Nursing Prioritization Delegation Assignment Q 19
A group of passengers enters the ED with complaints of cough, tightness in the throat, and extreme periorbital swelling. There is a strong odor exuding from their clothes. They report exposure to a “gas bomb” that was placed in the bus terminal. What is the priority action?
A. Readily transfer clients and visitors from the area
B. Check vital signs and auscultate lung sounds
C. Assist clients in the decontamination area
D. Direct clients to the cold or clean zone for immediate treatment
Correct Answer: C. Assist clients in the decontamination area
Decontamination in a specified area is the priority. The decontamination and support areas are established within the Warm Zone, also referred to as the Contamination Reduction Zone. Decontamination involves thorough washing to remove contaminants.
Option A: Decontamination triage is especially important in mass casualty incidents and should not be confused with medical triage. Decontamination triage is the process of determining which victims require decontamination and which do not. Rapidly identifying victims who may not require decontamination can significantly reduce the time and resources needed for mass decontamination.
Option B: Doing assessments and transferring others delay decontamination and do not protect the total environment. Set up or assign an area or building as a safe refuge/observation area for victims who do not require medical attention. Here they can be monitored for a delayed outbreak of symptoms or indications of residual contamination. Donning personal protective equipment and measures is vital before assisting with decontamination or assessing the clients.
Option D: The clients must undergo decontamination before entering cold or clean zones. In mass casualty incidents, decontamination corridors can be set up that consist of high volume, low-pressure water deluges. Assign personnel to decontamination stations to control and instruct victims when they enter the decontamination area.