Examkin

Question

Difficulty: HardEmergency Response Plan

An electrical fire erupts in the main supply room of a busy telemetry unit. The staff has already rescued the clients in immediate danger and contained the fire by closing the heavy fire doors. The incident commander now orders a complete horizontal evacuation of the remaining unit. To ensure the safest and most efficient clearance of the area, which client should the nursing staff evacuate NEXT?

  1. A
    A client with unstable angina receiving a continuous intravenous nitroglycerin infusion who requires a wheelchair.
  2. B
    A client in skeletal traction for a femur fracture who requires a specialized bed and multiple staff for transport.
  3. A client recovering from an open appendectomy who is receiving intravenous antibiotics and can walk independently.Answer
  4. D
    A client with a tracheostomy on a mechanical ventilator who requires a stretcher and two staff members for transport.

Answer

The client recovering from an open appendectomy who can walk independently should be evacuated next.
During a facility fire or internal disaster, evacuation must follow a specific sequence to prevent physical bottlenecks and maximize the number of lives saved with available resources. After clients in immediate danger are rescued, ambulatory clients are evacuated first because they require minimal staff assistance and can move quickly. This clears the hallways and allows staff to then focus on wheelchair-bound clients, leaving bedbound and critically ill clients for last.

Step-by-Step Solution

1
Analyze the disaster context.
The scenario involves an internal hospital disaster (fire) requiring a horizontal evacuation of the unit. The clients in immediate danger have already been rescued.
Establishing the phase of the disaster determines which prioritization framework to apply.
2
Recall the standard facility evacuation protocol.
The sequence is: 1) Clients in immediate danger, 2) Ambulatory clients, 3) Wheelchair-bound/semi-ambulatory clients, 4) Bedbound/critical clients.
This protocol ensures the greatest number of people are moved to safety in the shortest amount of time without causing hallway bottlenecks.
3
Evaluate the mobility and resource needs of each client in the options.
The client with the appendectomy is ambulatory. The client with angina requires a wheelchair. The clients with skeletal traction and on a ventilator are bedbound and require heavy equipment.
Identifying mobility status allows for proper sequencing according to the evacuation protocol.
4
Select the highest priority client based on the protocol.
The ambulatory client with the appendectomy requires the least staff assistance and can move quickly.
Evacuating ambulatory clients first clears the area rapidly, freeing up physical space and staff to subsequently assist the non-ambulatory and critical clients.

Key Concept

Facility Evacuation Prioritization during Internal Disasters
Rate this question

Topics

Emergency Response Plan

More questions from this topic