UNIT 5 - trauma disaster preparedness Flashcards
an event in which illness or injuries exceed resource capabilities of a community or medical facility.
disaster
(ex): violence, outbreaks, weather, earthquakes, fire, avalanches, nuclear, chemical
an event outside the healthcare facility that necessitates activation of emergency management system. A multi or mass casualty event.
external disaster
a disaster that can be managed by a hospital using local resources
multi casualty
a disaster that can’t be managed by local medical capabilities, and requires collaboration of multiple agencies. (state, federal, regional help is needed)
mass casualty
an event within a hospital and/or hospital campus. interferes with client and staff safety.
internal disaster
what is the outcome priorities of the internal disaster?
- ) safety **
- ) prevent further damage (ex close doors, extingis fires PASS)
- ) assist the best you can
what are some examples of natural mass casualty incidents?
- earthquakes
- hurricanes
- mudslides
- tornadoes
- floods
release of toxic biologic agents with a goal of stopping containment
bio terrorism
ex): anthrax, botulism, plague, smallpox, COVID-10(?
what is the nursing priorities when dealing with bio-terrorism?
- focus largely on stopping the spread of the disease and preventing contamination of healthcare facility.
- provide supportive care and treat accordingly as it becomes clear what the agent it.
_________ is getting the patients from the hot zone to the cold zone.
decontamination
what is the hot zone?
the zone with the highest potential for exposure. exclusion zone.
what is the warm zone ?
contamination reduction zone. transition between exclusion and support zone. area where the first responder’s enter and exit
what is the cold zone?
known as the support zone. area that is free from contamination and can be safely used as a planning and staging area.
unexpected occurrence that requires immediate attention
emergency
process of trying to have an action plan that decreases the impact of consequences of disaster (ex) boarding up windows for a hurricane.
mitigation
having a drill or plan or training that takes place ahead of time so one is prepared for a disaster.
preparedness
aftermath of the disaster. the chaotic part of the disaster.
response
after the disaster has occurred. and there is an attempt of restoration of whatever event has happened
recovery
what is it recommended that bystanders do that are present at the scene.
stop the bleed
person responsible for all aspects of an emergency response. this position must be filled by a physician or hospital administration.
hospital incident commander
communicates with and issues medical command orders to EMS providers when they seek direction. They decide acuity, and resource needs of the patients.
medical command physician
gathers facts and distributes them to the media. They are the liaison between the health care facility and the media.
public information officer
ensures the triage of all victims and directing or determining the movement of patients toward the treatment/transport. this position is filled by a physician or nurse.
triage officer role
what needs to be present in the 3 day emergency supply?
- non perishable food items (can opener)
- 1 gallon of water per person per day
- towels, blankets, garbage bags plastic bags, toilet tissue
- batteries, flashlights, hand held radio, pocket knife, and matches
- first aid kit, toiletries, hand sanitizer, medicine
what is the role of the nurse in the ED?
- organize nursing and ancillary staff
- triages, resuscitates, and treats the disaster victims
- client discharge recommendations (medically stable)
- nurses assigned to other areas
- those admitted for observation
- diagnostic evaluations and not bedridden
- soon scheduled to be discharged or care could occur at another facility
- no critical care change in the past 3 days
- could be cared for at home with support from family or home services.
characteristics of those that can be discharged in the case of an disaster. (need to make room for trauma victims)
what does START triage mean
S-simple T-triage A-and R-rapid T-treatment
what is the goal of the primary assessment during start triage?
first contact where your assign a triage category
considering the ongoing process that takes place after the patient has been moved to treatment or holding area awaiting transport. more assessment and treatment will be done
secondary part of start triage
what is the first thing that needs to be done when arriving to a trauma scene?
ensure that the area is safe
then…
call out for anyone that can hear and tell them to walk to a specific area
then…
what is the overall outcome triaging in a disaster situation?
doing the greatest good for the greatest number of people.
categorized by “walkie/talkie”
- ambulatory and non urgent
- minor injuries
green
categorized by those that can wait 30 mins - 2 hours to be treated
- delayed
yellow
categorized by those that need immediate care
- critical patient
- immediate threat to life
red
categorized by those that are deceased or have a low expectancy to live.
black
there should be someone that is _______ to stay with each group in case someone deteriorates they can be moved higher up in triage, except for black.
designated
remember ______. first question is always do they have the ability to walk or talk? then you assess
- respiratory effort
- pulses/perfusion
- mental status
RPM
all the walking wounded are classified as what?
green
respiration: if none, open/reposition the airway, if they start breathing. tag them red and if not tag _____.
black
if they are breathing greater than 30, tag them ____. if under 30, next assess pulse/perfusion/circulation. check the radial pulse if they have perfusion to periphery. if so we know organs are perfused. If they you answer yes to the pulse, check mental status. Pulse rate does not matter, matters that they have a pulse! No pulse tag them ____ or check capillary refill.
red ; red
if capillary refill is greater than 2 seconds assess for bleeding. If bleeding have someone put pressure on it, and tag them as ____.
red
can they follow commands? if they can tag them ______. if they can’t, and are confused in any way tag red.
yellow
If respirations are less than 30, radial pulse is present and/or capillary refill is greater than 2 seconds and can follow commands tag them as ______.
yellow
after tagging all patients….
- red tags should be transported stat
- begin initial treatment here
- yellow and green tags must be re-assessed more thoroughly
after the disaster event what should be done….
- administrative review
- critique the incident (debriefing and critical incident stress debriefing)
- modify the plan
- promote effective coping
- support groups
what happens after immediately after the event….
- restock supplies
- provide rest and transportation for staff
- debriefing for small groups of staff
- encourage and support co-workers
- take breaks when needed
- talk about feelings
- plenty of water and snack for energy
