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Difficulty: MediumEmergency Response and Hazardous Materials

A community hospital activates its mass casualty disaster plan following a structural collapse at a nearby stadium. The triage center is receiving a high volume of victims, and the charge nurse is distributing client assignments among the healthcare team. Which client assignment is most appropriate for the practical nurse (PN) to accept?

  1. A client designated with a green tag who requires wound cleansing and a sterile dressing application for a forearm laceration.Answer
  2. B
    A client designated with a red tag who is exhibiting paradoxical chest wall movement and requires immediate respiratory assessment.
  3. C
    A client designated with a yellow tag who has sustained blunt head trauma and requires an initial baseline neurological evaluation.
  4. D
    A client designated with a black tag who has agonal respirations and requires the administration of an intravenous (IV) push analgesic for comfort.

Answer

The assignment involving the green-tagged client who needs a sterile dressing application for a forearm laceration.
In a mass casualty incident, clients with green tags have minor injuries and are considered clinically stable. Wound cleansing and sterile dressing changes fall within the established scope of practice for a practical nurse (PN), as this involves a predictable outcome and standard procedural care on a stable client. The PN can safely and independently manage this assignment.

Step-by-Step Solution

1
Evaluate the stability and acuity of each client based on their disaster triage tag.
Red indicates immediate life-threatening injury, yellow indicates delayed but potentially serious injury, black indicates expectant/dying, and green indicates a minor 'walking wounded' injury.
Prioritization in disaster triage determines the level of care and immediacy required.
2
Analyze the specific nursing interventions required for each client.
The tasks include respiratory assessment, baseline neurological evaluation, IV push medication administration, and a sterile dressing change.
Delegation must accurately align with the complexity of the required task and the client's current clinical stability.
3
Match the required tasks and client stability to the practical nurse (PN) scope of practice.
Initial assessments (respiratory and neurological) and IV push medications are outside the PN scope. A sterile dressing change on a stable client is well within the PN scope.
Safe delegation mandates that PNs only accept assignments involving stable clients with predictable outcomes requiring standard procedures.

Key Concept

Mass Casualty Incident (MCI) Triage and PN Scope of Practice
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Topics

Emergency Response and Hazardous Materials

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