Disaster Management How to React respond and Prepare

Disaster Management

Disaster Management How to React respond and Prepare

The Disaster Management involves

  • Initial alert
  • Plan activation
  • Formation of command nucleus.
  1. Initial Alert:-

The hospital may be alerted by the emergency itself this happens in cases where.

The accident takes place near the hospital or the hospital is informed on the telephone or through a person.

The person in the hospital who receiver’s information about the disaster should gather details regarding   causalities.  There details include;

  • Place and time of accident.
  • Estimated number and type of causalities.
  • Source of communication.

The place and time of accident determine the reaction of time of the hospital while the type of causality dictates the type of preparation required by the hospitals.

  1.  Plan activation:

The designated hospital staff – causality medical officer, hospital controller, hospital administrator and senior specialist should be responsible for activating disaster management plan.

The switch board operators, clues on duty or causality in charge should notify the key personnel, activate emergency departments. Such as radiology department, O.T, blood bank, laboratory, medical stores, dietary services, security and ambulances.

The maximum no of staff should be available within 10 minutes of disaster notification.

The matron or senior nursing officer on duty should  prepare a  pre arranged  ward  receive  causalities.


The command nucleus , which  includes the  hospital  controller , matron or senior nursing  officer , and hospital  administrator should  be  formulated  immediately and it should be near  the causality department.


Blood Transfusion Facts Risks Procedures Side Effects

Blood Transfusion

Blood Transfusion Facts Risks Procedures Side Effects

Definition of Blood transfusion

Blood transfusion is an infusion of one person’s blood or  Blood Components (Donor) to another person (Receiver)  through blood Vessels i,e. who are needed Blood and Blood components,


Purpose of Blood Transfusion

1) To increase the oxygen carrying capacity in Anemia Conditions in suitable cases.

2) During the major surgery when much blood loss my be possible.

3) To maintain blood pressure and blood volume during hemorrhagic Condition.

4) To replace blood platelets and clotting factors in hemophilia.

5) To provide anti-bodies and leukocytes in severely ill patients.

6) Burns and Scalds,

7) Accidents and Trauma,

8) Abnormal vaginal bleeding.

Blood Donor

Donor is a person who gives the blood.

Who can Donate Blood

Donor should  be an adult between 17 to 45 years old age with 50 kg of weight at least and Hb not below 12.5 gms

Contra Indication of a Donor

  • Syphilis
  • Typhoid
  • Malaria
  • AIDS,
  • Communicable Diseases i.e, Hepatitis B, Viral Diseases,

Recipient is the person who receives blood.

The standard blood transfusion fluid provides

  • Whole blood.
  • Concentrated suspension of red blood cells.
  • Dried plasma (reconstituted with sterile distlled water)
  • Packed cells.
  • Fractionated cellular components.
  • Substitutes of Plasma. (Dextran 10% which are also referred to as plasma volume expanders).
  • Blood can be stored for 20 days at 4 to 6 centigrades in deep freeze.
  • Fresh blood is much better as blood platelets disintegrate with in twenty four hours.
  • Be sure that it is kept carefully

Types of Blood Groups

Blood must be matched by testing blood groups. Blood  Transfusion carried a bog risk without being tested for capability with the blood of a person receiving the blood (recipient) Each person has antibodies in to the blood, which reacts with foreign body proteins in the blood cells of another person causing agglutination or clumping of the red blood cells.

Types of Blood Groups (ABO system)

Those are 4 types





Group’A’. Has A antigen in the red cells and anti ‘B’ bodies in the plasma.

Group “B” Has B antigen in the red cells and anti “A’ Bodies in the plasma.

Group”AB” Has both A& B antigens in red cells but the plasma contains neither anti A or anti B bodies.

Group”O” Has  no A or  B Antigen in the red cells but has both anti “A: and anti “B” bodies in the Plasma.

Group “A” & “O” commonly found in European countries.

Rhesus Blood Group System

The Rhesus or RH Group was given this name as it was found that the same system of antibodies was present in the blood of the rhesus monkey .

These are two types:

Rhesus Positive or Rh+ve (D+ve)

Rhesus Negative or RH-ve (D-ve)

About 85% of Population is Rh+ve group and and about 15% of population os Rh –Ve group.

Transfusion of Rh +ve blood to a Rh negative individual can be dangerous,

since the Rh Negative blood cell produce antibodies to destroy the transfused cells.

The effect of a first transfusion may be effective slightly, but the individual become sensitive to

the Rhesus D factor and further transfusion with Rh positive blood may produce a serious reaction .

