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Difficulty: HardEmergency Response and Hazardous Materials

Following an industrial explosion, a community center is established as a mass-casualty incident (MCI) triage site. A practical nurse (PN) from a local clinic is deployed to assist the emergency response team. Which of the following actions by the PN are appropriate? Select all that apply.

  1. Directing ambulatory casualties with minor injuries to a designated holding area.Answer
  2. B
    Assuming primary responsibility for assigning initial triage tags to incoming victims.
  3. Applying pressure dressings to actively bleeding wounds on casualties awaiting transport.Answer
  4. D
    Removing casualties' chemical-contaminated clothing before donning personal protective equipment.
  5. Administering prescribed intramuscular tetanus toxoid injections to stable casualties.Answer

Answer

The appropriate actions include directing ambulatory casualties to a holding area, applying pressure dressings to actively bleeding wounds, and administering prescribed intramuscular injections.
During a mass-casualty incident, the practical nurse appropriately performs skills within their scope of practice. This includes providing basic first aid such as hemorrhage control, administering routine intramuscular medications, and assisting with overall site management by directing ambulatory 'walking wounded' patients to designated areas.

Step-by-Step Solution

1
Evaluate each action against the practical nurse (PN) scope of practice and general disaster management principles.
PN scope includes basic care, medication administration (non-IV push), and assisting with stable client procedures.
Practical nurses must function within their legal scope of practice even during emergency or mass-casualty situations.
2
Assess the safety principles of hazardous materials and disaster response.
Personal safety is the priority; PPE must be donned before contacting any contaminated clients or materials.
If the healthcare worker becomes contaminated, they become a casualty themselves and deplete available resources.
3
Differentiate between initial triage responsibilities and delegated supportive tasks.
Initial mass casualty triage requires advanced clinical judgment, which is outside the PN scope.
PNs assist in triage by performing designated tasks, such as airway repositioning or bleeding control, rather than independent sorting and tagging.

Key Concept

Emergency response protocols and the practical nurse's scope of practice during a mass-casualty incident.
Estimated Time:2m 0s
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Topics

Emergency Response and Hazardous Materials

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