Journal of emergency nursing : JEN : official publication of the Emergency Department Nurses Association
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Lack of outcomes-based research results in uncertainty about the effectiveness of any of the current triage systems in determining priority of care during actual chemical disasters. The purpose of this study was to determine whether the level of injury severity extrapolated from 5 triage systems correlated with actual injury severity outcomes of victims exposed to a chlorine disaster. ⋯ The extrapolated injury severity triage outcome categories from the 5 triage systems did not agree with the actual injury severity categories. Oxygen saturation measured by pulse oximetry provides early indications and is very predictive of outcome severity in incidents involving irritant chemical exposures such as chlorine, and should be a part of a mass casualty protocol for any irritant chemical incident. Additional research is needed to identify the most sensitive clinical measures for triaging victims of toxic inhalation disasters.
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Accurate trauma triage is imperative to facilitate appropriate resource mobilization for severely injured trauma patients. A critical window of opportunity exists to prevent secondary injury or death. Timely assessment with a multidisciplinary trauma team is essential to facilitate rapid diagnosis and treatment. However, consistent and accurate trauma triage proved daunting at our institution, resulting in instances of undertriage. ⋯ Designating trauma triage to an ED registered nurse proved to reduce undertriage rates. By providing staff education, infrastructure improvements, and leadership support, the role continues to thrive, resulting in improved care for severely injured trauma patients.
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Disaster education is important for everyone and especially nurses. Being informed, making individual and family communication plans, and creating the needed supplies to shelter in place or evacuate for one's self and family are required core readiness behaviors. Nurses also need to understand their role within the employer's emergency plans and incident command structure. All of these behaviors help the nurse to be ready and available to care for patients during disaster and emergency incidents.