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AORN Guidance Statement: Mass Casualty, Triage, and Evacuation
INTRODUCTION
This document is intended as a guide for perioperative registered nurses who are developing processes to facilitate a methodical response to disaster situations. This guidance statement may be used by health care organizations in developing policies and procedures related to responding to natural and man-made disasters and correlating hospital-wide disaster plans with specific perioperative challenges. This guidance statement addresses mass casualty, triage, and evacuation as it relates to the peri-operative setting.
AORN recognizes that a health care facilitys disaster plan, while required by accrediting and state agencies, may not include situational challenges specific to the perioperative setting during a disaster response. AORN also recognizes that the perioperative setting and available resources are varied and dependent on geographic location, ranging from large metropolitan trauma centers, ambulatory surgery centers, and specialty centers for invasive procedures (eg, cardiac catheterization laboratories, endoscopy suites, radiology departments) to small rural health care facilities.
BACKGROUND
Perioperative registered nurses experience daily schedule changes based on staffing, supplies, and the emergent status of surgical patients and procedures. In recent years, however, these schedule changes have involved more than this. The terrorist attacks of Sept 11, 2001, and the 2005 hurricane disasters in the southeastern United States have challenged perioperative registered nurses to adapt to and overcome difficult new situations.
Perioperative registered nurses must be prepared to handle local and regional casualties from man-made disasters (eg, biological, chemical, nuclear attacks) to natural disasters (eg, hurricanes, tornadoes, earthquakes, fire). Hospitals should have a disaster plan that is accessible to all members of the surgical team. New
employees and members of the staff should be familiar with the disaster plan. Updates should be incorporated as new information is acquired and shared with the surgical team.
Traditionally, hospital disaster drills involve a community disaster, such as a mass casualty automobile or airplane accident or hazardous waste spill. Disaster patients are triaged and tagged for disposition to various hospital departments. Those tagged for surgery are shown to the lounge to relax until the disaster scenario is completed. The question now has become: How do you prepare for the worst, when the worst may be unknown?
The world in which we live has changed. An approaching disaster can occur at any...