THE ROLE OF A NURSE IN MASS CASUALTY ADMISSIONS IN THE EARLY HOSPITAL STAGE

Abstract

Introduction. The difficult reality of today, which is associated with military events, makes us rethink the functioning of the entire medical system as a whole, prepare for emergencies that were practically irrelevant in civilian life and are acutely faced by the entire medical service today. Triage of patients, optimization of all medical resources, including personnel, has become an acute problem. The practice of triage arose during the war and remains closely linked to military medicine, but it has never been relevant, practiced or improved in peacetime, so for every medical professional it is a significant question that is not always easy to get a clear answer.

The aim of the study – to analyze the level of readiness and familiarity of the medical staff of medical institutions, the distribution of functional responsibilities of medical staff and nurses, including in case of mass admission, based on the order of the Ministry of Health of Ukraine of 24.02.2022 No. 368 “On Approval of the Emergency Medical Care Standard “Medical Triage in case of mass admission of victims at the early hospital stage”.

The main part. The department of emergency (urgent) medical care is one of the first chains in the provision of medical care at the hospital stage. His planned work will affect the quality of care and patient survival in the future. Quality outcomes require a well-developed response plan and awareness of all health care workers who are likely to work at the facility during an emergency. In order to analyze the effect of the internal protocol, it is necessary to conduct simulation exercises with working out various possible situations depending on the profile and predictability of injuries. A survey of 100 nurses from eight hospitals of different levels in different regions and with different experience of working with a mass influx of victims was conducted. The disposition of nurses to participate in the conduct of introductory and primary medical triage was analyzed. The results of this study showed that (69.00±4.60) % of nurses agree to triage at the initial triage stage, i.e. to the emergency department, where the main role of the nurse is to divide patients into four categories according to the START triage system and provision of medical assistance. However, (80.00±4.00) % respondents are categorically against (do not consider) their participation at the primary sorting stage.

Conclusions. The main task of emergency medical care at the hospital stage is to maintain the quality level of triage and medical care, despite the large number of hospitalized patients who arrive at the department at any time of the day or day of the calendar. Triage is a process that involves timely and accurate identification of patients who need immediate treatment and separation from those who also have injuries but whose condition allows them to temporarily postpone care.