Triage and Mass Casualty Incident Management
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Questions and Answers

What is the primary goal of triage in the Emergency Department?

  • To identify patients who need immediate surgery
  • To categorize patients based on their diagnosis
  • To decrease morbidity and mortality for all ED patients (correct)
  • To assign an acuity level to patients based on their age

    • According to the Emergency Severity Index, what is the timeframe for seeing patients categorized as Level 3?

  • Within 120 minutes
  • Within 15 minutes
  • Within 60 minutes (correct)
  • Within 30 minutes

    • What is the first decision point in the Emergency Severity Index algorithm?

  • Is the patient experiencing respiratory distress?
  • Is the patient dying? (correct)
  • Is the patient experiencing bleeding?
  • Is the patient in severe pain?

    • What is the purpose of the primary assessment in the triage process?

    <p>To perform a brief assessment of the patient's condition</p> Signup and view all the answers

    How long should the triage time take according to the NEA Triage?

    <p>2-5 minutes</p> Signup and view all the answers

    What is the primary goal of the START Triage Algorithm in managing mass casualty incidents?

    <p>To identify and prioritize patients who need immediate help</p> Signup and view all the answers

    What is unique about the JumpSTART Pediatric Triage algorithm compared to adult triage?

    <p>It takes into account the higher degree of resilience in pediatric patients</p> Signup and view all the answers

    What is the primary focus of the drills and exercises in operational management of mass casualty incidents?

    <p>Decontamination and triage procedures</p> Signup and view all the answers

    What was the key takeaway from the full-scale exercise involving an improvised explosive device (IED) scenario?

    <p>The need for enhancements to triage, decanting, and surgery prioritization</p> Signup and view all the answers

    What percentage of patients with potentially survivable wounds could have been saved, according to the exercise scenario?

    <p>Up to 1/3</p> Signup and view all the answers

    What is the purpose of the START triage algorithm in a Mass Casualty Incident?

    <p>To sort patients into immediate, delayed, and minor categories</p> Signup and view all the answers

    What is the process for triaging patients using the START algorithm in a Mass Casualty Incident?

    <p>Triage patients using the START algorithm, then perform mass decontamination and apply colored acuity tags</p> Signup and view all the answers

    What is the purpose of the colored acuity tags in the START triage algorithm?

    <p>To categorize patients by the severity of their injuries</p> Signup and view all the answers

    What is the frequency of START Triage Training for emergency department nursing staff?

    <p>Quarterly, with 10-15 minute sessions on each shift</p> Signup and view all the answers

    What is the purpose of the management of Mass Casualty Incidents training?

    <p>To educate staff on the principles of Mass Casualty Incident management</p> Signup and view all the answers

    What is the primary consideration when determining if a patient requires immediate intervention?

    <p>The patient's current vital signs and symptoms</p> Signup and view all the answers

    Which of the following patients would be considered a high-risk situation?

    <p>A patient with sudden onset of testicular pain</p> Signup and view all the answers

    What is the purpose of the Emergency Department Triage Decision Point B?

    <p>To determine if a patient can wait for treatment</p> Signup and view all the answers

    Which of the following patients would require a 10-minute EKG?

    <p>A patient with a history of chest pain</p> Signup and view all the answers

    What is the primary consideration when determining if a patient requires electrical therapy?

    <p>The patient's heart rate</p> Signup and view all the answers

    What is the primary goal of the initial trauma assessment?

    <p>To identify and treat or stabilize life-threatening injuries in an effective and timely manner</p> Signup and view all the answers

    What is the threshold for transporting children to a pediatric-capable trauma center?

    <p>Age &lt; 15 years</p> Signup and view all the answers

    What is a criterion for transporting a patient to a trauma center?

    <p>Significant passenger space intrusion (&gt; 12 inches into occupant site)</p> Signup and view all the answers

    What is assessed during the Across the Room Assessment?

    <p>Uncontrolled hemorrhage, breathing patterns, and mental status</p> Signup and view all the answers

    What is the respiratory rate criterion for transporting a pediatric patient to a trauma center?

    <p>RR &lt; 10 or &gt; 29</p> Signup and view all the answers

    What is the minimum pain rating for considering ESI level 2 criteria?

    <p>7/10</p> Signup and view all the answers

    How many resources are needed for a patient who requires an EKG and IV fluid hydration?

    <p>Two or more</p> Signup and view all the answers

    What is a characteristic of compensated shock?

    <p>Sympathetic nervous system kicks in, increasing heart rate and blood pressure</p> Signup and view all the answers

    Why is it important to weigh all children in the Emergency Department?

    <p>To determine their risk for heat and fluid loss</p> Signup and view all the answers

    What is a key difference between infants and children in the Emergency Department?

    <p>Infants show subtle signs of illness, such as poor feeding and irritability</p> Signup and view all the answers

    What is the primary assessment sequence in the Trauma Nursing Process?

    <p>A-B-C</p> Signup and view all the answers

    What is the first step in the primary assessment of a patient with uncontrolled bleeding?

    <p>C (Circulation)</p> Signup and view all the answers

    What is the purpose of the LMNOP mnemonic in the Trauma Nursing Process?

    <p>To perform lab tests and monitor the patient</p> Signup and view all the answers

    What is the correct way to transport an amputated body part?

    <p>Wrapped in sterile gauze, placed in a plastic bag, and transported on top of a cold pack</p> Signup and view all the answers

    What should be administered to offset the effects of potassium released when a tourniquet is released?

