Emergency management, violence, PTSD, Communication - Unit 4 exam Flashcards
What mass casualty color code would this be?
Shock
red
All of the following are S/S of what?
- Re-experience the traumatic event
- Flashbacks
- Sustained high level of anxiety or arousal
- General numbing of responsiveness
- Intrusive recollections or nightmares
- Amnesia to certain aspects of trauma
- Depression
- Survivors guilt
- Anger
- Substance abuse
- Relationship problems
- Suicidal thoughts
PTSD
What mass casualty color code would this be?
Hemorrhage
red
What is a hallmark sign of a tension Pneumothorax
Tracheal deviation to the unaffected side
First thing to do during the decontamination process
Remove and bag a patients clothing.
Eliminates 60-90% of contents asap
S/S of a Tension Pneumothorax
- Diminished breath sounds
- Deviated trachea to unaffected side
- Muffled heart sounds
- Decreased CO & BP
Nursing priorities for suspected child abuse
- STAY WITH PATIENT
- Reporting to authorities when there is reason to suspect child abuse or neglect
- Provide shelter and promote reassurance or safety
- Promote trust
Priority levels of care
- ABC’s
- Sudden change in VS and LOC
- Unstable metabolic disorders
- C/O Pain (except chest pain)
- Complex tmnt and skills
- D/C teaching and referrals
Treatment for PTSD
- Cognitive therapy
- Prolonged exposure therapy
- Group family therapy
- Eye movement desensitization and reprocessing
- Psychopharmacology
What mass casualty color code would this be?
Life-threatening, treatable with immediate attention
Red or Immediate
What mass casualty color code would this be?
Sprains
Green
occurs if air or blood cells collect in the pleural space and is not removed
Tension pneumothorax
What mass casualty color code would this be?
Fractures
Yellow
Ways to prevent hypothermia
o Remove wet clothing
o Cover with blankets
o Increase room temp
o Infuse warmed fluids
o Heat lamp
Clamping a chest tube can cause what?
A tension pneumothorax
What mass casualty color code would this be?
Burns <20%
yellow
What mass casualty color code would this be?
Potentially serious but stable enough to wait a short while for a medical treatment
yellow or delayed
5 rights of delegation
- Right Task
- Right Circumstance
- Right Person
- Right Direction/communication
- Right Supervision/evaluation
What mass casualty color code would this be?
Threatened loss of limb
red
What mass casualty color code would this be?
Airway obstruction
Red
What mass casualty color code would this be?
Minor injuries can wait for longer periods of time
Green or minimal
A condition where multiple broken bone rib fragments cause chest paradoxical breathing
Flail chest
What mass casualty color code would this be?
Tension pneumothorax
red
What mass casualty color code would this be?
Facial injury without airway involvement
Yellow
What mass casualty color code would this be?
Full thickness burns > 50% TBSA
Black
What mass casualty color code would this be?
High SCI
Black
What mass casualty color code would this be?
MI
red
When is someone who is being abused most in danger?
Period right after leaving the abuser
What mass casualty color code would this be?
Head injury
red
Nursing priorities for pt’s with PTSD
- Establish therapeutic relationship encourage patient to share feelings
- Provide safe , non threatening , routine environment
- Assess client for suicidal ideation , take precautions as needed
- Use multiple strategies to decrease anxiety (music, imagery, relaxation, breathing techniques )
- If pt is a child involve caregivers in treatment
How to treat an open pneumothorax from a GSW/stabbing
- Insert chest tube
- Only tape 3 sides of dressing over wound to prevent tension pneumo
What does this stand for?
START
Simple Triage & Rapid Treatment
What mass casualty color code would this be?
Minor burns
Green
Medications to treat PTSD
o SSRI (first line): paroxetine , sertraline
o Tricyclic antidepressants: Amitriptyline (evlavil)
o MOA inhibitors
o Benzos, busprione , propranolol
Communication with families in a crisis
- Keep them updated
- Allow to stay close
- Appoint an advocate
- Don’t use medical jargon
- Give factual information
S/S of PTSD
- Re-expiernce the traumatic event
- Flashbacks
- Sustained high level of anxiety or arousal
- General numbing of responsiveness
- Intrusive recollections or nightmares
- Amnesia to certain aspects of trauma
- Depression
- Survivors guilt
- Anger
- Substance abuse
- Relationship problems
- Suicidal thoughts
Reasons victims stay with their abuser
- Fear for their lives or lives of their children
- Fear of retaliation by the partner
- Fear of losing custody of their children
- Lack of financial resources
- Lack of a support network
- Religious reasons
- Having hope that the partner will change, and they can have good times again
- Lack of attention to the danger
Root cause analysis
- Identify problem
- Define problem
- Understand problem
- Identify Root cause
- Correct Action
- Monitor
*Repeat
What mass casualty color code would this be?
Lacerations
Green
What mass casualty color code would this be?
No pulse or breathing after airway opened
Black
What mass casualty color code would this be?
Ambulatory
green
Maslows Hierarchy of needs
- Self-actualization
- Self-esteem
- Love and belonging
- Safety and security
- Physiological needs
Components of the primary survey of an emergent patient
A - Airway with C -spine
B - Breathing/ventilation
C - Circulation
D - Disability
E - Exposure/environmental
What mass casualty color code would this be?
Torso wounds without shock
Yellow
What mass casualty color code would this be?
Transcranial GSW
Black
What mass casualty color code would this be?
Dead, no VS, injuries incompatible with survival
Black or expectant
What mass casualty color code would this be?
Soft tissue injuries with minimal bleeding
Yellow
Fast five interventions
- Full set of vital signs
- Further labs and x-rays
- Foley Catheter
- Facial trauma presence
- Facilitate family presence
How is flail chest treated
Intubation
Prioritization Principals
- Systemic before local
- Acute before chronic
- Actual problems before potential problems
- Recognize condition changes/emergencies (unstable) vs. expected findings (stable)
Conflict resolution steps and actions
- Strive for “win-win”
- Identify the problem or issue
- Generate a possible solution
- Evaluate suggested solutions
- Choose the best solution
- Implement the solution chosen
- Evaluate: Is the problem resolved?
How to treat a tension Pneumothorax
Needle decompression
What does this stand for?
S.A.L.T
S – Sort
A – Assess
L – Lifesaving Interventions
T – Treatment and/or transport
Mnemonic for collecting pt history during second survey
- A - allergies
- M - medications
- P – previous medical history
- L – last meal
- E – event history or mechanism of injury/Any alcohol or drugs involved?
- H - head-to-toe assessment once client is stable
What mass casualty color code would this be?
Severe abdominal injury
Red
Components of a secondary survey of an emergent patient
F - Fast 5
G - Give comfort measures
H - History
