Case Study, Chapter 72, Terrorism, Mass Casualty, and Disaster Nursing Objective: 2

The local community hospital routinely practices activation of its Emergency Preparedness Plans. One key aspect of the emergency preparedness exercise is to provide all staff with opportunities to practice their various roles during an actual emergency. Registered nurses from the Emergency Department frequently have key roles in patient triage and emergency management. How is triage different in a disaster from triage on a routine day in the Emergency Department? Triage in a local community hospital is different on the emergency department in a way that in community or in a disaster management, the rescuer first identify if the place is safe or unsafe, before applying the first aid and follow the ABCD, also the patients are victims of disasters, whether man made or natural phenomena, while in the actual emergency department, nurses directly apply the triage and most of the emergency drugs and equipments needed are almost complete and continuously monitor the patient. What are the triage categories during a Mass Casualty Incident? First, I will check the place, then categorize them or have a color coding, red for immediate, or for those people that suffered from any airway obstruction or difficulties, sucking chest wounds, open fractures of long bones that needs early and immediate medical action. Yellow- delayed, for people who have stable wounds w/o evidence of significant hemorrhage and who present as stable but requires medical intervention. Green for minimal who does not need immediate action, no danger to life, such as sprains, upper extremities fracture and black for expectant, those people who have a small chance to survive, such as unresponsive patient, high spinal cord injury and those patient w/ no pulse, no BP, and pupils fixed and dilated. During the disaster exercise, a simulated patient with a penetrating head injury who does not respond to painful stimuli and has a Glasgow Coma Scale of 5 is brought to the Emergency Department. In what category should the patient be placed? Explain your answer. The patient was in category of expectant, because GCS of 5 was in a state of coma, (COMATOSE IS NOT GCS 5 BUT GCS 3) and even in a painful stimuli the patient does not respond it means that patients score in eye movement is one or no response. In addition, the patient has a minimal chance to survive.