Disaster Management Flashcards

In the START triage system, a patient who is breathing but has a respiratory rate greater than 30, no radial pulse, and does not follow commands is classified as:

Answer: Red (Immediate)

In START triage, this patient fails the perfusion check (no radial pulse) and mental status check, classifying them as Red (Immediate) requiring urgent intervention.

During a mass casualty incident, the trauma nurse's FIRST priority upon arriving at the scene is:

Answer: Establishing a triage area and beginning triage

The first priority in an MCI is to establish a triage area and begin rapidly triaging patients to categorize the scope of injuries and direct limited resources appropriately.

Which decontamination principle is most critical before treating victims of a chemical exposure incident?

Answer: All patients must be decontaminated before entering the treatment area

All potentially contaminated patients MUST be decontaminated before entering the treatment area to prevent secondary contamination of healthcare workers and the facility.

In disaster triage, which patient would be classified as Black (Expectant)?

Answer: A patient with extensive burns over 90% of body surface area who is apneic after airway repositioning

A patient with 90% body surface area burns who is apneic even after airway repositioning is classified as Black (Expectant) as survival is unlikely even with full resources.

The Hospital Incident Command System (HICS) is activated during a disaster primarily to:

Answer: Provide a standardized organizational structure for managing the hospital's disaster response

HICS provides a standardized, scalable command structure that organizes the hospital's disaster response, ensuring clear communication, defined roles, and efficient resource management.

During a mass casualty event, a nurse must make triage decisions for 50 patients. Which ethical principle guides the shift from individual patient care to population-based care?

Answer: Beneficence — doing the greatest good for the greatest number

The utilitarian principle of beneficence — maximizing benefit for the greatest number — guides MCI triage, requiring a shift from individual-focused to population-focused care.

In the JumpSTART pediatric triage system, what additional step is performed for a non-breathing child that differs from adult START triage?

Answer: Five rescue breaths before classifying as Expectant

JumpSTART includes five rescue breaths for apneic children with a palpable pulse, recognizing that pediatric cardiac arrest is more commonly respiratory in origin and potentially reversible with ventilation.

A hospital is preparing for a surge of 200 patients from a mass casualty incident. Which strategy best manages this surge capacity?

Answer: Activating discharge protocols, opening auxiliary treatment spaces, and calling in off-duty staff

Surge capacity management requires a multi-pronged approach: rapidly discharging stable inpatients, opening overflow treatment areas, and activating callback systems for additional staff.

Which type of disaster agent causes delayed symptom onset of hours to days, making initial triage particularly challenging?

Answer: Biological agents such as anthrax

Biological agents often have incubation periods of hours to days, meaning exposed individuals may appear asymptomatic during initial triage and present later with severe illness.

After a building collapse, a trapped patient is extricated after 6 hours of limb compression. The nurse should anticipate which life-threatening complication upon release?

Answer: Crush syndrome with hyperkalemia and acute renal failure

Crush syndrome occurs when prolonged compression causes rhabdomyolysis, releasing myoglobin, potassium, and other toxic metabolites into the circulation upon reperfusion, leading to hyperkalemia, cardiac dysrhythmias, and acute renal failure.

The concept of 'reverse triage' in disaster management refers to:

Answer: Discharging current inpatients to create capacity for incoming casualties

Reverse triage involves evaluating current hospital inpatients and rapidly discharging those who can safely leave to free beds, staff, and resources for incoming disaster casualties.

Which communication system is recommended for inter-facility coordination during a multi-hospital disaster response?

Answer: Regional Healthcare Coalition radio network and unified communication platform

Regional Healthcare Coalition (HCC) radio networks and unified communication platforms provide redundant, standardized communication across multiple hospitals during disasters when normal infrastructure may fail.