By Michael Beach DNP ACNP-BC PNP

Be ready whilst catastrophe moves with this entire advisor to the fundamentals of catastrophe coaching and reaction. From the levels of a catastrophe via the entire parts of an institutional plan to express occasions, you ll have the data you wish at your fingertips...from a nursing standpoint.

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Although this may be obvious, what may not be obvious is that as additional victims from the MCI arrive, there may be critical patients needing immediate testing. CT scans and standard radiological studies should be reserved for head, chest, and abdominal studies. Most stable obvious fractures and sprains should not be sent to radiology until the incident has resolved. Immediate treatment should include splinting and evaluation for and, if necessary, restoring distal neurovascular function and comfort measures, including pain control; radiological studies should be delayed.

Never triage backward. Victims may deteriorate and become either more of a priority or become expectant and receive comfort measures only, but they should never be seen as getting better. Whatever caused the triage officer to classify someone at a certain level should remain. Secondary triage should only decide who of the immediate victims should be treated or transferred first and if any of the victims have now deteriorated. Victims classified as delayed may become immediate, but they should never become minor.

NIMS allows each group to contribute its specialized service while allowing for a centralized command structure. Communication is facilitated as each group is allowed to use its own system. Each area retains command of its section but is assigned by the IC to perform specific tasks allowing for expertise in each area. 6 The ICS is designed to expand and contract as necessary and to adapt to the needs of the institution and incident. At its smallest, it only needs an IC controlling one group; at its largest there would be one IC with several leaders from other organizations and multiple groups under each section.

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