EXAM 5 Flashcards
1 cause of death
trauma
first step in emergency
check the scene -this must be done before providing care
primary survey
A=airway (with cervical spine stabilization and immobilization),
B=breathing (rate, rhythm, and effort),
C=circulation (SBP of at least 90 with radial pulse, 60 with carotid or femoral pulse)
D=disability (neurological assessment – GCS (if less than 8, intubate),
E=exposure/environmental control (measures to keep the patient warm, removing clothing to assess for other injuries)
Secondary survey
F - full set of vitals , EKG, pulse ox, foley, NG/OG tube, labs
Give comfort
history head to toe
inspect posterior
ESI 1
unstable, needs immediate care, cardiac arrest, intubated trauma victim, severe overdose
ESI 2
threatened, needs care in minutes, chest pain, multiple trauma, child with fever and lethargy (bc meningitis), disruptive psychiatric patient, immunosuppressed patient
ESI 3
stable, needs care within 1hour, abdominal pain, GYN disorders
ESI 4
stable, care can be delayed, simple laceration, cystitis, typical migraine
ESI 5
stable, care can be delayed, cold symptoms, re-check, minor burns
black tag
expectant) are used for the deceased and for those whose injuries are so extensive that they will not be able to survive given the care that is available.
red tag
(immediate) are used to label those who cannot survive without immediate treatment but who have a chance of survival.
yellow tag
(observation) for those who require observation (and possible later re-triage). Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances.
green tag
(wait) are reserved for the “walking wounded” who will need medical care at some point, after more critical injuries have been treated.
white tag
(dismiss) are given to those with minor injuries for whom a provider’s care is not required.
golden hour
refers to the first hour or initial time period following initial traumatic injury. Survival rates increase with proper care during the time soon after injury.
lethal triad
often cause deaths during the first 24 hours. The “lethal triad” are coagulopathy, acidosis, and hypothermia.
platinum 10 minutes
no patient should have more than 10 minutes of stabilization on the scene prior to transport to a trauma center.
coagulopathy
results from blood loss and tissue injury leading to an imbalance between clotting, anti-coagulation and fibrinolysis in the early stage of trauma which results in continued bleeding
due to hypothermia and acidosis
tx: fluid and warm blood products
acidosis
Lactic acid rapidly accumulates and cannot be cleared by the body causing a drop in pH.
promotes hypotension, impairs O2 delivery, leads to arrythmias, and liver cannot clear lactic acid
hypothermia
shivering, which inc metabolic demands and o2 consumption
leads to ischemia, dec contractiltiy, arrythmias, impaired clotting
focus of lethal triad care
correcting hypovolemia, preventing and treating shock, and maintenance of adequate oxygenation
warm fluids, transfusion, early intubation and ventilation, warm blankets, warm room
who should be notified
primary and secondary nurses
ED docs
EMT/ED techs
OR/anesthesia
Resp therapist
lab techs
radiology
ICU
security
9 nursing roles
Know facility’s role in emergency and disaster response
Know and use the chain of command
Locate facility’s emergency/disaster response plan
Know and demonstrate role in emergency/disaster response
Participate in drills
Demonstrate correct operation of equipment needed
Know personal limits in knowledge, skills
Apply creative problem-solving and flexible thinking
Take personal responsibility and contribute to solutions
red cross definition of disaster
an occurrence, either natural or man-made, that causes human suffering and creates human need that victims cannot alleviate without assistance - NEED OUTSIDE HELP
stanhope and lancaster def of disaster
any human-made or natural event that causes destruction and devastation that cannot be relieved without assistance - NEED outside help
charge nurse role
use chain of command
4 phases of disaster response
Mitigation
Preparedness
Response
Recovery
Langan and James’ 5 Stages of Disaster:
Non-disaster – before the treat of disaster becomes real. Time to plan and educate – this is mitigation.
Pre-disaster – event is certain to occur but has not yet happened. Time to warn and evacuate – this is preparation.
Impact – disaster is occurring, effects are felt
Emergency – community comes to help of those affected, outside resources mobilized – this is response.
Reconstruction – rebuilding, restoration, mitigation of effects – this is recovery.
when should preparation begin
at personal level
nurses role in preserving evidence 6
care for patient first
contact law enforcement
obtain specimens
avoid damaging evidence
bag and preserve evidence
document
6 people more at risk for difficulty in responding and recovery from disaster
Extremes in age
People dependent on treatment and care
The disabled
Economically disadvantaged
People with mental health disorders
People who have experienced previous emergency/disaster
