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SEMESTER 6: Chronic, Clinical, Emerg > Emerg FINAL > Flashcards

Emerg FINAL Flashcards

1
Q

during triage, ALL ambulatory patients are marked as what colour?

What is the exception..

A

GREEN
- literally everyone, even kids

….EXCEPTION: children who are carried to the GREEN by other victims must be assessed first in those areas

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2
Q

What is a good mnemonic to help you remember START triage?

A

R P M
or
30 2 Can do

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3
Q

why do adults and children have different triage assessment tools?

A

children and adults do NOT have the same physiology

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4
Q

What does START stand for?

A

simple triage and rapid treatment

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5
Q

Why doesn’t START triage work for children?

A
  • following commands may not be appropriate for age
  • cap refill may not be accurate due to cool environments
  • resps count can over or under triage children
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6
Q

When is the time you would tag someone as YELLOW during START triage?

A

they are unable to ambulate, resps under 30, cap refill under 2sec and can follow commands.
- they have everything approved other than the ability to ambulate

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7
Q

Why do we need a pediatric tool?

A
  • too optimize ALL victims, not only children
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8
Q

Who developed the jumpSTART tool?

A

Lou Romig

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9
Q

How do you determine if you use JumpSTART or START?

A
  • if the victim appears to be a child.. use JumpSTART

- if the victim appears to be a young adult… use START

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10
Q

Who is evaluated first in secondary triage?

A

infants, those who were carried

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11
Q

in jumpSTART, what is the target resp?

A

15-45

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12
Q

What does AVPU stand for and what is it used as?

A

a tool to evaluate consciousness.

  • ALERT
  • VERBAL (responsive to✓)
  • PAIN (responsive to✓)
  • UNRESPONSIVE
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13
Q

AVPU is the last step of jumpstart triage. How would you use this tool to differentiate RED tags from YELLOW tags?

A
  • YELLOW: alert and appropriate pain and verbal response

- RED: unresponsive or inappropriate pain/verbal response

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14
Q

What is the modification for nonambulatory children?

A
  • if RED, then leave RED
  • if YELLOW,
    …..leave YELLOW if significant external signs of injury (burn, bleeding, amputation, deep wound, tender abd.)
    ……GREEN if no significant external injury
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15
Q

Who is considered for the modification of nonambulatory children?

A

(infant, development delay, disability, prior acute injury)

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16
Q

What’s your call?

A young school aged boy is found lying on the roadway 10 ft from the bus.

  • Breathing 10/min
  • Good distal pulse
  • Groans to painful stimuli
A

RED

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17
Q

What’s your call?

An adult male is kneeling across the road from the bus, he says he is too dizzy to walk.

  • RR 20
  • CR 2
  • obeys commands
A

YELLOW

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18
Q

What’s your call?

A toddler comes out from inside the bus, walking toward you and crying.

  • no obvious bleeding
  • torn clothes
A

GREEN

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19
Q

What is your call?

A young school aged boy props himself up on the road.

  • RR 28
  • Good distal pulse
  • Answers question and commands.
  • Has obvious deformity of both lower legs
A

YELLOW

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20
Q

For jumpstart triage, when are the only times you tag BLACK?

A
  • apneic after positioning airway and pulse unpalpable

- pulse palpable, remains apneic after 5 rescue breaths

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21
Q

For start triage, when is the only time you tag black?

A

remains apneic after positioning airway

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22
Q

START and jumpSTART are examples of ______.

A

primary triage

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23
Q

What is primary triage?

A

first look at an MCI

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24
Q

What is the CTAS?

A

Canadian ED triage and acuity scale

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25
Q

What are the levels of CTAS?

A 
level 1: resuscitation
level 2: emergent
level 3: urgent
level 4: less urgent
level 5: non urgent
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26
Q

Pts should have initial triage assessment within __mins of arrival.

A

10 minutes

27
Q

If a pt is level 1 CTAS, what is the time to assessment?

A

IMMEDIATE, they are near death without intervention

28
Q

If a pt is level 2 CTAS, assessments every __mins

A

15 minutes

29
Q

If a pt is level 3 CTAS, assessments every __mins

A

30 minutes

30
Q

If a pt is level 4 CTAS, assessments every __mins

A

60 minutes

31
Q

If a pt is level 5 CTAS, assessments every __mins

A

120 minutes

32
Q

What presentations would a pt have if they fall under level 1 triage for CTAS?

