Is Disaster Triage A Just System

The emergency services need to be called, and given all the correct information, such as, if you are with the casualty now, how many people are involved, the patients age/gender, if they are conscious. Computer software then uses this information to determine the priority of the call which is then categorised into emergency or non emergency.

Triage is usually the first step of the emergency room and helps determine severity of each patient. Once through triage, the patient

Whenever disaster or mass casualty happen their will injuries and life lost. In order to care for these individual we must separate them by category for the least serious to the most critical ones. To care for the individual certain areas are set up into three four different stage s. The first stage consist of the Hot Zone is the most contaminated area, typically requiring that responders wear some level of personal protective equipment. Another zone is the warm area where most of your decontamination work takes place.

Triage may also be used for patients arriving at the emergency department, or telephoning medical advice systems, among others.In recent years, it has become common to use the term

America’s emergency rooms see this type of critical events as a daily occurrence. Often you will find that people will go to the emergency department for care because the ER cannot refuse to care for that come to be seen. If we look into the Emergency Medical Treatment and Active Labor Act any person seeking care must receive assessment and immediate care for their ailment. Often the issue is financial, if a patient is seen at a doctor’s office co-pay or full payment is required at the time of service. With many Americans that do not carry medical insurance their ability to attend to the issue prior to it becoming an emergency is not

Firstly, the QI team recognizes the cost of increasing patient transport employees by 300%, however the benefits associated with this plan can be found in the patient satisfaction survey due to the overall improvement in quality of care delivered to the patient. Through the increase of patient transport employees, the emergency room will reduce the possibility of patient injuries during transportation and avoid any future patient lawsuits against the hospital for negligence. The elimination of such future incidents will help the hospitals save money from legal fees that will be used to cover the costs of increasing employees. Additionally, streamlining the process of patient transportation will enable the emergency room to serve more patients hence increasing the revenue generated by the department. Not only will placing a standard procedure in place to enhance the triage procedure benefit the Admission Process, the cost incurred will be miniscule compared to the benefits associated with it. As a result of this evaluation, the development of a standard procedure for the triage system is one of the most efficient plans developed by the QI

Emergency workers are trained to manage emergency situations and it is expected as part of the job role that they will encounter death and serious injury (Iranmanesh, Tirgari & Bardsiri 2013,

In a disaster where healthcare facilities are face with a large number casualties, mass casualty triage is use to allocate the facilities resources to do the greatest good for the most people. Mass casualty is a four colored coded tag system, starting with red tags; immediate, these are life or limb threatening, but are survivable. Followed by yellow tags; delayed, which are injuries that are significant and require medical treatment; however, they are non-life or limb threatening and can wait for hours. Next are green tags; minimal injuries that are minor and can wait for hours or days be for receiving treatment. Lastly is the black tags; expectant, which are injuries that are extensive and chances for survival is unlikely (Hinkle & Cheever,

Tuesday, August 30th, the morning after Hurricane Katrina hit New Orleans, Louisiana, Anne Pou, a head-and-neck surgeon, looked out the window of Memorial Medical Center to see water gushing from the sewer gates, rushing towards the hospital (Fink). Senior administrators quickly set up a command center to assess the impending danger gushing towards the hospital and to decide what the next plan of action should be. Decisions were made to evacuate patients in order of importance. Richard Deichmann, the hospital’s medical-department chairman also suggested that patients with Do Not Resuscitate (DNR) orders should go last (Fink). The plan was set to action as the natural disaster continued to take its toll on the limited medical personnel available

In the hospital facility, the nurses have a triage chart where they follow, there were two setting: civilian and combat. In both setting, there were four categories: delayed/ urgent, immediate or critical, minimal/minor and expectant/catastrophic. However, combat and civilian setting has different process of casualties. In combat setting, the process of priority was immediate, delayed, minimal and expectant. However, in civilian setting the process were critical, catastrophic, urgent and minor.

I also felt the individual with the potential limb amputation should have been placed on immediate instead of delayed. Even though they placed a tourniquet on the patient’s arm to control the hemorrhaging, the risk of him losing his limb should have been high priority. The delayed category is only for individuals with finger and toe amputations. The immediate category consists of life or limb. I also did not see any information about the staff conducting reassessments of the individuals to confirm their triage category. I do believe after reading this chapter that I could play an essential role in disaster triage. It is a very black and white system that is easily understandable. I enjoy working in a fast pace environment and helping those in need. However, I do believe training and constant refreshers are essential to obtaining and maintaining the learned

This model integrates various assessment and triage protocols with three primary crisis-oriented intervention strategies: the seven-stage crisis intervention model, psychological debriefing, and trauma support services (Roberts, 2005). With this method, there are three different strategies; the seven-stage crisis intervention model, psychological debriefing, and trauma support services. Breaking down the ACT model is as follows; A is for assessment/appraisal of immediate medical needs, threats to public safety and property damage (Roberts, 2005). C is connecting to support groups, the delivery of disaster relief and social services, and critical incident stress debriefing (Mitchell and Everly’s CISD model) implemented (Roberts,2005). The T is for traumatic stress reactions, sequelae, and post-traumatic stress disorders (PTSDs) (Roberts, 2005).

Next, the emergency nurse must still do a head to toe assessment, depending on the signs and symptoms exhibited by the pt. Another ER assessment done in trauma pts is the use of the “primary survey,” which organizes the approach to the pt so that immediate threats to life are rapidly identified and effectively managed. The primary survey is based on the mnemonic “ABC” and “DE” for major trauma. This is the order of priority. The A=airway/cervical spine, B=breathing, C=circulation, D=disability, and E=exposure. Sometimes nursing diagnoses are noted if the pt is at high risk of injury. Next the doctor assesses the pt, so no nursing diagnosis are planned or implemented at this time. The doctor then makes the decision is the pt needs to be admitted to the hospital or if the pt will be discharged home with instructions for continued care or follow ups. If the pt is admitted, the nurses will start to put together nursing diagnosis which will be planned, implemented, and evaluated when the pt moves a room in the hospital.

A current issue today that impacts the society's citizens, health care and the profession of nursing is the health care system's response to large disasters. Earthquakes, floods, and hurricanes are large natural disasters that occur worldwide. Acts of terrorism are another form of disaster that our society has suffered from, however these are man-made disasters. Disasters affect families, children, schools, businesses, health care professionals, and also the health care system. In the instance that a disaster should occur, the health care system must be fully prepared; this includes having a clear and effective plan and collaborating with organizations in that area beforehand. A disaster prepared plan can allow the health care professionals to provide adequate care and support to the public. This particular issue is interesting because many people are not aware of the planning and the details that must be considered in disaster preparedness and response plans. All individuals particularly in the health care profession, such as nurses, must be well-educated about this topic to better the health care system’s response to large disasters.

Triage is also used when used trying to prioritize medical equipment in the hospital (Stoppler, 1996). In the hospital the nurses have to document patients that enter and the severity of their injuries. The reason for that is because there are other people in the hospitals that were waiting, and this can determine how long patients need to wait to be seen. Considering the criteria that nurses or medical staffs evaluate, other than the patients’ medical statuses can cause them to want to help everyone that want to be seen. When there is a non-medical situation, they may help they people in need of specialized assistance first. It is important to make sure that when helping patients the health care personnel make the right decision in prioritizing.