Secondary Prevention - ANS-early identification and treatment
Tertiary prevention - ANS-Avoiding complications
Norms are considered - ANS-The right patterns of behavior for a society
Crisis is - ANS-a time limited response lasting 4 to 6 weeks
What initiates a crisis - ANS-A crisis is initiated by internal or external demands that are
perceived as a threat to a persons physical or emotional functioning.
Precipitating event is stressful and unusual or rare.
maturational crisis - ANS-Describes unfavorable person-environmental relationships
that relate to maturational events such as leaving home for the first time, completing
school or accepting the responsibility of adulthood.
Situational Crisis - ANS-Occurs whenever a specific stressful event threatens a person's
biopsychosocial integrity and results in some degree of psychological disequilibrium
Aventitious Cirsis - ANS-Initiated by an unexpected unusual events that can affect an
individual or
a multitude of people. National and natural disasters.
During an adventitious crisis (e.g., flood, hurricane, forest fire) that affects the
well-being of many people, the interventions of the PMH-APRN will be a part of
the community's efforts to respond to the event.
Goal for people experiencing crisis - ANS-To return to pre-crisis level of functioning.
Role of APRN in Crisis - ANS-he role of the PMH-APRN is to provide a framework of
support systems that guide the
client through the crisis and facilitate the development and use of positive coping skills.
Assess risk of homicide/suicide/self-injury
,Assess coping skills
Assess perception of problem and support mechanisms
Asses social - individual, family, community. Social support
Disaster - ANS-A disaster is a sudden ecological or man-made phenomenon that is of
sufficient
magnitude to require external help to address the psychosocial needs as well as
the physical needs of the victims
MCI triage category: Expectant - ANS-Injuries are extensive and chances of survival are
unlikely
even with definitive care. Separate and provide comfort
Unresponsive patients with penetrating head wounds, high
spinal cord injuries, wounds involving multiple anatomical sites
and organs, 2nd/3rd degree burns in excess of 60% of body surface area, seizures or
vomiting within 24hr after radiation
exposure, profound shock with multiple injuries, agonal
respirations; no pulse, no BP, pupils fixed and dilated
MCI Category: Immediate - ANS-Injuries are life-threatening but survivable with minimal
intervention. Individuals in this group can progress rapidly to expectant
if treatment is delayed.
Sucking chest wound, airway obstruction secondary to
mechanical cause, shock, hemothorax, tension pneumothorax,
asphyxia, unstable chest and abdominal wounds, incomplete
amputations, open fractures of long bones, and 2nd/3rd degree
burns of 15%-40% total body surface area
MCI Category: Delayed - ANS-Injuries are significant and require medical care but can
wait
hours without threat to life or limb. Individuals in this group receive
, treatment only after immediate casualties are treated.
Stable abdominal wounds without evidence of significant
hemorrhage; soft tissue injuries; maxillofacial wounds without
airway compromise; vascular injuries with adequate collateral
circulation; genitourinary tract disruption; fractures requiring
open reduction, débridement, and external fixation; most eye
and CNS injuries
MCI Category: Minimal - ANS-Injuries are minor and treatment can be delayed hours to
days.
Individuals in this group should be moved away from the main triage
area.
o
Upper extremity fractures, minor burns, sprains, small
lacerations without significant bleeding, behavioral disorders or
psychological disturbances
Psychological Assessment - ANS-Assess the victim for behaviors that indicate a
depressed state, presence of confusion, uncontrolled weeping or screaming,
disorientation, or aggressive behavior. Ideally, the PMH-APRN should assess the
coping strategies the victim uses to normally manage stressful situations.
ABC's of Psychological First Aid - ANS-The
ABCs of psychological first aid
include focusing on A (arousal), B
(behavior), and C (cognition). When arousal is present, the intervention
goal is to decrease excitement by providing safety, comfort, and
consolation. When abnormal or irrational behavior is present, survivors
should be assisted to function more effectively in the disaster and when
cognitive disorientation occurs, reality testing and clear information
should be provided.
After initital assessment the PMH- APRN should - ANS-support the
development of resilience, coping, and recovery while providing
technical assistance, training, and consultation
Goals of care - ANS-include helping the victims prioritize and match available
resources with their needs, and preventing further complications,
monitoring the environment, disseminating information, and
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