Transfusion of ABO Group Blood

Group”A” receive from “A” Group and “O” group

Group”B” Receive from “B” Group And “O” Group

Group “AB ‘ (Universal recipient ): Receive from “A” “B” “AB” or “O” Group

Group “O” (Universal donor ): Receive from only Group “O”

General  Instructions for Blood Transfusion

  • Blood should be fresh.
  • Correct blood Group and Rh Type must be given to correct patient. Any error in the labeling of blood can lead to serious consequences.
  • Blood must be stored at 4 -6 Degree’s Celsius  in the refrigerator should not below 4 Degree’s Celsius  or heated.
  • Avoid shaking the container, if needed blood can be mixed gently and if cells have settled at the bottom.
Equipments needed for Blood Transfusion
  • Disposable blood transfusion set(1).
  • Canula No 20 (1) for child canula No.23 (1)
  • Sterile swabs.
  • Antiseptic lotion.
  • I/V Stand .
  • I/V hanger.
  • Adhesive plaster.
  • Emergency Medicine tray.
Procedure for Blood Transfusion
  • Perform Hand washing Before Procedure,
  • Identify the Client with Hospital Registration Number,Name and Diagnosis,
  • Ensure informed consent from Patient and Attenders,
  • Teach patient what are the event of an adverse Blood transfusion reaction, such as skin rash, rapid breathing, rapid heart rate,chills, vomiting, back pain,
  • Check patients vital signs, i.e, Blood Pressure, Temperature, Pulse Rate, Respiratory Rate,
  • Check for Physician Orders verify the blood component, Clients identity by comparing the laboratory blood records, i.e,  Blood Bag unit Number on the blood bag label, The blood ABO group, Rh factor,expire date,
  • Inspect for Blood bag appearance of components clots, cloudiness,abnormal color,
  • Take the equipments to bed side.
  • Prepare the patient.
  • Hand wash and wear gloves,
  • IV cannula should be inserted in the vein with complete aseptic technique.
  • It should be kept in position with Adhesive tape and fully comfortably.
  • In small child or in case of difficult patient splint is needed . It should be securely placed with proper bandage.
  • Open Blood administration set and clamp roller completely,
  • Spike blood component blood bag unit port,
  • Infuse blood slowly for fist 15 minutes,
  • Regulate the rate of flow from 40-45 drops per minutes or according to the Physician’s order.
  • Observe and document client’s condition i.e, Blood Pressures, Temperature, Respiration rate, Pulse rate,
  • Keep constant watch on the Patient, inspect the bottle frequently .
  • When blood transfusion was completed clamp roller,
  • Record on the chart time, amount of blood given and vital signs .
  • For Recipient 1) I.V. disposable Set, Arm Splint , I.V stand 2) Warm normal saline in bowl of hot water.
  • wash hands and Record and document procedure,

Precaution for Blood Transfusion

Stop Blood if patient gets rigor.

Note: Donor’s blood must be tested for syphilis, malaria and AIDS. Before giving the blood, it must be grouped carefully to make sure that it will not cause clothing with recipient’s blood. It must matcj,

Do not warm the blood before using it as it raises the temperature of the blood and encourage the growth of bacteria.

Do not wash the bottle for several hours after blood has been given, in case it is necessary to recheck blood type.

If any complications of Blood Transfusion

Stop Blood Transfusion,
Replace IV Set (IV Tubing),
Inform Blood Bank,

Risks and Complications of Blood transfusion

1) Raised Pulse.

2) Difficult Breathing.

) Oedema.

4) Cough.

5) Cardiac and respiratory distress.

All the above signs should be carefully watched for and reported immediately.

6) Renal Failure

7) Pyrenial reaction

8) Thrombosis.

9) Hematoma

10) Sepsis.

11) Air embolism


Bed Making Nursing Procedure Types of Beds Purposes and Principles General Instructions for Patient

Bed Making

Bed Making Nursing Procedure Types of Beds Purposes and Principles General Instructions for Patient &   Staff Nurses Need to be Learn different types of Beds for specific needs and purposes of clients i.e unoccupied bed, Occupied bed,

Bed Making Nursing Procedure Types       

Unoccupied Bed,

Occupied Bed,

Cardiac Bed,

Fracture Bed,

Critical Care Bed,

Maternity Bed,

Electric Bed

Bed Making Nursing Procedure Types Purposes and Principles

  1. To Make Clients comfort,
  2. To observe clients,
  3. To provide clean and Hygienic environment for the client,
  4. To provide client with safe and comfortable Bed making to take Rest and promote sleep,
  5. To adopt the needs of clients,
  6. To be ready for any critical illness,
  7. To provide Nursing care to the Clients

Principle for Bed making Nursing Procedure

Prevent cross infection and multiplication of microorganism during Bed Making,

Procedure application of strict aseptic Technique,

Hand wash before and after procedure

Change linen frequently to ensure cleanliness,

Damp dusting recommended for cleaning with soap water, disinfectant solution,

Comfortable, Clean and Safe Bed Making will ensure rest and promote sleep and also prevent complications of prolonged bed ridden patient, i.e, Pressure sore, foot drop,

Make bed wrinkle free and smooth,

Maintain good body alignment and body mechanics to prevent fatigue,

Follow systemic ways of functioning saves energy and times,

Bed Making Nursing Procedure General Instructions,

Before Bed Making and after Bed Making procedure does the Hand wash it can prevent and Minimise cross infection,

Do not mix clean and soiled clothes,

Maintain good body mechanics,

Protect economy of time, Material and energy,

Make the bed firm smooth and unwrinkled

Practice economy of time, energy and material

Arrange the bed clothes in such a way that they allow freedom in the day time but come over the shoulders at night and the top linen loose over the feet.

