Discharging a patient in disaster triage

[sandtiger]

Situation: You're a nurse in a disaster area, and you need to make a bed available, so you need to recommend one patient for discharge... do you pick the most stable patient or the patient that can't be helped anymore?

[Anyausa]

I think the stable patient needs to be removed. The other patient is dying so will you have a heart to move him away? He has no time and energy for it...

But of course I may be wrong...it is nclex world!!!

[waitingforthedream]

I am not sure of this, but in disaster triage the person you know wont make it goes. alot different from regular triage. But someone with more experience in this area may say differentely. Anyone out there know with more certainty?

[skim410]

I remember reading somewhere that they use a color system. So first priority goes to the RED (life-threatening situations, such as shock, airway/breathing problems, etc), then YELLOW (injuries that are not life-threatening and minor, like a broken bone, controlled bleeding, etc.), next GREEN (those with minor injuries that can walk; they may help in a diaster situation), last is BLACK (those with irreversible trauma or dead)

[spongebob6286, BSN, RN]

I remember reading somewhere that they use a color system. So first priority goes to the RED (life-threatening situations, such as shock, airway/breathing problems, etc), then YELLOW (injuries that are not life-threatening and minor, like a broken bone, controlled bleeding, etc.), next GREEN (those with minor injuries that can walk; they may help in a diaster situation), last is BLACK (those with irreversible trauma or dead)

is that the same when it comes to discharging a pt or just for prioritization only?

[msslim]

We learned that you would move the patient that can't be helped anymore, which is a black tag because they are more likely to die. That is only for disaster triage. I had a practice style question that asked which pt. would you move if the only space available was the morgue and the answer was the pt. that can't be helped anymore. So I would guess that would be the patient

[Anyausa]

this is kind of crazy....Stable patient is fine, is stable, he in my understanding should be removed...

And the dying patient, where I should put him? Throw him away like a trash?

I know it is disaster time, no time for thinking...but the moral issue....i am so confused...

I would remove stable patient. I wont change my mind:))

[waitingforthedream]

Disaster triage is completely different from what we are taught as a nurse. Yes pt. is stable, but may still need monitoring. Pt. that has no chance of making it, with so many more patients expected needs to move to make room for people who have a chance to survive. We make them comfortable and that is it. Think of the movie "Pearl Harbor", the nurse needed to make a black X on the forehead of the pt's. that had no chance, gave them morphine, moved them, and moved on to pt's. that could survive. Yes it seems unethical, but it is a disaster zone, you try to save as many as possible by not wasting time on people with little or no chance of surviving.

[Anyausa]

yes, I understand..but I would "waste" my time on someone who is stable also.

Man, this exam drives me crazy!:))

Cheers

[waitingforthedream]

Yeah, the questions are killer! I hope I never need to triage in a disaster setting, I just don't think I could do it.