• Conjunctivitis, Otitis media etc. • Viral syndromes. • Low grate fever. • Toothache • Nausea, vomiting, without signs of dehydration. • Minor abrasions, sprains, cuts.
47 Patient's Assessment • Within 2-5 mins of arrival. • Gather Subjective and Objective data. • “PQRST” (for pain) systemic approach to patient assessment. • Data collection regarding medication usage. • Immunization history (esp., for children).
48 Assessment of Triage Patient PRIMARY SURVEY: • Rapid identification of patients with urgent life threatening conditions. • A=Airway • B=Breathing • C=Circulation. • D=Disablility • E=Expose
49 PQRST for Pain Assessment
OLD CART Assessment For Chief Complain 50
Three Possible Outcomes 1. • „Under - triage‟ 2. • „Correct (or expected) triage 3. • „Over - triage‟
Principles of Disaster Triage • Do the greatest good for the greatest number of people • Employ the most efficient use of available resources • Treat as many as possible who have a chance of survival. • Base treatment on exclusion criteria • Agreed upon criteria = Triage Process • Return key personnel to duty as quickly as possible
Is patient dying ? Level II, III, IV, V Can patient wait ? How many resources ? Yes No Level I Yes No Level II E M E R G E N C Y S E V E R I T Y I N D E X Level III, IV, V ONE Level IV TWO Level III NON Level V
54 What do you think? 1. 40 y/o old female c/o epigastric pain, vomiting 2. 50 y/o male with a ripping sensation in his chest? 3. 23 y/o with RLQ pain and fever? 4. 19 y/o post partum, hypotensive & fever? 5. 2 y/o, vaccines, drooling & fever? 6. 4 week old male, vomiting after every meal? 7. 80 y/o with abdominal pain, vomiting bilious? 8. 4 m old diff breathing, congestion-winter months? 9. Healthy 52 y/o who ran out of his blood pressure medicine yesterday 10.22 y/o involved in a car accident 2 days ago, wants to be checked. Nothing hurts. 11.46 y/o with a cold
References • Garcia, M. L. (1985). Disaster nursing: Planning, assessment and intervention. Maryland: an Aspen Publications • Lewis, S. M., Collier, I. C., & Heitkemper, M. M. (2004). Medical-Surgical Nursing (5 th . ed.). St. Louis: Mosby • Newberry, L. (2003). Sheehy‟s emergency nursing: Principles and practice (5th ed.). Emergency nurses association. St. Louis: Mosby.
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