One hundred victims of a train derailment are brought to the Emergency Department of a small rural hospital. An older client with extensive crushing injuries to the lower extremities and pelvis has a blood pressure of 42/28, a thready pulse of 120 beats/minute, and a respiratory rate of 10 breaths/minute with periods of apnea. Using the disaster triage system, which action should the nurse take?
Explanation & Rationale
A. Transporting to radiology is inappropriate in disaster triage; diagnostic testing is not prioritized for patients with non-survivable injuries. B. Obtaining a crash cart wastes valuable time and resources that could be used for patients with a chance of survival. C. Initiating an IV is not appropriate for a patient in the expectant category, as resources should be conserved for those in the immediate or delayed categories. D. Assigning a black triage tag is correct because this client has signs of irreversible shock, inadequate respirations, and injuries incompatible with survival given limited resources in a mass casualty event. The black category is for those who are deceased or expected to die, allowing resources to be directed to salvageable patients.