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Zorluk: Çok zorEmergency Response Plan

An off-duty nurse is the first responder at the site of a massive natural gas explosion in a multi-story hotel. Applying the adult START (Simple Triage and Rapid Treatment) algorithm, which victim MUST the nurse classify as Immediate (Red tag)?

  1. A victim unable to stand with no obvious physical trauma, a respiratory rate of 24 breaths/min, and a palpable radial pulse, who stares blankly and does not obey the command to squeeze the nurse's handCevap
  2. B
    A victim lying on the ground with an open, eviscerated abdominal wound, a respiratory rate of 28 breaths/min, and a palpable radial pulse, who is screaming in pain and correctly states their name and location
  3. C
    A young adult victim with severe facial trauma who is completely apneic, and after the nurse manually opens the airway, the victim does not take any spontaneous breaths
  4. D
    A victim walking around the blast zone holding a blood-soaked towel to a deep scalp laceration, with a respiratory rate of 26 breaths/min, who is crying and searching for a family member

Cevap

The victim who is unable to stand, has stable vital signs, but stares blankly and does not obey commands must be classified as Immediate (Red tag).
Under the START algorithm, victims are sequentially assessed for ability to walk, respiratory rate, perfusion, and mental status. The correct client cannot walk, has respirations <30 breaths/min, and has a palpable radial pulse, but fails the final step: obeying commands. An inability to follow simple commands indicates significant neurological impairment or poor cerebral perfusion, strictly mandating a Red (Immediate) tag despite the lack of obvious external trauma.

Adım Adım Çözüm

1
Evaluate ambulatory status for all victims.
Victims who can walk (such as the client with the scalp laceration) are immediately designated as Green (Minor).
This clears the immediate scene of stable individuals so resources can be directed to the non-ambulatory.
2
Assess respiratory effort for non-ambulatory victims.
If apneic, open the airway. If still apneic (such as the young adult with facial trauma), tag as Black (Expectant). If the respiratory rate is >30 breaths/min, tag as Red.
Resources are not expended on unsalvageable clients during a mass casualty incident.
3
Assess perfusion and mental status for victims with respiratory rates <30 breaths/min.
The victim with the evisceration has intact perfusion and follows commands, so they are tagged Yellow (Delayed). The victim with no obvious trauma fails the mental status check (cannot obey commands), so they are tagged Red (Immediate).
Altered mental status indicates a life-threatening systemic issue (e.g., increased intracranial pressure or shock) requiring immediate intervention, superseding the visual severity of other injuries.

Anahtar Kavram

Disaster Triage (START Algorithm)
Tahmini Süre:1m 30s
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Konular

Emergency Response Plan

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