Emergency and Disaster NUrsing

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2. - involves the provision of nursing
care for patient with acute injuries
or life threatening illnesses.
- Usually, care is provided at ED,
Urgent care, Trauma unit and/or
ICU/CCU
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4. French word “trier” to sort
Sorting of clients based on the
severity of health problems
Hierarchy based on the potential
for life loss
Advanced skills
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5. S T A R T - SIMPLE TRIAGE AND RAPID
TREATMENT
- quick assessment of respiration,
perfusion, mental status
S A V E - SECONDARY ASSESSMENT OF
VICTIM ENDPOINT
-used to identify who may benefit from
care available
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6.  3 categories of TRIAGE
(Berner’s)
1. Emergent
2. Urgent
3. Non-urgent
4. Fast-track
DOK OBET

7. I Emergent
Highest priority
Life threatening conditions, limbs
Must be treated immediately
 Airway compromise
 Cardiac arrest
 Shock
 Stroke
 Major Burns
DOK OBET

8. II Urgent
Threatening conditions
Not immediate
Must be seen within 1 hour
 Fever
 Minor Burns
 Lacerations
DOK OBET

9. III Non-urgent
Can be addressed within 24 hours
 Chronic conditions
 Dental problems
 Missed Menses
4th category
Fast track – simple first aid
may be treated in the ED or safely
referred to a clinic or physician’s
office. DOK OBET

10. Assess and Intervene (Primary
survey)
A airway
B breathing
C circulation
D disability
E expose
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11. HEAD
MOUTH , LIPS & TEETH
EYES
NOSE & EARS
FACE
SPINE & TRUNK
LIMBS
DOK OBET

12. done after the priorities has been
addressed.
a. Complete History and PE
b. Diagnostic and laboratory testing
c. ECG, Arterial lines, urinary catheters
d. Splinting of suspected fractures
e. Cleaning and dressing of wounds
f. other necessary interventions
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Specific Body Injuries
1. Blows to the Eyes
A. Chemical Burns

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B. Eye Knocked Out

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C. Foreign Object

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2. Nose bleeds

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3. Knocked Out Tooth

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4. Impaled Objects

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5. Amputation

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6. Sucking Chest Wound

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7. Abdominal Injuries

28. Or Mass Casualty Incident
Refers to a situation in which the
number of casualties exceeds the
number of resources
An event involving a number and/or
severity of casualties, which is
beyond the capabilities of available
care teams and facilities.
DOK OBET

30.  is a system used by medical or emergency personnel
to ration limited medical resources when the number
of injured needing care exceeds the resources
available to perform care so as to treat those
patients in most need of treatment who are able to
benefit first.
 NATO

31. Simple triage is used at the scene of a mass
casualty incident to select patients into those who
need immediate transport to the hospital in order to
save their lives and those who can wait for help later.
Advanced triage, doctors may decide that
some seriously injured people should not receive
certain care because they are unlikely to survive.

32.  Triage separates the injured into four groups:
1. The DECEASED who are beyond help,
2. the injured who can be helped by IMMEDIATE
transportation,
3. the injured whose transport can be DELAYED, and
those with
4. MINOR injuries the walking wounded who need
help less urgently.

35. 1. Red / Immediate
 Injuries are life-threatening but survivable with
minimal intervention.
 Individuals in this group can progress rapidly to
expectant if treatment is delayed.

36. 2. Yellow/ Delayed
 Injuries are significant and require medical care, but
can wait hours without threat to life or limb.
 Individuals in this group receive treatment only after
immediate casualties are treated.

37. 3. Green/ Minimal
 Injuries are minor and treatment can be delayed
hours to days.
 Individuals in this group should be moved away from
the main triage area.

38. 4.Black / Expectant –
 Injuries are extensive and chances of survival are
unlikely even with definitive care.
 Persons in this group should be separated from other
casualties, but not abandoned. Comfort measures
should be provided when possible

39. 5.White / Dismiss (walking
wounded)
First aid and home care are sufficient, a
doctor's care is not required. Injuries are
along the lines of cuts and scrapes, or
minor burns.

