13.4 Disaster Nursing

Question 1

Multiple Casualty Incidents (MCI)

Answer 1

• Healthcare facilities are required to fill a Emergency Operations Plan (EOP) to prepare for this

Question 2

EOP Elements

Answer 2

Activation Response
- Where, how and when the response is initiated

Internal/External Communication Plan
- Communication between hospital and pre-hospital area

Plan for Coordinated Patient Care
- Plan for patient care including transfers to and from the hospital and other facilities.

Security Plans
- How to control a chaotic situation

Identification of External Resources
- Local/State/Federal resources

Plan for People Management and Traffic Flow
- How to manage patients, media, personnel.

Data Management Strategies
- Electronic Health Records and backup systems

Demobilization Responses
- Deactivation of responses to not exhaust unnecessary resources.

After-Action Report (Corrective Plan)
- Facilities often see increased volumes of patients 3 months after an incident. Debriefings must be provided immediately and at a later date

Practice Drills Plans

Anticipated resources such as water and food

MCI planning such as mass fatalities and morgue readiness

Education plan for all above resources

Question 3

Disaster Triage

Answer 3

• The goal is to save the largest amount of survivors

Issues
- Inadequate resources
- Infrastructure limitations
- Limited transportation
- Hospital resources are overwhelmed

Considerations
- Managing internal issues
- Communicating with families and the media
- Caring for families
- Stress management

Question 4

Triage

Answer 4

• Sort patients based on needs for immediate care and medical needs will strip available resources.

Primary Triage
- Usually done on the scene or at the hospital

Question 5

START Acronym

Answer 5

• If the patient can walk it is considered a minor injury (Green)
• If patient cannot breathe and airway cannot be opened they are considered deceased (Black)
• If patient is breathing but has no pulse then they are immediate (red)
• If there is a pulse but they are not responsive they are delayed (yellow)

Question 6

3 T’s of ED

Answer 6

• Triage
• Treatment
• Transport

Question 7

Types of Treatment in ED

Answer 7

Black - Expectant
Red - Immediate
Yellow - Delayed
Green - Minimal

Question 8

SALT

Answer 8

• Sort
• Assess
• Live-Saving Interventions
• Treat/Transport

If they have obvious life threats assess them first

If they have purposeful movements assess them second

If they can walk assess them third

Question 9

Disaster Triage

Answer 9

Red (Immediate)
- Life threatening. GET THEM TREATMENT
- Severe breathing alterations, circulatory issues, and mental status LOC.
- Spinal cord injuries, neurogenic/cardiogenic shock, hemorrhage, severe burns, respiratory trauma (collapsed lung, pneumothorax)

Yellow (Delayed)
- Second highest priority because they have serious injuries but they are breathing, have good circulation, good mental status.
- Major bone fractures, open wounds, deep lacerations

Green (Minimal)
- Patient can walk
- Minimal injuries and non-life threatening

Black (Expectant)
- They are in the process or have already died
- Injuries are to the point of no survival
- No breathing, no circulation