QUEZON, BRITNEY KIM E.
NCM 120: EMERGENCY NURSING
DISASTER RESPONSE
Disaster Response
- The immediate actions taken in the aftermath of a disaster
to protect against further loss of life and property.
Triage
- French word, “trier” means to sort or choose.
- The process which places the right patient in the right place
at the right time to receive the right level of care.
- The process of prioritizing which patient are to be treated
first and is the cornerstone of good disaster management
in terms of judicious use of resources.
- Disaster triage will always be a difficult and daunting task
Essential Personal Abilities to be an Effective Triage Officer
• Clinically experienced
• Good judgement & leadership
• Calm & Cool under stress
• Decisive
• Knowledgeable of available resources
• Sense of humor
• Creative Problem solver
• Experienced and knowledgeable regarding anticipated
casualties
Types of Triage
Daily Triage
- routine basis at ER
- highest intensity of care is given to the most seriously ill
patients, even if they have a low probability of survival
Incident Triage
- occurs when ER is stressed by a large number of patients
but care & resources are still given
- there are delays longer than normal, but eventually, all who
presents themselves for care is attended to
Disaster Triage
- employed when local emergency services are
overwhelmed to the point that immediate care cannot be
provided to everyone who needs it
Tactical-Military Triage
- similar to disaster triage but follows military mission
objectives rather than traditional civilian guidelines in triage
& transport decisions
Special Conditions Triage
- used when patients present incidents involving radiation,
chemical, or biological contaminations. PPE is mandated
to all personnel. GOAL: prevent secondary transmission
Mnemonics for Quick Assessments (In-Hospital)
1. VOMIT
V – visualize, verbalize, vital signs + ABCDEs
O – oxygen
M – monitor
I – IV/IO insertion
T – Treat
2. ABCDEs (part pf Vital Signs)
A – airway
B – breathing
C – circulation
D – disability
E – exposure
Airway
• Is the airway clear?
• Can the patient talk?
• Is the trachea deviated?
• Is the insides of the mouth swollen?
• Is there a neck injury?
Breathing
• Does the chest rise symmetrically?
• Is the work of breathing increased?
• Are the lung sounds equal?
Circulation
• Check BP
• Check PR
• Check CRT
• Check Central and Peripheral Pulses
Disability
• AVPU or GCS
Exposure
• Check for Temperature, Bleeding, Burns, Trauma, any
attachments to the body
3. SAMPLE (part of Verbalize)
S – signs and symptoms
A – allergies
M – medications
P – pertinent past medical history
L – last meal
E – events
VOMIT Assessment
Visualize
Vital Signs + ABCDE
Verbalize
Consciousness
Temperature Airway
Signs & Symptoms
Breathing
Pulse Rate Breathing
Allergies
Color
BP Circulation
Medications
RR Disability
Pertinent Past Med Hx
O2 Sat Expose
Last Meal
Pain Score
Events
Glucose Levels
Medical Assessment Triage Levels
Level 1:
Resuscitation
• Conditions that are threat to life and limb
requiring immediate aggressive interventions.
• Seen immediately
• Patients who are unresponsive or unconscious,
or those who are suffering from these
conditions:
- cardiac and respiratory arrest
- unresponsive / unconscious
- life and limb threatening
- major trauma
Level 2:
Emergent
• Conditions that are a potential threat to life,
limb, or function.
• Seen within 15 mins
• The patient is showing signs of distress or
experiencing a condition that can become life
threatening and needs to be re-evaluated. Must
be continuously monitored
- active seizures
- signs of stroke (slurring speech, facial
dropping)
- profuse bleeding
- severe allergic reaction
- respiratory distress
