1. What is emergency management?

- Emergency management is the discipline of dealing with and avoiding risks, particularly those that have
catastrophic consequences for communities, regions, or entire countries. It is the dynamic process of
preparing for, mitigating, responding to and recovering from an emergency. Planning, though critical, is
not the only component. Training, conducting drills, testing equipment and coordinating activities with
the community are other important functions. Effective emergency management relies on the
integration of emergency plans at all levels of government and non-government, including individuals
and community organizations.

2. Enumerate 3 challenges emergency nursing faces due to diversity of conditions and situations
that present unique challenges.

3. What is triage? Its French origin?

- The process of sorting people based on their need for immediate medical treatment as compared to
their chance of benefiting from such care. Triage is done in emergency rooms, disasters, and wars, when
limited medical resources must be allocated to maximize the number of survivors. Triage in this sense
originated in World War I. Wounded soldiers were classified into one of three groups: those who could
be expected to live without medical care, those who would likely die even with care, and those who
could survive if they received care.

- The term comes from the French verb trier, meaning to separate, sort, shift or select. The etymology of
“triẚge” is French. Studies have shown that trier, which is the verb form of triẚge, dates back to the
12th-century Gallo-Romance term triẚre. That word can be divided into triẚ and eur, which mean,
respectively, “three” and “crushing.” The French word triẚge means “to thin out” in Japanese and “to
categorize” in English. “Thinning out” signifies the removal of damaged items toward improving the
overall quality. The original meaning of “triẚge” is closer to the notion of thinning out than to
categorization. However, the concept of sorting could also apply to such French terms as preselection,
selection, and choix.

4. Define the following:

a. Emergent patients

b. Urgent patients

c. Nonurgent patient

5. What is triage tag?

6. Give 3 examples each of cases which are tagged;

a. Red

b. Yellow
c. Green

d. Black

7. When we manage the SCENE, we remember the mnemonic RPM, which stands for:

A.R

B.P

C.M

8. What is the other name for E-cart? Where is it located? Its purpose?

- Other names:

 Crash cart
 Emergency cart
 Emergency response cart
 Code cart
 Emergency trolley

- Location: An E-cart should be conveniently located in an area known to all physicians and ancillary
personnel. Although crash carts can differ somewhat depending upon their location, the basic crash cart
will contain similar equipment.

- PURPOSES:

 To provide immediate access to supplies and medications.

 To facilitate coordination of emergency equipment.
 To ensure a properly stocked crash carts will be readily available.
 To ensures a properly functioning defibrillator will be readily available.
 To save the valuable time at the time of emergency .

9. What is the ABCD principle?

a. Airway
- If the patient responds in a normal voice, then the airway is patent. Airway obstruction can be partial
or complete. Signs of a partially obstructed airway include a changed voice, noisy breathing (eg, stridor),
and an increased breathing effort. With a completely obstructed airway, there is no respiration despite
great effort (ie, paradox respiration, or “see-saw” sign). A reduced level of consciousness is a common
cause of airway obstruction, partial or complete. A common sign of partial airway obstruction in the
unconscious state is snoring. Untreated airway obstruction can rapidly lead to cardiac arrest. All health
care professionals, regardless of the setting, can assess the airway as described and use a head-tilt and
chin-lift maneuver to open the airway.
b. Breathing
- In all settings, it is possible to determine the respiratory rate, inspect movements of the thoracic wall
for symmetry and use of auxiliary respiratory muscles, and percuss the chest for unilateral dullness or
resonance. Cyanosis, distended neck veins, and lateralization of the trachea can be identified. If a
stethoscope is available, lung auscultation should be performed and, if possible, a pulse oximeter should
be applied. Tension pneumothorax must be relieved immediately by inserting a cannula where the
second intercostal space crosses the midclavicular line (needle thoracocentesis). Bronchospasm should
be treated with inhalations. If breathing is insufficient, assisted ventilation must be performed by giving
rescue breaths with or without a barrier device. Trained personnel should use a bag mask if available.

c. Circulation
- The capillary refill time and pulse rate can be assessed in any setting. Inspection of the skin gives clues
to circulatory problems. Color changes, sweating, and a decreased level of consciousness are signs of
decreased perfusion. If a stethoscope is available, heart auscultation should be performed.
Electrocardiography monitoring and blood pressure measurements should also be performed as soon as
possible. Hypotension is an important adverse clinical sign. The effects of hypovolemia can be alleviated
by placing the patient in the supine position and elevating the patient’s legs. An intravenous access
should be obtained as soon as possible and saline should be infused.

d. Disability
- The level of consciousness can be rapidly assessed using the AVPU method, where the patient is
graded as alert (A), voice responsive (V), pain responsive (P), or unresponsive (U). Alternatively, the
Glasgow Coma Score can be used. Limb movements should be inspected to evaluate potential signs of
lateralization. The best immediate treatment for patients with a primary cerebral condition is
stabilization of the airway, breathing, and circulation. In particular, when the patient is only pain
responsive or unresponsive, airway patency must be ensured, by placing the patient in the recovery
position, and summoning personnel qualified to secure the airway. Ultimately, intubation may be
required. Pupillary light reflexes should be evaluated and blood glucose measured. A decreased level of
consciousness due to low blood glucose can be corrected quickly with oral or infused glucose.

10. What is a secondary survey?

- The secondary survey is a systematic approach to identify any bleeding or fractures. This system starts
at the head and works down to legs. It is performed once the patient has been resuscitated and
stabilised. It involves a more thorough head-to-toe examination, and the aim is to detect other
significant but not immediately life-threatening injuries. If during the examination any deterioration is
detected, go back and reassess the primary survey.

References:

http://uasem.org/what-is-emergency-management

https://www.medicinenet.com/script/main/art.asp?articlekey=16736
https://onlinelibrary.wiley.com/doi/pdf/10.1002/ams2.293

https://trauma.reach.vic.gov.au/guidelines/early-trauma-care/secondary-survey#:~:text=The
%20secondary%20survey%20is%20performed,not%20immediately%20life%2Dthreatening
%20injuries.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273374/#:~:text=ABCDE
%20principles&text=Causally%20focused%20treatment%20can%20then,and%20treated%3B
%20and%20so%20on.

https://www.sciencedirect.com/topics/nursing-and-health-professions/crash-cart