A
  • code/arrest
  • signs of shock
  • near death asthma
  • severe resp distress
  • altered mental state
  • major trauma
33
Q

What presentations would a pt have if they fall under level 2 CTAS triage?

A
  • chest pain
  • severe anaphylaxis
  • overdose
  • sexual assault
  • diabetes (hyper/hypo)
  • severe headache
  • back pain
    ……..etc.
34
Q

What are the differences between institutional triage verses field triage?

A

institutional triage = CTAS

field triage = START and JumpSTART

35
Q

What are the 4 parts of the Canadian Emergency Mgmt Framework?

A
  • prevention/mitigation
  • preparedness
  • response
  • recovery
36
Q

What is Risk Assessment for and what are the 3 questions asked to determine it?

A

to evaluate hazards, then remove them and/or minimize risk.

  • what is the probability of the occurence?
  • what impact would it have?
  • what is your preparedness?
37
Q

Black is considered ______

A

dead

38
Q

Green is considered ____

A

minor

39
Q

Yellow is considered____

A

delayed

40
Q

Red is considered ____

A

immediate or life-threatening

41
Q

Why are resources important in triage?

A

during disasters, patient care needs overwhelm response resources

42
Q

When resources are overwhelmed, what rule must we follow?

A

do the greatest good for the greatest number of people

43
Q

“do the greatest good for the greatest number of people”…. what is this rule called?

A

utilitarian rule

44
Q

Triage is only the initial assessment. T or F

A

FALSE…. triage is a dynamic process that is usually done more than once

45
Q

What is the goal of primary disaster triage?

A

sort pts based on their needs

- recognize futility … this triage is based on physiology

46
Q

What is the best triage tool?

A

there is no such thing, there has been no evidence data to validate all of the assessment tools against each other.

47
Q

What is the goal of secondary triage?

A
  • what is the pts CURRENT AND ANTICIPATORY NEEDS
48
Q

NATO guidelines for Red tag:

A
  • airway obstruction
  • burns of face or neck
  • shock
  • cardiorespiratory failure
  • sucking chest wound
  • severe external hemorrhage
49
Q

NATO guidelines for Yellow tag:

A
  • open thoracic wound
  • avascular limb
  • fractures
  • abd wound
  • severe eye injury
50
Q

NATO guidelines for Green tag:

A
  • able to ambulate
  • burns of less than 20% BSA
  • minor laceration
  • sprains
  • superficial burn
51
Q

NATO guidelines for Black tag:

A
  • burns of over 85% BSA
  • GCS under 8
  • multisystem trauma
  • impending death
52
Q

What is the goal of tertiary triage?

A

optimize INDIVIDUAL outcome

53
Q

Triage category blue means….?

A

probably unsalvageable, minimal signs of life present

54
Q

What are some important WMD triage challenges that must be taken into consideration?

A
  • who goes first?
  • at what stage does triage take place?
  • difficult to conduct pt assessment with responders in protective gear
  • **agents of attack may be mixed. how do you treat conventional injuries AND chemical, nuclear, exposure at the same time?
55
Q

What are the 3 chemical toxindromes?

A
  • cyanide
  • nerve agents
  • phosgene/vesicants
56
Q

Pt has severe burns over most of their body, minimal pulmonary involvement. Out of the three chemical toxindromes, what were they likely exposed to? are they RED or BLACK

A

phosgene and vesicant!

  • BLACK
57
Q

Pt has rapid onset of apnea and preserved circulation. Out of the three chemical toxindromes, what were they likely exposed to? are they RED or BLACK

A

Cyanide!!

  • RED
58
Q

Pt is seizing, in severe distress. Out of the three chemical toxindromes, what were they likely exposed to? are they RED or BLACK

A

Nerve agents!!

  • RED
59
Q

What is the limiting factor to consider in MCI triage?

A

RESOURCE AVAILABILITY

60
Q

What is CISM?

A

critical incident stress management

  • “EMOTION FIRST AID”
  • umbrella term for all programs and services aimed to reduce stress and PTSD risk in individuals who have experienced disaster
61
Q

What is CISD?

A

critical incident stress debriefing
- small group program where leaded discussion and story-telling is made about a disastrous event that was experienced by all involved

62
Q

What are the 3 primary goals of ICS?

A
  • provide order to the predicted division of labour
  • ensure overall safety
  • ensure work is efficient and effective.
63
Q

What is the definition of disaster?

A

When the number of injured exceeds the resources available

SEMESTER 6: Chronic, Clinical, Emerg (4 decks)

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