Question

1. Develop a mass casualty scenario and provide a description of four clients, each with an injury that aligns with one of the four survival potential levels. (Include all four levels).

Answer 1

Our goals for every mass casualty incident should be Do the best we can for the most we can. Manage scarce resources. Do not relocate the disaster.

Survival potential is the reciprocal of mortality. Because reproductive potential does not account for the number of gametes surviving, survival potential is a necessary component of biotic potential. In the absence of mortality, biotic potential = reproductive potential.
The ordered steps we need them to follow are embodied in the following:

1. Safety.
2. Scene size up.
3. Send information.
4. Set up the medical group.
5. Start triage.

According to this, the survival potential level that the nurse should assign Brianna during triage is level 2 urgent because she has some serious injuries that have to be taken care of but they don't pose an immediate risk to her life.

Each hospital has its own policy that specifies who has the authority to activate and how to activate the disaster or emergency preparedness plan.The medical command physician is responsible for identifying the resource needs of the clients

The Emergency Management Plan for Mass Casualty Incidents (MCI) is for. events occurring inside and outside the hospital requiring additional staff, resources, communication, and preparation.

1 Disaster triage tag system Correct 2 Automated tracking system 3 Hospital incident command system 4 National incident management system An automated tracking system is a valuable component of the hospital's emergency preparedness infrastructure as it is used to determine the number of casualties of a particular level.No aspect of nursing care is delegated when the case method of care delivery is used, thus eliminating the need for supervising others.

Typical Mass Casualty Triage Categories-

MINIMAL
Sick or injured, but expected to survive with or without care, sometimes referred to as “walking wounded”
DELAYED
Requires care that can be safely delayed without affecting probability of survival.
IMMEDIATE
Requires immediate care for a good probability of survival.
EXPECTANT
Alive, but with little or no chance of survival given current available resources.
DECEASED
A fatality with no intrinsic respiratory drive and no other signs of life.

1. Ineffective airway clearance R/T upper airway obstruction by tongue and soft tissues, inability to clear respiratory secretions as evidenced by unclear lung sounds, unequal lung expansion, noisy respiration, presence of stridor, cyanosis, or pallor.

Client Expected Outcome-

The client maintains patent airway as evidenced by clear lung sounds, equal lung expansion and absence of stridor, cyanosis and pallor.

Nursing Interventions-

Assess respiratory rate pattern, lung sounds, lung expansion, signs of tissue hypoxia, cyanosis, pallor-presence of airway secretions occlusion of oropharynx by epiglottis or tongue; aspiration of vomitus or oral secretions.

Rationale-provides data for planning care.

Elevate had of bed to 30 degree angle or place client in lateral or semiprone position.

Rationale- head elevation prevents aspiration. Lateral position permits the jaw and tongue to fail forward, thus promoting drainage of secretions.

- Insert oral airway (if tongue is paralyzed or is obstructing the airway).

Rationale-prevents obstruction of airway; obstructed airway leads to cerebral hypoxia which increases ICP.

Suction airway intermittently.

Rationale- in the absence of cough and swallowing reflexes, secretions rapidly accumulate in the posterior pharynx and upper trachea and can lead to aspiration. Intermittent suctioning prevent this.

Administer humidified oxygen to the airway before and after suctioning.

Rationale- prevents hypoxia which may be caused by sucking out of air while suctioning.

Initiate chest physiotherapy and postural drainage (unless contraindicated)

Rationale- promotes pulmonary hygiene

Prepare for endotracheal intubation or tracheostomy

Rationale-allows efficient removal of tracheobronchial secretions and protects the airway from aspiration.

Connect the client to mechanical ventilator as needed.

Rationale- helps maintaining oxygenation when spontaneous respiration is not possible.

Increase amount of fluids administered at least 2.5 litre per day.

Rationale- loosens airway secretions promoting easy removal.

Auscultate chest at least every 8 hours.

Rationale-helps detect adventitious breath sounds or absent breath sounds.

Monitor ABG measurements.

Rationale- help detect complications of respiratory problems at the earliest.