    <p>Calcium gluconate</p> Signup and view all the answers

    What is the purpose of the A-J mnemonic in the Trauma Nursing Process?

    <p>To perform primary assessment and intervention</p> Signup and view all the answers

    What is the correct sequence of actions when applying a tourniquet?

    <p>Apply pressure with hands, apply tourniquet, and apply dressing</p> Signup and view all the answers

    What is the primary goal of the Patient Experience Nursing Bundle?

    <p>To improve patient satisfaction</p> Signup and view all the answers

    What is the purpose of the IPASS component in the Patient Experience Nursing Bundle?

    <p>To introduce and manage the oncoming RN</p> Signup and view all the answers

    What is the purpose of the hourly rounding component in the Patient Experience Nursing Bundle?

    <p>To check on patient's comfort and needs</p> Signup and view all the answers

    What is the most common type of stroke?

    <p>Ischemic stroke</p> Signup and view all the answers

    What is the main cause of blocked or narrowed blood vessels in the brain?

    <p>Fatty deposits that build up in blood vessels</p> Signup and view all the answers

    What is a Transient Ischemic Attack (TIA) also known as?

    <p>Ministroke</p> Signup and view all the answers

    What is the importance of identifying the signs and symptoms of stroke immediately?

    <p>To activate the stroke team</p> Signup and view all the answers

    What is the result of a blood vessel in the brain leaking or rupturing?

    <p>Hemorrhagic stroke</p> Signup and view all the answers

    What is the duration of a Transient Ischemic Attack (TIA)?

    <p>As little as 5 minutes</p> Signup and view all the answers

    What is the primary effect of fatty deposits building up in blood vessels in the brain?

    <p>Severely reduced blood flow</p> Signup and view all the answers

    What is the term for a temporary period of symptoms similar to those of a stroke?

    <p>Transient Ischemic Attack</p> Signup and view all the answers

    What is the result of a blood vessel in the brain leaking or rupturing?

    <p>Hemorrhagic Stroke</p> Signup and view all the answers

    What is the most common type of stroke?

    <p>Ischemic Stroke</p> Signup and view all the answers

    What is the importance of identifying the signs and symptoms of stroke immediately?

    <p>To prevent permanent damage</p> Signup and view all the answers

    Who can activate the stroke team?

    <p>Any staff member</p> Signup and view all the answers

    Study Notes

    Mass Casualty Incident Preparedness

    • Close ED walk-in and EMS entrances, decompress Kimmel Core, and move MCI equipment cards to the triage area
    • All arriving patients enter through the Kimmel ambulance entrance, with mass decontamination and START triage algorithm applied as needed

    START Triage

    • A five-level triage instrument that categorizes ED patients by evaluating both patient acuity and needed resources
    • Algorithm uses four decision points to sort patients into one of the five triage levels:
      • Decision Point A: Is the patient dying?
      • Decision Point B: Should the patient wait?
      • Decision Point C: Resource need
      • Decision Point D: Assigning an acuity level

    Emergency Department Triage

    • Objectives: identify patients who need immediate care, perform a brief primary assessment, assign an acuity level, and assign a location of care
    • Primary assessment: subjective and objective data collection, including airway patency, breathing effectiveness, circulation effectiveness, disability, and environmental exposure
    • Emergency Severity Index (ESI) categorizes patients into five levels, with Level 1 being the most critical and Level 5 being the least critical

    Management of Mass Casualty Incidents

    • Regular planning team meetings, hands-on mass decontamination training, discussion-based and operational exercises, and special event planning
    • Training and education: START Triage Training, hands-on decontamination training, and structured walkthroughs
    • Proactive decontamination team staffing and management of mass casualty incidents

    Infectious Disease and High Consequence Pathogens

    • Donning PPE: visually inspect, disinfect hands, coverall, boot covers, N95 respirator, gown, and face shield
    • Measles addendum: a case was missed at NYULI, resulting in canvasing over 100 staff, patients, and visitors due to possible exposure
    • Top 10 countries with high measles risk: Kazakhstan, Azerbaijan, Yemen, India, Iraq, Ethiopia, Kyrgyzstan, Russia, Pakistan, and Indonesia

    Trauma Triage

    • Simple Triage and Rapid Treatment (START) algorithm: a rapid and streamlined triage with two specific goals: speed and identifying who needs the most help
    • JumpSTART Pediatric Triage: a slightly different START algorithm for pediatric patients, considering their higher degree of resilience and likelihood of survival with a long period of apnea

    Trauma Nursing Care

    • Trauma team structure and roles: communication, debriefing, and trauma assessment
    • Across the room assessment: gathering informed observational data, including bleeding, breathing, appearance, and pain
    • TDAP: definitive care or transfer to an appropriate trauma center

    Shock

    • Definition: unable to adequately perfuse tissues
    • Stages of shock: compensated, decompensated, and irreversible
    • Characterized by the buildup of lactic acid

    Pediatric Triage

    • Standardized approach: considering age, size, and developmental stage
    • Infants and children cannot be evaluated through layers of clothing
    • Stranger anxiety, heat and fluid loss, and hypotension as a late marker of shock

    Stroke

    • Definition: damage to the brain from interruption of its blood supply
    • Types of stroke: ischemic, hemorrhagic, and transient ischemic attack (TIA)
    • NYU time goals: door to attending physician evaluation (DAPT)

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    Related Documents

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    Description

    Test your knowledge of triage algorithms, including START Triage and JumpSTART Pediatric Triage, and learn how to manage mass casualty incidents effectively. Assess patient priority and make rapid decisions to save lives.

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