Concepts of Emergency and Trauma Nursing
The primary survey for a trauma client organizes the approach to the client so that life threatening injuries are rapidly identified and managed. It is based on the standard mnemonic ABCDE. What does ABCDE stand for?
A= Airway and cervical spine control
B=Breathing
C= Circulation
D=Disability
E= Exposure
What type of clients are given a red tag in a mass casualty situation?
clients who have an immediate threat to life are given the highest priority (Class I category and are given a red tag.)
Patients who are severely hypothermic are at high risk for cardiac arrest. Why would you want to avoid using active external rewarming with heating devices on these patients?
It is dangerous and contraindicated in this population due to rapid vasodilation
by increasing its activity and blowing off excess carbon dioxide.
When caring for patient in the ED the nurse needs to ensure client and staff safety. How can this be done?
Use two pt identifiers per Joint Commission, follow hospital security plan, including de-esclations strategies for people who are aggressive, search belongings to identify essential medical info., Use standard fall precautions, and isolate pts who present with signs and symptoms of contaigous infectious disorders.
Why do clients with black tags in a mass casualty situation not receive care?
In disaster military style triage is used this approach identifies the dead or expectant dead with black tags. This practice helps to maintain the goal of triage which is doing the most good for the most people.
What clinical manifestations may indicate systemic toxicity in a client who was bit by a brown recluse spider?
Fever and chills
What are the clinical manifestations of metabolic acidosis?
reduced muscle tone and deep tendon reflexes, lethargy and drowsiness, increased respirations and depth,.
How would you classify a patient as nonurgent?
the patient can tolerate waiting several hours for helath care services without significant risk of clinical deterioration.
Non urgent or walking wounded are given what color of tag in a mass casualty event?
Green tag
In a client who has just had a near drowning experience and is presenting with agnonal breaths but has a pulse what would the nurse do?
immediately iniatiate airway clearance and ventilator support measures, including delivering rescue breaths
Respiratory acidosis occurs as a result of ?
underventilation
How would you classify a patient as urgent?
a patient who is at risk for deterioration and needs to be seen quickly but is not in an immediately life-threatening situation.
What is the role of the hospital incident commander and the medical command physician in a disaster situation?
Hospital incident commander= physician or administrator who assumes overall leadership for implementing the emergency plan.
Medical command physician= physician who decides the number, acuity, and resource needsof patients.
What are the recommendations for a client with partial thickness and full thickness frostbite?
rapid rewarming in a water bath (they will experience severe pain so IV analgesics are vital!)
A strict low carb, low calorie diet can cause what type of acid-base imbalance?
Metabolic acidosis
If resusitation efforts are under way when family arrives, 1-2 family members may be given the opportunity to be present during life saving efforts.
How can staff PTSD during a mass casualty event be prevented?
Counseling, support co-workers, monitor each others stress level and performance, take breaks when needed, talk about feelings, drink water and eat healthy snacks for energy, keep in touch with family and friends, don't work for more than 12 hours/day
Why is ECG monitoring vital in patients who have been struck by lightening?
Because lightening can cause serious myocardial injury whih may be manifested by angina and dysrhythmias
Sodium bicarbonate antacids may increase a client's risk of what acid base imbalance?
Metabolic alkalosis