Disaster Preparedness and Management by Michael Beach DNP ACNP-BC PNP

By Michael Beach DNP ACNP-BC PNP

Be ready while catastrophe moves with this accomplished consultant to the fundamentals of catastrophe coaching and reaction. From the levels of a catastrophe via all the components of an institutional plan to precise occasions, you ll have the knowledge you wish at your fingertips...from a nursing point of view.

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Qxd 3/12/10 5:50 PM Page 31 TABLE 2–1 Color Coding of Disaster Tags COLOR STATUS CONDITION Black Expectant or deceased Victims deceased or not expected to recover under the austere circumstances with limited resources. Red Immediate Victims with the most severe injuries or illnesses who will benefit most from the limited resources in the austere environment. Those severely injured or ill who are expected to recover. Yellow Delayed Victims with potentially serious injuries or illnesses but who are able to wait until those more in need are transported or treated.

3,22 START System The START system was developed by Huag Hospital and the Newport Beach Fire Department. It is designed to allow personnel with limited medical knowledge and skill to triage victims in 60 seconds or less per victim. The system evaluates victims based on four criteria: can he respond and walk, how fast are his respirations, what is his perfusion status, and what is his mental status (see Fig. 2–4, Table 2–4). • First: All walking wounded, those who can get up and walk to a designated area, are classified as minor.

Routine treatment and testing, such as obvious fractures, should wait. 4 If the holding areas for minor, delayed, critical, and expectant patients are separated by distance or structure, then an officer, responsible to the triage officer, should be assigned to each of these areas. Teams of paramedics or nurses in combination with practitioners or physicians may be necessary if large numbers of victims present all at once or in rapid succession. This team approach also may be necessary at the location of a large MCI or at designated treatment locations in the event of very large-scale disasters.

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