RED - QSEN
The Role of a Registered Nurse in an MCI (Mass Casualty Incident)Strategy Advance Reading: Chapter 10 – Principles of Emergency and Disaster PreparednessReference:Ignatavicius, D.D., Workman, M.L., & Rebar, C.R. (2018).?Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). St. Louis, MO: Elsevier.YouTube video as introductory topic – October 3, 2017 Las Vegas shooting incident LectureDisaster Triage Tag System Red tags?- (immediate) are used to label those who cannot survive without immediate treatment but who have a chance of survival.Yellow tags?- (observation) for those who require observation (and possible later re-triage). Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances.Green tags?- (wait) are reserved for the "walking?wounded" who will need medical care at some point, after more critical injuries have been treated.Black tags?- (expectant) are used for the deceased and for those whose injuries are so?REDYELLOWGREEN BLACKReference: Ignatavicius, D.D., Workman, M.L., & Rebar, C.R. (2018).?Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). St. Louis, MO: Elsevier, p.152. Utilize Triage algorithmReference:U.S. Department of Health & Human Services.?(2017).?START adult triage.?Retrieved from c) Sample Scenario After a mass casualty event, the nurse is triaging clients in the field. Which client is correctly classified?38-year old with an open femur fracture: BLACK TAG42-year old with multiple abrasions and contusions: YELLOW TAG54-year old with third-degree burns over 90% of the body: GREEN TAG61-year old who is having difficulty breathing and is wheezing: RED TAGReference: Ignatavicius, D.D., Workman, M.L., & Rebar, C.R. (2018).?Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). St. Louis, MO: Elsevier, p. 152. Group DiscussionStudents are divided into 5 groups with 4-5 members, depending on total number in class. Each group is given 5 patients with specific MCI conditions and will utilize the triage tag system and triage algorithm to classify patients. Patient conditions can be a combination from the following:Disaster Triage Tag System RED9-year boy with airway obstruction39-year old female with signs and symptoms of shock6-year old boy with signs of dehydration with systolic BP of 7233-year old male with head injury in and out of consciousness59-year old female with no major injuries and shortness of breath with oxygen saturation level of 88%YELLOW66-year old male with open fracture of both legs with distal pulses33-year old female with an abdominal wound with no signs of shock45-year old male with fall and fractured right tibia and fibula7-year old girl with head injury and no loss of consciousness8-year old boy with facial laceration with bleeding controlled with pressure dressingGREEN 6-year old girl with an amputated left index finger89-year old female with nausea and vomiting45-year old male with a sprained right ankle66-year old male with facial and torso lacerations with no major bleeding72-year old female with dislocated right hipBLACK75-year old male patient with massive head trauma45-year old female with extensive full-thickness body burns39-year old male patient with high cervical spinal cord injury requiring mechanical ventilation44- year old male with chest trauma and major hemorrhage55-year old female with lacerated femoral artery and thready carotid pulseSAMPLE SCENARIO FOR 1 GROUP 10-year-old boy with massive head injury, no spontaneous breathing, BP 60 palp22-year-old female with a close fracture of the left arm60-year-old male with a laceration in the leg complaining of shortness of breath15-year-old girl with glass embedded in the eyes52-year-old male with a pulse of 30 and a blood pressure of 70/30Group Sharing with Instructor FacilitationFeedback from students and InstructorRelated topics for discussionDescribe the hospital preparedness and team classifications as to roles and functions in cases of an MCI.What are the nurses’ role and in relation to the interprofessional team roles?Assess patients and families in terms of the psychosocial aspect- How are they able to adapt after the event?PTSDASD – Acute Stress DisorderHow do nurses provide support to survivors and families?Active listeningAppropriate referralsDiscuss how to meet staff psychosocial and emotional needs by the process of debriefing. ................
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