Jim Keogh - Schaums Outline of Emergency Nursing

SCHAUMS
outlines

SCHAUMS
outlines

James Keogh, RN

James Keogh, RN-BC, AAS, MBA, is a registered nurse and has written Schaum's Outline of Pharmacology, Schaum's Outline of Nursing Laboratory and Diagnostic Tests, Schaum's Outline of Medical-Surgical Nursing, and Schaum's Outline of Medical Charting and coauthored Schaum's Outline of ECG Interpretation. His books can be found in leading university libraries including Yale University School of Medicine, University of Pennsylvania Biomedical Library, Columbia University, Brown University, University of Medicine and Dentistry of New Jersey, Cambridge University, and Oxford University. He is a former member of the faculty of Columbia University and a member of the faculty of New York University.

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ISBN 978-0-07-178981-3

MHID 0-07-178981-2

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• Triage is the systematic process of prioritizing patients based on patient acuity when confronted with limited medical resources. The goal is to allocate medical resources that will result in a positive difference in the patients outcome.
• Triage was developed by French physicians during World War I to organize treatment of soldiers on the battlefield.
• Triage is a continuous process because the patients condition can change during interventions to stabilize the patient. In a trauma, a patients injuries may appear minor at first but may become more serious following the initial triage assessment. Therefore, patients must be continuously evaluated until stabilized.
• There are two models for triage:
  • Primitive: the practitioner prioritizes patients based on the practitioners best guess at the time of assessment. This method is used in the earliest stage of an incident and when there are more patients than can be practically assessed by the practitioner.
  • Modern: the practitioner prioritizes patients based on physiological and scientific assessment. This method is used in the later stage of an incident and when the ratio of patients to practitioner is relatively low.
• There are two methods of triage:
  • Primary: primary triage requires the practitioner to detect and treat life-threatening conditions.
  • Secondary: secondary triage requires the practitioner to detect and treat non-life-threatening conditions.
• The practitioner performs a primary triage assessment when the patient is first presented to him or her. A commonly used primary triage model is Simple Triage and Rapid Treatment (START), which was developed at Hoag Hospital in Newport Beach, California. The results of the primary triage assessment enable the practitioner to assign the patient to one of four treatment categories.
  • Minor: these are patients who are likely to live regardless of the care they receive. Sometimes these patients are referred to as the walking wounded.