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Nursing in Disasters

Nursing in Disasters

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Published by: api-3822433 on Nov 26, 2009
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03/18/2014

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4-25-08
Kathy Batton
Nursing in Disasters
\u2022
Disasters and Nursing
o

A sudden and massive disruption in health care service because of hostile elements of any
kind (natural and man-made) requiring survival resources be brought into action in the
shortest possible time using the fewest resources

o
Does not necessarily mean numerous injured or dead. It may be 5 critically injured MVA
clients taken to a small community hospital.
\u2022
Disaster Types
o
Natural
\ue000
Tornadoes
\ue000
Hurricanes
\ue000
Earthquakes
\ue000
Blizzards
\ue000
Epidemics
o
Man-Made
\ue000
Fires
\ue000
Explosions
\ue000
Nuclear accidents
\ue000
Bombings
\ue000
Biological
\ue000
Chemical
\ue000
Radiation
\ue000
War
\u2022
Nurses Role in Disaster Triage
o
Triage will be based on utilization of resources to treat the MOST people
o
Good of the \u201cwhole\u201d becomes more important than good of the individual
4-25-08
Kathy Batton
o
Potential outcomes/ survivability and available resources is the issue-not degree of injury
o
Nurses will still be involved with assessment and basic treatment
\u2022
Disaster Triage Categories
o
Immediate/ Priority 1/ Red Tagged
\ue000
Life threatening injuries that are survivable with minimal interventions
\ue000

Examples: airway obstruction, sucking chest wounds, tension pneumothorax,
hemothorax, open fractures of long bones, burns (2nd and 3rd degree as long as it
is 15%-40% of the TBSA)

\ue000
This group can rapidly deteriorate without treatment and become black tagged
o
Delayed/ Priority 2/ Yellow Tagged
\ue000
Significant injuries that are survivable with medical care, but aren\u2019t going to die
immediately without care
\ue000
Examples: stable abdominal injuries, fractures that need reducing, eye injuries,
soft tissue injuries, facial injuries without airway difficulties
\ue000
Can go from yellow to red as they get sicker
o
Minimal/ Priority 3/ Green Tagged
\ue000
Minor injuries, treatment can be delayed for hours or days without death
\ue000
Examples: sprains, cuts, fractures that don\u2019t have to be reduced surgically, psych
people
o
Expectant/ Priority 4/ Black Tagged
\ue000
Significant injuries, chances of survival are minimal even with immediate care or
walking wounded
\ue000

Examples: nursing home patients who are DNR, unresponsive people with penetrating head wounds, major burns over 60% of body, fixed and dilated pupils, brain matter coming out of ears, this is also the walking wounded

\ue000
People that will be fine even if they don\u2019t get medically treated. Usually the
walking wounded are trying to care of the dying.
o
After triage category decided the person is tagged and treated and / or transported, triage
continues at each point of care.
\u2022
Disaster Levels
4-25-08
Kathy Batton
o
Level I-local emergency response personnel and organizations can contain and
effectively manage the disaster and its aftermath
o
Level II-regional efforts and aide from surrounding communities are sufficient to manage
the effects of the disaster
o
Level III- local and regional assets are overwhelmed; state wide or federal assistance is
required
\u2022
Terrorism Recognition and Awareness
o
Be aware of an unusual increase in the number of people with fever of GI problems
o
Unusual illness for time of year
o
Cluster of client from a specific location
o
Large number of rapidly fatal cases with death in 72 hours
o
Increase in disease in otherwise healthy population
\u2022
Levels of protection for health care workers
o
Level A- highest level of respiratory, skin, eye, mucus membrane protection
\ue000
Covered from head to toe, breathing apparatus, chemical resistant
o
Level B-same respiratory but less skin and eye protection, still wear chemical resistant
suit
o
Level C-air purified respirator, with filters that remove harmful substances and a
chemical resistant coverall, gloves, boots, and splash hood
o
Level D- what you would normally wear plus universal precautions
\u2022
Weapons of Terror
o
Biological Weapons
\ue000
Easily obtained
\ue000
Easily disseminated
\ue000
Significant morbidity and mortality
\ue000
Signs and symptoms similar to common diseases
\ue000
May be liquid, dry, applied to foods or water or vaporized

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