Question

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?

What are the triage categories during a Mass Casualty Incident?

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?

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?

What are the triage categories during a Mass Casualty Incident?

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?

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?

What are the triage categories during a Mass Casualty Incident?

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?

Answer 1

Triage is a very crucial decision while managing cases in the emergency and trauma department where urgent care has to be delivered. The triage helps to categorize patients according to the their severity of ailments and survival ability, so that care can be provided with minimal use of resources available.

ANSWER 1) The triage in disaster is different from rountine triaging. In a normal scenario, the triage is done by categorizing the patients according to the severity of the injury i.e the patient with a severe head injury or a patient with myocardial infaraction, a young patient who needs conscious may be treated first. The color codes placed are green for those who is ambulatory needs minimal care, yellow requires treatment but can be delayed, Red indicates life threathening conditions that needs immediate care and treatment, black for dead patients or minimal chance of survival patients are placed.

In case of disaster the triage is done according to the chance of survival i.e the patients with more chances of survival is treated first. The color codes are Red- critical- likely to survive if simple care is given within minutes. Blue- catastrophic- unlikely to survive or complicated care is needed, yellow- urgent- likely to survive if simple care is given within hours, Green- likely to survive even if care is delayed for hours, Black- dead casualities.

Answer 2) Simple triage system is used in mass casuality incident in order ro sort patients who need critical attention and immediate transport to the hospital and those with serious injuries. The various color codes are :

• Red- critical- likely to survive if simple care is given within minutes.

• Blue- catastrophic- unlikely to survive or complicated care is needed,

• Yellow- urgent- likely to survive if simple care is given within hours,

• Green- likely to survive even if care is delayed for hours,

• Black- dead casualities.

ANSWER 3) The patient as per the triage system, should be placed in red zone that is patients who is given highest priority, who can survive if immediate care is given. The triage during disaster based on the Glasgow coma scale states :

• Score of 1-10 indicates priority i.e red.
• Score of 11 indicates immediate or urgent care within 2-4 hours i.e yellow
• Score of 12 indicates delayed care i.e green
• Score 0 indicates dead i.e black