The mattress must be turned aired and made free of lumps and creases.

Make adaptations according to weather climatic differences,

Individual needs customs and habits of our clients.

Always get extra help to make a bed for helpless patients and prevent them from falling.  i.e., the side rails may be used to prevent them falling,

Keep a reasonable distance from the face of the patient to prevent cross infection.

Check the cot, mattress and pillows daily for the presence of vermin’s and destroy them if found on the bed.

The nursing principles such as individually, comfort, safety and good workman ship should be kept in mind during the bed making.

Unoccupied Bed Making
Empty Hospital Beds

Unoccupied bed making is done the bed is empty (Patient not at bed), Unoccupied bed is the easiest Bed Making procedure,


–   To make a bed which comfortable and safe for the patient, neat, economical in time and effort.

Preliminary assessment

Check the doctor’s order for specific precautions regarding the movement and positioning of the patient.

Assess the patient ability for self care.

Check the furniture and linen available in the patient’s unit.

Assess the number of clean linen needed.

Assess the articles needed for comfort of the patient. E.g. blankets back rest et

Preparation of the articles

The usual articles and supplies  in the patient’s unit are:


Mattress and pillows

Chair or stool

Bedside table

Bed side  locker.



Articles needed for the complete hange of linen are:

Mattress covers.

Towel sheet.

Draw sheet.

Pillow case.

Detergent powder in a container.

Tray Containing:

–          Basin with water and a duster.

–          2 sheets

–          Draw sheet and mackintosh

–          Blanket if necessary

–          Counter pane and pillow, pillow case

–          Kidney tray, paper bag

Unoccupied Bed Making Procedure:

  1. Place stool or chair at the foot end of the bed, locker at 45 degree angle.
  2. Collect the cleaning equipment and clean linen. Place on the stool or chair in the order of use.
  3. Loosen the bed linen starting from head end and go round.
  4. Dust the mattress and the cot from head end to foot end. Then clean the bottom and legs of the cot.
  5. Place the sheet on the mattress keeping the center fold in the center of the bed. Unfold the sheet keeping the right side of the hem, upper most.
  6. Pull the sheet to the foot end of the bed. If long enough, tuck 30-37 cms under the top of the mattress and make a mitred corner. Tuck at the food end and along the sides of the mattress.
  7. if the sheet is short place the sheet at the foot end edge of the mattress and tuck on the side nearest to the nurse.
  8. Centre the mackintosh on the mattress with the upper edge about 16 inches from the top of the mattress. Centre the draw sheet over the mackintosh and tuck in at the sides of the mattress.
  9. Centre the top sheet on the foundation with the wrong side of hem upper most and place the top sheet hem at the edge of the mattress. Pull the sheet to the foot end of the bed and make the mitred corner at the lower edge of the mattress on the side nearest to the nurse.
  10. Centre the blanket on the top sheet. Place the upper edge of the blanket 8 inches below the top of the bed. Fold the top sheet over the blanket. Tuck in the lower edge of the blanket under the mattress. Make the mitred corner.
  11. Centre the counterpane on the bed. Place the upper edge of the counter pane even with the top edge of the mattress. Pull the counterpane at the foot of the bed. Tuck in and make the mitred corner. Leaving the sides of the counterpane hanging free.
  12. Go to the opposite side of the bed. Fan fold each piece of linen at the center of the bed in order. Repeat the steps from 5 to 9.
  13. Return to the opposite side of the bed. Cover the pillow with the pillow case. Adjust the pillow case to the size of the pillow. Place the pillow under the counter pane.
  14. Clean the locker and chair replace the locker and the chair in the respective place. Aline the cot with other cots in the ward. Wash, dry and replace equipment.

  1. For remarking the bed

(a)    Place stool or chair at foot end of the bed and the locker at 45o angle the bed.

(b)   Untuck the bed linen from all sides and place pillow on the stool or chair.

(c)    Fold the linen from the head end to the foot end.

(d)   Fold the counter pane, blanket and top sheet in quarter and place them in stool or chair one by one with the open ends away from the ward entrance.

(e)    Fold the draw sheet and dust the mackintosh fold and put them on stool (or) chair.

(f)    Fold the bottom sheet and put it on the stool.

(g)   Dust the mattress and cot.

(h)   Repeat the steps from 5 to 10.

For admission bed:

a) Fan fold the top linen at the foot end of the bed.

b) Use long bed mackintosh and two sheets.

For fracture bed:

Use fracture bed or wooden boards and firm mattress