40.  In addition to the standard
practices of triage as mentioned
above, there are conditions where
sometimes the less wounded are
treated in preference to the more
severely wounded.

41. Triage tags are designed to
communicate the triage
category, treatment
rendered, and other
medical information.
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45. Triage in Disaster
Triage
category
Priority Color Conditions
Immediate 1 RED Chest
wounds,
shock, open
fractures, 2-3
burns
Delayed 2 YELLOW Stable
abdominal
wound, eye
and CNS
injuries
Minimal 3 GREEN Minor burns,
minor
fractures,
minor
bleeding
Expectant 4 BLACK Unresponsive,
high spinal
cord injury

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BACKGROUND INFORMATION
• Definition of First Aid:
• Is an immediate care rendered to help an
acutely ill and / or injured person before the
arrival of the Doctor or arrival to the
medical facility.
• Serve as a bridge between the victim and
the doctor / or medical facility for survival.

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Goals of First Aid:
 Keep the victim alive
 Prevent the victim’s condition
from getting worse
 Help promote recovery from the
injury or illness
 Ensure the victim receives
medical care

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1. Unfavorable surroundings
3. Pressure from Victim or
Relatives
2. The Presence of Crowds
Hindrances in giving
First Aid

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Basic Life Support
Cardiopulmonary
Resuscitation

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Life Support
1. Basic Life Support – is an
emergency procedure that
consist of recognizing
respiratory arrest or cardiac
arrest or both and the proper
application of CPR to maintain
life until a victim recovers or
advanced life support is
available.

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Advanced Cardiac Life
Support
The use of special equipment
to maintain breathing and
circulation for the victim of
cardiac emergency.

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Early CPR Early
Defibrillation
Early Advanced
Care
Early Access
The Chain Of Survival

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1. The First Link: IMMEDIATE RECOGNITION & ACTIVATION OF EMS
2. The Second Link: EARLY CPR
3. The Third Link: RAPID DEFIBRILLATION
It is the event initiated after the patient’s collapse until the arrival of Emergency Medical
Services personnel prepared to provide care.
It is most effective when started immediately after the victim’s collapse. The probability of
survival approximately doubles when it is initiated before the arrival of EMS.
4. The Fourth Link: EFFECTIVE ACLS
It is the cornerstone therapy for patients who have just suddenly collapsed probably
due to ventricular fibrillation and pulse-less ventricular tachycardia.
Provided by highly trained personnel like paramedics.
FIVE LINKS for ADULT VICTIMS
5. The Fifth Link: INTEGRATED POST-CARDIAC ARREST CARE
Post cardiac arrest care after return of spontaneous circulation (ROSC) can improve the
likelihood of patient survival with good quality of life.

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TRANSMISSION OF DISEASES
AND THE FIRST AIDERS
1. How Diseases are transmitted.
a. Direct Contact Transmission

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b. Indirect Contact
Transmission

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c. Airborne Transmission

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• Disease precaution
 Blood borne diseases
Use of gloves, or protective cloths, or plastic, eye
goggles,
 Air borne diseases
Use of mask
NOTE: Therefore, we must practice the
Body Substance Isolation (B.S.I.)
precaution.

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3. BODY SUBSTANCE
ISOLATION (BSI)
A. Personal
hygiene

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B. Equipment
cleaning and
disinfecting

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C. Protective Equipment

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Basic Life Support – CPR Visual Aids
Cardiac Arrest & Cardiopulmonary Resuscitation
TR 5-3
1. SPONTANEOUS signs of circulation are restored.
2. TURNED over to medical services or properly trained and authorized
personnel.
3. OPERATOR is already exhausted and cannot continue CPR.
4. PHYSICIAN assumes responsibility (declares death, takes over,
etc.).
PNRC – DOH Tie-up Project

63. When to STOP (Continuation):
S - SPONTANEOUS signs of circulation are
restored
T -TURNED over to medical services or
properly trained and authorized
personnel
O - OPERATOR is already exhausted and
cannot continue CPR
P - PHYSICIAN assumes responsibility
(declares death, takes over, etc.)
S – SCENE becomes unsafe (such as traffic,
impending or ongoing violence—gun
fires, etc)
S – SIGNED waiver to stop CPR

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