How is triage different in a disaster from triage on a routine day in the emergency department?

1. The local community hospital routinely practices activation of its Emergency Preparedness Plans. One key aspect of the emergency preparedness exercise is to provide all staff with opportunities to practice their various roles during an actual emergency. Registered nurses from the emergency department frequently have key roles in patient triage and emergency management. (Learning Objective 2)

1. How is triage different in a disaster from triage on a routine day in the emergency department?
2. What are the triage categories during a mass casualty incident?
3. During the disaster exercise, a simulated patient with a penetrating head injury who does not respond to painful stimuli and has a Glasgow Coma Scale of 5 is brought to the emergency department. In what category should the patient be placed?

2. The nursing staff in the emergency department are placed on alert for a Level I disaster at a local mall. A bomb exploded, and there were multiple causalities as a result. A field disaster triage was set up, and the hospital was notified of a bus load of patients who would arrive at the emergency department for needed care. The ambulance will bring patients needing emergent care. (Learning Objective 5)

1. What physical injuries may occur after the primary blast event, and what management is needed?
2. What physical injuries may occur after the secondary blast phase, and what management is needed?