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Difficulty: Very hardEmergency Response Plan

A hospital activates its Emergency Operations Plan (EOP) in response to a mass casualty incident involving a suspected aerosolized biological agent (inhalational anthrax) at a local stadium. The facility is immediately overwhelmed with hundreds of victims seeking rapid evaluation and treatment. Which action by the nursing staff demonstrates a correct understanding of disaster response protocols?

  1. Discharging a hemodynamically stable inpatient who is 48 hours post-cholecystectomy and tolerating oral intake to their home.Answer
  2. B
    Initiating airborne transmission-based precautions and placing all exposed victims in negative-pressure isolation rooms.
  3. C
    Allocating immediate medical resources to intubate an apneic victim who fails to resume spontaneous breathing after airway repositioning.
  4. D
    Delegating the initial clinical triage and respiratory screening of the ambulatory 'walking wounded' victims to unlicensed assistive personnel.

Answer

Discharging a hemodynamically stable inpatient who is 48 hours post-cholecystectomy and tolerating oral intake to their home.
During a mass casualty incident, the hospital's Emergency Operations Plan requires the rapid expansion of inpatient capacity. Discharging a client who is 48 hours post-operative, hemodynamically stable, and tolerating oral intake is a safe and necessary action to free up acute care resources for incoming disaster victims.

Step-by-Step Solution

1
Analyze the scenario.
A mass casualty incident (MCI) involving a biological agent has overwhelmed the hospital, necessitating severe resource preservation and prioritization.
Understanding the nature of the disaster dictates which protocols override standard daily operations.
2
Evaluate the need for inpatient capacity expansion.
Stable inpatients who can safely continue their recovery at home must be discharged.
During an EOP, freeing up acute care beds is critical to accommodate the influx of critical disaster casualties.
3
Assess the infection control requirement for the specific agent.
Inhalational anthrax is not transmitted from person to person.
Applying unnecessary airborne precautions and using negative-pressure rooms inappropriately depletes critical facility resources.
4
Apply mass casualty disaster triage principles (START method).
Apneic victims who do not breathe after airway opening are tagged Expectant (Black).
Resources must not be wasted on resource-intensive interventions like intubation for non-salvageable clients when others can be saved.
5
Determine the scope of delegation during an emergency.
Initial triage and assessment cannot be delegated to UAPs.
Clinical judgment is required to prioritize victims, a responsibility that remains with the registered nurse regardless of the surge.

Key Concept

Mass Casualty Incident (MCI) Resource Management and Triage
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Topics

Emergency Response Plan

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