencies

Natural Disasters

Public Health Emergencies

Acts of Terrorism

Acts of War

Physiological Considerations in Pediatric Care Following a Disaster or Public Health Emergency






Nutritional Requirements



Children With Functional and Access Needs

Psychosocial Considerations in Pediatric Care

Pediatric Care During Disasters

Pediatric Disaster Triage

Prehospital Treatment

Prehospital Medical Transportation and Evacuation

Emergency Department Treatment

Reunification and Family Assistance Planning

Community Hospital Preparedness

Care in Shelters

Care in Refugee Camps and Camps for Displaced Populations

Long-Term Care Following a Disaster

Pediatric Care During Public Health Emergencies

Exposure to Nuclear and Radiological Agents

Prehospital Treatment

Emergency Department Treatment

Exposure to Biological Agents

Definitive Treatment

Ethical and Legal Considerations in Pediatric Disaster Care

Pediatric Death Following Disasters and Public Health Emergencies

Planning for Disasters—Pediatric-Specific Considerations

Pediatric Considerations in Healthcare Preparations


Study Questions

Internet Activities

Support Preparedness


12. Disaster Nursing in Schools and Other Community Congregate Child Care Settings

Cheryl K. Schmidt, Devin Terry, Dona M. Friend, Shannon Finley, Joy Jennings, Susan Roettinger Ritchie, Kelly J. Betts, and Jody Bryant

Chapter Overview

Growth and Developmental/Cognitive Considerations

Elementary and Secondary Schools

Child Welfare Agencies

Juvenile Justice and Residential Settings

Child Care Settings





Study Questions

Internet Activities


Appendix 12.1 Index to Recommendations and Responsible Entities

13. Care of the Pregnant Woman and Newborn Following a Disaster

Kathleen Leask Capitulo and Robbie Prepas

Chapter Overview

Physiology of Normal Pregnancy

Pregnancy During Disaster Conditions

Complications of Pregnancy

Hypertension, Pregnancy-Induced Hypertension, and Eclampsia

Diabetes Mellitus

Bleeding Disorders in Pregnancy

Blood Disorders

Other Medical Conditions in Pregnancy Occurring During a Disaster

Assessment of the Pregnant Woman and Baby

Cardiovascular System

Childbirth During Disasters

Stages of Childbirth

Complications of Labor and Delivery: Malpresentation

Care of the Umbilical Cord

Physiology of Postpartum Mother and Newborn

Special Assessment/Conditions of the Newborn

Postpartum Management in Disasters

Special Considerations for Mother and Baby in Disasters

Infections and Communicable Diseases

Special Infectious Disease Considerations

Environmental Cleanliness and Sanitation


Trauma in Pregnancy

Performing Cardiopulmonary Resuscitation

Breastfeeding and Infant Nutrition

Breastfeeding Challenges


Lack of Food, Malnutrition, and Starvation

Crisis Conditions Associated With Pregnancy


Infections in Postpartum and Lactating Women During Disasters


Zika Virus

Ebola Virus Disease

Shelters and Practical Considerations for Austere Environments

Death of the Mother or Infant—Bereavement Concerns and Interventions

Maternal Death

Perinatal Death

Healing Professional Interventions in Maternal/Perinatal Bereavement

Returning Home Safely

Flood Water in Streets and Buildings

Toxic Exposures During Pregnancy

Returning Home

Risk of Violence, Abuse, Slavery, and Human Trafficking

Posttraumatic Stress Disorder



Appendix 13.1 Breastfeeding: A Vital Emergency Response. Are You Ready?



14. Disaster Nursing and the United Nations 2015 Landmark Agreements—A Vital Force for Change in the Field of Disaster Nursing

Rishma Maini, Joanne Bosanquet, and Virginia Murray

Chapter Overview

Disasters and Their Impacts

The 2015 UN Landmark Agreements

The Sendai Framework for Disaster Risk Reduction

Roles and Responsibilities of Nurses in Implementing the Sendai Framework

How Can Nurses Actively Engage in and Lead on Disaster Risk Reduction and Disaster Risk-Management Policy Nationally and Globally?

Nurses Engaging and Leading Nationally

Nurses Engaging and Leading Globally

Role of the World Health Organization

Who Collaborating Centers


Study Questions


Useful Links


15. Complex Humanitarian Emergencies

Frederick M. Burkle, Jr.

Chapter Overview

Defining CHEs

Conventional Warfare

Unconventional Warfare

Major Characteristics

International Response

Measuring the Human Cost

Assessments, Data Collection, and Analysis

Direct Indices

Indirect Indices

Epidemiological Models

Developing Country Health Profiles

Developed Country Health Profiles

Chronic/Smoldering Country Health Profiles

Postconflict Phase Consequences

Shifting Aid From Rural to Urban Environments

Future Complex Humanitarian Emergencies

Professionalization of the Humanitarian Workforce


Study Questions


Additional Resources

16. Nursing in Disasters, Catastrophes, and Complex Humanitarian Emergencies Worldwide

Pat Deeny and Kevin Davies

Chapter Overview

Scale of Disasters Worldwide

Growth of Aid Agencies and Contribution of Nursing

Development of an International Workforce

Ethical Issues in Disaster Nursing

Communication and Transport as Obstacles to Aid Relief

Care of Displaced Persons and Refugees


Study Questions


17. Natural Disasters

Tener Goodwin Veenema, Andrew Corley, and Clifton P. Thornton

Chapter Overview

Types and Consequences of Natural and Environmental Disasters

Severity of Damage

Trends in Natural Disaster

Cyclones, Hurricanes, and Typhoons

Risk of Morbidity and Mortality


Risk of Morbidity and Mortality


Risk of Morbidity and Mortality




Risk of Morbidity and Mortality

Heat Wave

Risk of Morbidity and Mortality



Risk of Morbidity and Mortality



Risk of Morbidity and Mortality


Risk of Morbidity and Mortality

Volcanic Eruptions

Risk of Morbidity and Mortality

Winter/Ice Storms

Risk of Morbidity and Mortality



Risk of Morbidity and Mortality



Study Questions

Internet Activities


Case Study 17.1

Case Study 17.2

Case Study 17.3

18. Environmental Disasters and Emergencies

Tener Goodwin Veenema, Clifton P. Thornton, and Andrew Corley

Chapter Overview

Environmental Emergencies

Environmental Disasters

Environmental Public Health Tracking: Protecting Communities Through Integrated Environmental Public Health Surveillance

