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Difficulty: MediumEmergency Response Plan

Several self-transported clients arrive simultaneously at the emergency department entrance covered in an unidentified chemical powder following an incident at a local industrial plant. Some clients are coughing uncontrollably, while others report severe skin irritation. Which of the following is the priority action for the triage nurse?

  1. A
    Initiate the START triage algorithm to rapidly categorize the clients based on their respiratory status.
  2. B
    Delegate unlicensed assistive personnel to assist the clients in removing their contaminated clothing in the waiting room.
  3. Don appropriate personal protective equipment and direct the clients to an external decontamination area.Answer
  4. D
    Transfer the clients exhibiting respiratory distress immediately into negative-pressure isolation rooms.

Answer

The priority action is to don appropriate personal protective equipment and direct the clients to an external decontamination area.
In any hazardous materials (hazmat) incident, the overarching priority is to protect the healthcare facility and its staff from secondary contamination. Before any medical assessment, triage, or intervention can occur, the nurse must ensure their own safety by donning specialized personal protective equipment (PPE) and directing the contaminated clients to a designated external decontamination area. Allowing contaminated individuals into the emergency department would compromise the safety of all staff and current clients, potentially rendering the facility unusable.

Step-by-Step Solution

1
Identify the incident type and primary threat.
The scenario describes a hazardous materials (hazmat) exposure with an unidentified chemical powder.
Recognizing the presence of a chemical contaminant changes the immediate response protocol from medical triage to facility protection and decontamination.
2
Determine the overarching safety priority.
Contaminated clients entering the hospital can cause secondary exposure to staff and other patients, compromising the entire facility.
In any disaster response, ensuring the safety of the healthcare team and maintaining the functionality of the facility are paramount.
3
Select the appropriate initial intervention.
Before any medical assessment can safely occur, healthcare personnel must don specialized personal protective equipment and direct the clients to be decontaminated outside the facility.
Decontamination must occur outside the main hospital structure to prevent the hazardous substance from spreading indoors.

Key Concept

Hazardous Materials (Hazmat) Emergency Response and Decontamination
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Topics

Emergency Response Plan

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