Which one of the following principles guides nurses' priorities at a disaster caused by a collapsed building… - SCTIMST Staff Nurse - 2016

SCTIMST Staff Nurse - 2016

Community Health Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2016

Explanation

The core principle of disaster triage is to provide the 'greatest good for the greatest number' of people, which differs from standard emergency care.
Rapidly identifying and segregating those with minimal injuries (the 'walking wounded' or Green tag) is a crucial first step in managing a chaotic scene.
This strategy allows limited medical resources to be focused on those with severe but survivable injuries (Red and Yellow tags).
Those with minor injuries can often be directed to a safe area and may even be able to assist with simple, non-medical tasks, thus becoming a resource themselves.

Option A: While severe hemorrhage is a high-priority (Red tag) condition, triage is a comprehensive sorting process for all victims, not a system based on treating a single injury type first.
Option C: Triage priority is based on physiological assessment (breathing, circulation, mental status), not the specific diagnosis. A head injury's priority depends on its severity and its impact on vital functions.
Option D: In disaster triage, priority is based on survivability and physiological status, not age. Giving automatic priority to children could divert resources from more salvageable adult victims.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Disaster Triage Principles as background academic context rather than a clinical decision trigger.
Nurses must be prepared to shift their mindset from individual patient care to population-based care during a disaster. This requires difficult ethical decisions to maximize overall survival.
Adhering to a standardized triage system like START prevents responders from being overwhelmed and ensures a consistent, efficient approach to victim care.
What if? If this were a standard emergency department scenario with only three patients arriving, the nurse would prioritize the most critically ill patient (e.g., the one with hemorrhage or a severe head injury), which is the opposite of the disaster triage principle.

How to Approach the Question

First, identify the context of the question: a 'disaster' or 'mass casualty incident'. This is a critical cue that standard emergency protocols do not apply.
Recall the fundamental principle of disaster triage: 'do the greatest good for the greatest number of people'. This means maximizing the number of survivors with limited resources.
Evaluate each option against this core principle.
Eliminate options that focus on treating the 'sickest first' without considering survivability (e.g., hemorrhage, head injuries) or non-medical factors (e.g., age).
Select the option that best reflects the utilitarian goal of efficiently managing the scene and resources to save the most lives, which includes quickly identifying and moving the least injured.

Concept Tested & Keywords

Concept Tested: Disaster Triage Principles
Stem keywords: disaster, collapsed building, earthquake, nurses' priorities
Lead-in keywords: principles guides
Clinical cues: Mass casualty incident (MCI) setting implies a shift from standard emergency care.

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart B (pp 276-535 of 550) pp. 178-180, 179-181