There is a radiologic dispersion bomb (dirty bomb) explosion in a subway station. In what order should the nurse deliver patient care at the scene of the explosion?
Choice 1. Begin direct patient care for complaints of fatigue and nausea.
Choice 2. Decontaminate clothing of patients.
Choice 3. Assess patients for burns and blunt trauma.
Choice 4. Evacuate patients from the exposure area.
Correct Answer: 3, 4, 2, 1
The major activities performed for patients who have suffered a nuclear casualty are triage, evacuation or sheltering, search and rescue, radioactive monitoring, decontamination, and direct patient care. The patient will be assessed for injuries such as burns or blunt trauma. The victim should be evacuated from the exposure area, along with the healthcare provider and first responders. Decontamination should begin as soon as patients are evacuated from the exposure area. This may include an initial onsite decontamination followed by a second decontamination procedure at the healthcare facility. There may be some early complaints of radiation exposure such as nausea or fatigue. The manifestations of serious radiation exposure may not occur for several hours and do not suggest imminent death.
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