Question

1. ED nurses may provide care for patients with cold-related injuries. Discuss presentation and appropriate nursing care for these patients.
2. ED nurses may also provide care for patients with heat-related illness. Discuss presentation and appropriate nursing care for these patients.
3. Explain the disaster triage tag system (triage during mass casualty conditions). Include specific injuries appropriate for each category.
4. Explain the ED three-tiered triage system (triage under normal conditions). Include specific injuries appropriate for each category.
5. What are the priorities for discharging patients if inpatient beds are needed in a disaster?

Answer 1

# Presentation of patient with heat related illness are :-

1.Cramps: nausea; vomiting; muscle cramps, spasms or pain; dizziness; exhaustion; sweating

2.Exhaustion: pale, moist or flushed skin; weakness; headache; dizziness; cramps; sweating; faint feeling

3. Stroke: high body temperature; fainting; dizziness; seizure; nausea and vomiting; cramps

# Nursing care for Heat-Related Emergencies

1.Assess the scene and check for your safety.

2.Activate EMS (Call 9-1-1) if person experiences heat stroke or heat exhaustion condition worsens.

3.Get a First Aid kit and wear personal protective equipment.

4.If person is experiencing:

Heat Cramp: have the person rest and drink juice or a sports drink, which contains sugar and electrolytes; lightly stretch or massage the cramped area

Heat Exhaustion: move the person to a cooler environment; loosen or remove clothes; apply a wet towel; give small amounts of water or a drink with sugar and electrolytes (activate EMS if condition worsens)

Heat Stroke: instantly cool the person and if possible, immerse in cool water up to the chin

5.If necessary in severe conditions, provide CPR.

# Presentation of cold-Related illness are :-

1. Frostbite numbness; skin discoloration: waxy or grayish-yellow skin; black blisters; cold; hardened skin.

2. Hypothermia: shivering; numbness; glassy stare; indifference or loss of consciousness; slow pulse and slow breathing; slurred speech; hard and painless body parts; person appears to be dead

# Nursing care for Cold-Related Emergencies

1.Assess the scene and check for your safety.

2.Activate EMS (Call 9-1-1).

3.Get a First Aid kit and wear personal protective equipment.

4.If person is experiencing:

Frostbite: remove tight and wet clothing from affected area; pat skin dry; do not rewarm the area if there is the danger of it refreezing; if you rewarm, use warm, not hot, water

Hypothermia: get the person to a warmer place; remove wet clothing and cover the person with a blanket and any additional articles of clothing to provide warmth.

# Triage system is the process of prioritising the patient according to the severity of injury or disease so that the care can be provided without any delay .

Goals of triage systems are :-

-Prioritize care for all patients

-Regulate patient flow through the ED

-Determine the most appropriate area for treatment

# Urgency categories :-

Emergent

Urgent

Nonurgent

1. EmergentI- Immediate care required; condition is threat to life, limb, or vision; "severe"

2. Urgent - Care required as soon as possible; condition presents danger if not treated; "acute' but not "severe"

3. Nonurgent- Routine care required; condition minor; care can be delayed (pt could probably see primary care provider i.e. rash)

# The priorities for discharging patients if inpatient beds are needed in a disaster are :-

- patient is stable

- urgent care is provided so that the patient