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Zorluk: OrtaEmergency Response Plan

A major commercial train derailment has resulted in a mass casualty incident (MCI), causing a sudden influx of critically injured trauma clients at a local hospital. The hospital administrator has activated the Emergency Operations Plan (EOP) to surge capacity. The charge nurse on a medical-telemetry unit is evaluating current clients for immediate discharge to free up inpatient beds. Which of the following clients should the nurse recommend for safe discharge? Select all that apply.

  1. A client admitted 24 hours ago with suspected angina who has had three negative serial troponin levels and a normal electrocardiogram.Cevap
  2. A client with an asthma exacerbation who was admitted 2 days ago, now has clear breath sounds, and requires only an albuterol metered-dose inhaler every 6 hours.Cevap
  3. A client admitted 3 days ago with a deep vein thrombosis who is now fully transitioned to an oral anticoagulant and has therapeutic laboratory values.Cevap
  4. D
    A client admitted 12 hours ago with bacterial pneumonia who has a current temperature of 101.8°F (38.8°C) and is receiving scheduled intravenous antibiotics.
  5. E
    A client with atrial fibrillation whose heart rate remains at 120 beats/minute while receiving a continuous intravenous diltiazem infusion.
  6. F
    A client who reported increasing episodes of resting chest pain over the past 24 hours and is scheduled for an urgent cardiac catheterization in the morning.

Cevap

The clients appropriate for safe discharge include the client with negative serial troponins and a normal ECG, the asthma client stabilized on a metered-dose inhaler, and the DVT client transitioned to an oral anticoagulant.
During a disaster response requiring hospital capacity surges, the safest clients to discharge are those who are medically stable, can take oral or inhaled medications, and do not require continuous assessment or monitoring. The client with negative troponins and normal ECG has had a cardiac event ruled out. The asthma client has resolved acute symptoms and is manageable on home inhalers. The DVT client is stabilized on oral anticoagulants. All three of these clients have a low risk of sudden deterioration and can safely complete their recovery at home.

Adım Adım Çözüm

1
Analyze the goal of activating the Emergency Operations Plan (EOP) for a mass casualty incident.
The goal is to surge capacity by freeing up hospital beds for critically injured incoming casualties.
Understanding the objective helps determine the criteria for discharging current inpatients.
2
Establish the criteria for safe discharge during a disaster surge.
Clients must be medically stable, not require continuous intravenous therapies or cardiac monitoring, and be able to manage their care safely at home.
Only clients whose absolute risk of acute deterioration is very low can be safely discharged early.
3
Evaluate each client's acuity and stability.
The clients with negative troponins, resolved asthma symptoms on inhalers, and DVT on oral anticoagulants are stable. The clients with a fever on IV antibiotics, rapid atrial fibrillation on a diltiazem drip, and resting chest pain awaiting urgent catheterization are unstable.
Identifying unstable clients prevents unsafe discharges that could result in severe adverse outcomes.

Anahtar Kavram

During a mass casualty incident, the Emergency Operations Plan (EOP) involves discharging the most medically stable clients to surge capacity. Safe discharge criteria prioritize clients who have stable vital signs, have transitioned to oral or self-administered medications, and no longer require acute invasive monitoring or intravenous therapies.
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Emergency Response Plan

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