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Difficulty: MediumEmergency Response and Hazardous Materials

A practical nurse (PN) is assisting a disaster medical team at the site of a multi-vehicle highway collision. The PN evaluates an adult victim who has a deep, actively bleeding laceration on the right thigh. The victim's respiratory rate is 24 breaths/minute, and they are crying but able to follow commands. Which action should the PN take first?

  1. Apply direct, firm pressure to the actively bleeding laceration.Answer
  2. B
    Tag the victim with a red emergency triage ribbon and immediately move to evaluate the next person.
  3. C
    Instruct an unlicensed assistive personnel (UAP) to conduct a comprehensive physical assessment of the victim.
  4. D
    Reassure the victim by stating, "Do not worry, everything is going to be perfectly fine."

Answer

The correct action is to apply direct, firm pressure to the actively bleeding laceration.
In any emergency response or mass casualty scenario, the priority is to identify and treat immediate threats to life using the Airway, Breathing, and Circulation (ABC) framework. The victim's active hemorrhage is a critical circulation issue. Direct pressure is the fastest and most effective initial action to control severe bleeding and prevent hypovolemic shock.

Step-by-Step Solution

1
Analyze the scenario and the client's current status.
The victim is breathing adequately (24 breaths/minute) and has an intact mental status (able to follow commands), but has an actively bleeding thigh laceration.
Initial assessment during a mass casualty incident identifies immediate threats to life.
2
Apply the Airway, Breathing, and Circulation (ABC) prioritization framework.
The client's airway and breathing are stable, but the active hemorrhage represents a critical compromise to circulation.
ABCs dictate that life-threatening circulation issues must be stabilized immediately.
3
Determine the most appropriate initial nursing intervention.
The nurse must apply direct pressure to the wound to control the bleeding.
Direct pressure is the primary and most immediate method to stop severe hemorrhage before taking any further triage or delegation actions.

Key Concept

Disaster Triage and ABC Prioritization
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Topics

Emergency Response and Hazardous Materials

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