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ASSESSMENT WITH TRIAGE. Pat Glass, R.N. Jessamine County Schools Director Nursing Services Health Services Coordinator. School Emergencies. Be prepared for all types of emergencies:

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Assessment with triage

ASSESSMENT WITH TRIAGE

Pat Glass, R.N.

Jessamine County Schools

Director Nursing Services

Health Services Coordinator


School emergencies
School Emergencies

  • Be prepared for all types of emergencies:

    Injuries – playground, physical education, lab-related, shop classes (wood shop, Agriculture, mechanics, etc.)

    Weather related emergencies – tornado, earthquake, frostbite, etc.

    Explosion

    School shooter

    Train Derailment

    Nuclear threat

    Fire


Triage
TRIAGE

Triage – “sorting”

Triage Categories

Emergent

Urgent

Non-urgent


Triage1
TRIAGE

  • Process:

    Assessment

    Intervention

    Evaluation

    Disposition


Triage color codes
Triage Color Codes

  • Black – deceased or dying

  • Red – immediate care required (correctable, life-threatening :emergent)

  • Yellow – Delayed (serious but not life-threatening : urgent )

  • Green – Minor (non-emergent, minimal care)


Establish areas
Establish Areas

  • Establish treatment areas:

    Triage

    Disaster First Aid

    Continuity of Care

    Disposition of patients (whether released to parents or transported to hospital)

    Documentation


Triage cont
Triage (Cont.)

  • Primary Triage – Quickly assess

  • Secondary Triage – Match patients with current resources, perform initial treatment, and prioritize for transport

    Remember – Additional resources and personnel will arrive. First Goal is to “create order out of chaos”. Providing care to as many as possible with the resources at hand.


Triage cont1
TRIAGE (Cont.)

  • Documentation must include:

    Assessment

    Triage Category

    Intervention

    Response to intervention

    Disposition (make sure that info is communicated to private physician &/or ER staff)


Triage2
TRIAGE

  • Follow-up

    Communicate with family, private doctor, EMS staff, &/or ER staff in order to document the outcome for the student’s records.


Students with special needs
Students with Special Needs

This can address many different scenarios. Students with chronic health conditions such as diabetes, asthma, epilepsy, and students who require a wheelchair, ventilator, oxygen therapy, suctioning, tube feedings, etc..

This also relates to a need for accessing emergency medications.


Students with special needs cont
Students with Special Needs (Cont.)

These students will need quick assessment and continuity of care. Employees that are currently assigned to these students during school hours will be excellent resources in during the disposition and follow-up phases of triage.


Mass casualty disasters
MASS CASUALTY/DISASTERS

  • Have a PLAN!!!!!!

    1. Who in the building is trained in CPR & First Aid?

    2. How quickly can you access help from the other schools?

    3. Do your nurses have “ER to-go kits”?

    4. Where are you going to put bodies?

    5. Do you have an area designated for parents to pick up their children?

    Classroom lists, ER cards, Sign out process


Disaster mass casualty planning
DISASTER/MASS CASUALTY PLANNING

  • Sign out process – how to insure that student has been assessed before leaving

  • “HOLD IN PLACE” situation:

    Students that have medical needs, such as medication, tube feedings, O2 therapy, dietary needs, catheterizations, etc.

    Is the teacher or IA in the classroom trained well enough to handle the medical needs if no medical person can get to that classroom for several hours?

    Medical Supplies – Extra ER supplies at each location. Need enough to handle basic needs until able to release students or help arrives.


Develop a plan
DEVELOP A PLAN

  • Meet with local agencies to coordinate the best plan

    Police

    EMS

    Fire

    Health Dept.

    Emergency Management Coord.


Resources
RESOURCES

  • Disaster Preparedness Guidelines for School Nurses, (NASN publication)

  • “The Role of School Nurses in Emergency Management Planning” Deborah Strouse, RN,BSN, Med, NCSN (School Nurse Columbus City Schools)

  • CDC website


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