470 study guide

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Community Health Final

Chapters 27, 28, 29, 30, 31, & 32

Chapter 27: Violence

Violence is a national public health problem.

Interpersonal violence

Homicide (15th

leading cause of death in the united states)o

The united states ranks first in the industrial world in violent death rates

o Who is usually the perpetrator of a female homicide?

An intimate partner- 30% of female murder victims are killed by an

intimate partner

Homicide is the leading cause of death in pregnant women

Suicide is the 8th leading cause of death for all Americans. More people die from

suicide than from homicide in the united states.

Intimate partner violence (IPV)

o Ipv is the single greatest cause of injury to women between the ages of 15-24

o Rape is not about love or sex; its about power and control

o

The most dangerous time for a victim is when the victim leaves or attemptsto leave the relationship, because it is seen as an erosion of the abusers

control. (The victim is most likely to be abused at this time more than any

other time in the relationship)

o Power & control wheel

Professional intervention is required to break the cycle of abuse. I

am legally required to report this.

Child abuse

o Most child abuse occurs within the family

Physical abuse

Shaken baby syndrome

o

Violent shaking of an infant causes brain and spinalcord trauma

o Leading cause of death from child abuse in the us

o In approximately 65-90% of shaken baby cases, the

father or mothers boyfriend is the perpetrator

o An 84 year olf woman lived with her youngest

daughter, the daughters live in boyfriend, and 1

child. On this visit, the nurse noted the woman

appeared depressed and dehydrated. Both wrists

were swollen and scabbed. When asked if she was all

right, the woman protested she was fine and her

daughter took good care of her. What action should you take?

According to the text, working with victims of

elder abuse, the nurse must establish rapport

& trust first; remember that competent adults

have the right to make decisions about their

own care, including to stay in a abusive

situation; the nurse should discuss measures



to relieve stress and possible respite care

options with the daughter. The second goal is

to report the abuse.

Wisconsin has always had, and will generally retain, a

voluntary reporting system. Voluntary rather than mandatory

reporting was selected based on this state’s commitment toan adult’s right to self -determination.

Community violence

o Workplace violence (what are most dangerous for health care staff)

In the health care field, the most frequent areas for the occurrence

of violence are the emergency departments, psych units, geriatric

units, and waiting rooms

o Gangs

Although gang problems declined in the 1990s, they have steadily

increased since that time

In 2007, there were estimated 788,000 youth gang members in

27,000 active gangs. By 2011 there were 30,000 gangs in the us—anever-increasing problem!

o Hate Crimes

Often considered worse than other crimes involving violence

because the crime is personal, attacking the victims identity

Chapter 28: natural & man made disasters

Disaster vs emergency

Disaster: any event that causes a level of destruction, death, or injury that affects the

abilities of the community to respond to the incident using available resources

Emergencies differ from disasters in that the agency, community, family, or individualcan manage an emergency using their own resources.

Often times a disaster event may be beyond the ability of the community to respond to

and recover from the incident using its own resources

A disaster affects the whole community, whereas an emergency occurs at a personal

level and the person, family, community can manage the event with their own

resources.

Acts of terrorism

Terrorism is “the use of force or violence against persons or property in violation of the

criminal laws of the united states for purposes of intimidation, coercion, or ransom

Threats of terrorismo Assassinations

o Kidnapping

o Hijacking

o Bomb scares & bombings

o

Computer based attacks

o Chemical, biological, nuclear, radiological weapons

Terrorists goal: to coerce and create fear to accomplish their goals



When should a disaster planned be developed?? Before the disaster occurs!

Local, state, & federal responsibilities

Remember! Agencies and disaster incidents are handled at the lowest possible

organizational and jurisdictional level

Local government

o Responsible for the safety and welfare of its citizens

o The local office of “emergency management” is responsible to develop a

community disaster plan, have emergency drills to test the plan, and

determine the proper response

Federal government

o Main goal: ensure continuity of essential federal functions during any

disruption

National incident management system (nims): integrates practices in disaster preparedness

and response into a comprehensive national framework for incident management.

Federal emergency management agency (fema): Mission= to lead the efforts to prepare the

nation for all hazards and to manage the federal response and recovery efforts following a

national incident

Fema also initiates proactive mitigation activities, trains first responders, and

manages the national flood insurance program and the us fire administration

American red cross (ARC): though chartered by congress to provide disaster relief, is not a

government agency. Primarily a volunteer organization.

Preparedness/planning State: Individual and family preparedness

Individual and family preparedness includes training in first aid, assembling a

disaster emergency kit, establishing a predetermined meeting place away from

home, and making a family communication plan.

Who should create a disaster plan including emergency supplies and where to

meet in case of emergency? Your family

Community disaster planning

The plan should indicate who has the power to declare there is a disaster and has the

power to initiate the disaster plan.

Response stage

“30-2 can do”

o where “30” is the # of respirations, “2” is the # of seconds needed to check

perfusion, and “can do” relates to checking mental status

o

to assess an individual within the 1 minute guideline, the system uses three

characteristics:

First, respirations are checked;



Second, perfusion by pinching the nail bed and observing the

reaction;

Third, mental status, by asking simple questions beginning with,

“who are you? Then “where are you hurt?”

o Remember! Before search and rescue begins, safety must be considered

Disaster triage

Start: Simple Triage And Rapid treatment

Red- life threatening; requires immediate care

Yellow- urgent, but can wait an hour, such as someone with an open fracture but

controlled bleeding

Green- walking wounded, can delay for three hours

Black- mortally wounded, no care required (dead)

The classic phases of a community’s reaction to a disaster:

1. heroic phase

a.

during this phase, nearly everyone feels the need to rush to help peoplesurvive the disaster

b. medical personnel may work hours without sleep, under very dangerous

and life threatening conditions, in order to take care of their patients.

2. honeymoon phase

a. individuals who have survived the disaster father together with others who

have simultaneously experienced the same event.

b. Bonds are formed between victims, between health care workers, and

between victims and health care workers who have shared experiences.

3.

disillusionment phase

a. when time has elapsed and a delay in receiving help or failure to receive the

promised aid has not occurred, feelings of despair occur. Depression mayset in.

4. reconstruction phase

a.

once the community has restored some of the buildings, businesses, homes

and services, and some sense of normalcy is occurring, feelings of despair

will subside

b. counseling support for victims and helpers may need to be initiated to help

people recover.

On an individual level, common responses to a traumatic event include:

cognitive: poor concentration, disorientation, indecision, shortened attention span,memory loss, unwanted memories, difficulty making decisions

emotional:

physical

behavioral

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