Environmental Protection Agency

CDC National Environmental Public Health Tracking Network

Examples of Environmental Hazards and Their Impact

Air Pollutants

Chemical Spills

Risk Management Program Rule (40 CFR 68)

Land, Waste, and Brownfields


Oil Spills

Unconventional Gas and Oil Production


Radiation Release and Contamination




Study Questions

Internet Activities


Case Study 18.1

Case Study 18.2

Case Study 18.3

Case Study 18.4

Case Study 18.5

Case Study 18.6

Case Study 18.7

19. Restoring Public Health Under Disaster Conditions: Basic Sanitation, Water and Food Supply, and Shelter

Mary Pat Couig, Tener Goodwin Veenema, and Adam B. Rains

Chapter Overview

Basic Public Health Functions

Health Promotion

Maslow’s Hierarchy of Needs

Risk Factors for Infectious Disease Outbreaks From Disasters

Rapid Assessment of Population Health Needs

The Role of the Public Health Nurse Following a Disaster

The Sphere Project

Vulnerabilities and Capacities of Disaster-Affected Populations



Access To Toilets

Design of Toilets

Foodborne Illness

Food Safety

Magnitude of Foodborne Illness

Major Foodborne Diseases From Microorganisms

Foodborne Illness Investigation

Challenges in Food Safety

Food Safety Is Essential for Disease Prevention in the Aftermath of a Disaster

Shelter From the Elements

Personal Hygiene

Vector Control

Methods of Vector Control

Restoration of Electrical Power


Study Questions



Appendix 19.1 The Essential Functions of Public Health

20. The Role of the Public Health Nurse in Disaster Response

Janice Springer

Chapter Overview

The Unique Contribution of the PHN

Historical Perspective

Emerging Roles

Role of the PHN in a Disaster

ESF-6 Mass Care

ESF-8 Public Health and Medical Services

Role of the PHN in Prevention and Health Education


Community Groups

Primary and Secondary Schools

Faith-Based Groups

Correctional Institutions

Vulnerable Populations

Post-Disaster Assistance

Care of the Caregiver

Role of the PHN in a Biological Event

Role of the PHN in Infectious Disease Emergencies

Role of the PHN in Medical Countermeasure Dispensing

Role of the PHN in a Chemical Disaster

Role of the PHN in a Radiological Event

Role of the PHN on a Multidisciplinary Response Team


Study Questions


21. Climate Change and Health: the Nurse’s Role in Policy and Practice

Karen Levin and Thomas Chandler

Chapter Overview

Physical Drivers of Climate Change

Selected Health Outcomes

Extreme Weather Events

Thermal Extremes (Heat and Cold)

Vectorborne and Zoonotic Diseases

Food- and Waterborne Diseases

Vulnerable and Susceptible Populations



Urban Poor

Mental Health

The Nurse’s Role in Climate Change

What Are Nurses Doing?

Future Work to Be Done


Study Questions

Useful Links




22. Disaster Triage

Lou E. Romig and E. Brooke Lerner

Chapter Overview

Basic Principles of Disaster Triage

Phases of Disaster Triage: From the Field to the Hospital

Basic Differences Between Daily Triage and Disaster Triage at the Hospital

Daily Triage in the Hospital Setting

In-Hospital Triage Systems for Daily Operations

Disaster Triage in the Hospital Setting

Prehospital Disaster Triage

SALT Triage

Simple Triage and Rapid Treatment


Triage Tags

The Job of the Triage Officer

Disaster Triage for Hazardous Material Disasters


Study Questions


23. Disaster Management

Kristine M. Gebbie and Kristine Qureshi

Chapter Overview

Classifications of Disasters

Internal Disaster

External Disaster

Combined External/Internal Disaster

The Role of Leadership

The Disaster Management Process

Preparedness/Risk Assessment




Staff Competency

The Plan

Relationships and Partnerships

Introduction to Hospital Incident Command System

HICS Structure

Specific HICS Functional Roles

HICS Updates and Coalition Building

Communication During an Emergency Event

Adapting Care to the Context


Evaluation and Follow-Through


Study Questions

Useful Links


24. Public Health Emergencies Involving Community Violence and Civil Unrest: Taking Planned Action

Roberta Proffitt Lavin, Wilma J. Calvert, Sue Anne Bell, Sheila R. Grigsby, and Anne F. Fish

Chapter Overview

Civil Unrest

Ferguson, MO

Social Issues as Foundational Elements in Civil Unrest

Active Shooter

Types of Active Shooters

Active Shooter

Mass Shooting

Mass Killings


Active Shooter Incidents in the Healthcare Setting

Mitigation and Preparedness


Active Shooter Management in the Prehospital Setting


Community Resilience

Mental Health Support


Considerations for Nurses in Mass Shootings

Considerations for Nurses in Civil Unrest


Study Questions

Useful Links


25. Management of Burn Mass Casualty Incidents

Lisa Puett

Chapter Overview




Burn Triage in MCIs

Pathophysiology of Burn Injury

Management of a Mass Casualty Burn Patient

Primary Survey<...