NCMB 418 (CU 15) Flashcards
old French word “trier” means
to sort
Used in:
* hospital emergency rooms
* on battlefields
* disaster sites when limited medical resources must be allocated
Triage
number of victims is < 100
Multiple
number of victims is > 100; MCI
Mass
immediately affected by the event
Direct Victim
family member or friend of the victim or a first responder
Indirect Victim
evacuees of the disaster
Displaced
a group of people who have fled their home or even their country as a result of famine,
drought, natural disaster, war or civil unrest
Refugees
Starts the process by clearing
the ‘walking wounded’ using
verbal instructions
MASS
M -
A -
S -
S -
- Move
- Assess
- Sort
- Send
S
A
L
T
*Sort
*Assess
*Life-threatening intervention(s)
*Treat and Transport
minor - “walking wounded”
Green
expectant (deceased)
Black
client needs immediate treatment within the hour but has a chance of survival
Red
client not in immediate danger; treatment may be delayed for an hour
Yellow
Immediate
Delayed
Minimal
Expectant
Immediate = red
Delayed = yellow
Minimal = green
Expectant = black
- Identification of patients who should not wait to be seen
- Prioritization of incoming patients
Emergency Department Triage
life- or limb-threatening
Severity
immediate treatment is needed to alleviate symptoms
Acuity
A -
B -
C -
D -
A – Requires immediate LSI
B – high risk situation
C – number of resources needed
D – danger zone
high risk instability criteria
ESI level 1 or 2
evaluates expected resource needs
ESI level 3, 4, or 5
- failure of the heat regulating mechanisms of the body
- body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down
Heat Stroke
Assessment of heat stroke
- CNS dysfunction
- Headache, dizziness, nausea, vomiting and confusion
- Elevated body temperature
- Hot, dry skin; and usually anhidrosis
- Tachypnea, hypotension, and tachycardia
mgt for heat stroke
- Stabilizing oxygenation
- Remove patient’s clothing
- Ice applied to the neck, groin, chest,
- Survival for at least 24 hours after submersion into liquid (usually
water)
Near-Drowning
mgt of drowning
- Immediate CPR
- Ensure an adequate airway and oxygenation
- ET intubation
- Rectal probe
- ECG monitoring
- Indwelling urinary catheter
- NGT
is any substance when ingested, inhaled, absorbed,
applied to the skin, or produced within the body in relatively small
amounts, injures the body by its chemical action
Poisoning
Stinging Insects: Management
- Stinger removal
- Wound care with soap and water
- Ice application
- Oral antihistamine and analgesic
- Epinephrine
- Desensitization therapy
Cause swelling and tissue damage wherever you’ve been bitten
Cytotoxins
Disrupt the blood vessels.
Haemorrhagins
Prevent the blood from clotting
Anti-clotting agents
Cause paralysis or other damage to the nervous system.
Neurotoxins
Break down muscles
Myotoxins
not applied as initial first aid at the site of the snake
ice or a tourniquet
med for snake bite
- Corticosteroids (contra. in first 6-8 hours)
- Parenteral fluids
- Vasopressors
- Antivenin (antitoxin)
Most effective if administered within 12 hours after the snake bite.
Antivenin
antivenin is premedicate with
diphenhydramine and cimetidine
Before administering antivenin and every 15 minutes thereafter, the circumference of the affected part is measured proximally.
true
The most common cause of allergic reaction to the antivenin is
too-rapid infusion
Corrosive poisons include alkaline and acid agents that can cause tissue destruction after coming in contact with mucous membranes
Ingested (Swallowed) Poisons
- Iye, drain cleaners, toilet bowl cleaners, bleach, non-phosphate
detergents, oven cleaners, and button-shaped batteries
Alkaline agents
toilet bowl cleaners, pool cleaners, metal cleaners, rust removers, battery
acid.
Acid products:
- to induce vomiting in the alert patient
Syrup of ipecac
for the obtunded patient Gastric aspirate is saved and sent to the laboratory for testing (toxicology screens)
Gastric lavage
if poison is one that is absorbed by charcoal
Activated charcoal administration
is never induced after ingestion of caustic substances or petroleum distillates
vomiting
a sudden illness that occurs after ingestion
of contaminated food or drink
FOOD POISONING
is a serious form of food poisoning that requires
continual surveillance.
Botulism
– take sips of weak tea, carbonated drinks, or tap water
Mild nausea
diet for food poisoning
low-residue, bland diet
- may occur as a result of industrial or household incidents or attempted suicide
- exerts its toxic effect by binding to circulating hemoglobin and thereby reducing the oxygen-carrying capacity of the blood
CARBON MONOXIDE POISONING
mgt for carbon monoxide poisoning
o Expose to fresh air immediately
o Loosen all tight clothing
o Initiate CPR
o Prevent chilling
o Oxygenation
the amount and duration of exposure of the skin to the
chemical.
Skin Contamination / Poisoning (CHEMICAL
BURNS)
