Module 5: Discussion

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    Nicole Stuhlmiller

    Rescue efforts intensify when the generators fail, as nurses must ventilate patients by hand. The death counts rise, and so does the heat. The critical decision that kept people alive was that they could move some of the patients. The nurses ventilated the patients by hand.
    Which decisions resulted in death? The moving of the sicker patients to the staging area when the power went out. Ventilation was performed by hand, and it was less efficient. DNR patients were also not given priority; they were essentially passed by for those with no DNR.
    Who was the man with the boats calling for rescue if the night? A white man in fatigue yelled at people that they needed to get moving, take one bag, no animals, and they were to meet on the first floor. Boats were to leave in 30 minutes. Most didn’t like that, refusing to leave their beloved pets. When people went to the first floor, they were greeted with no boats and no rescue. Some returned to find items missing. It was a hoax. Why were pets brought to the hospital? Pets were brought into the hospital to save them. Knowing staff and their family wouldn’t leave them behind to die. How is the Cloverleaf an essential part of this story? Cloverleaf is a “lily-pad” SARBOO search and rescue base off interstate 10. Cloverleaf was vital because it was a transfer and hold station.
    When Mark LeBlanc enters the hospital to save his mother, he is taken aback by the tone of resignation among the staff. Is he just viewing the situation from an outsider’s perspective, as someone who did not spend the past 48 hours lifting patients to the helipad for rescue, or does he have a point? I believe that Mark Leblanc was justified in his anger. To see one’s parent in the state where he found her would have also enraged met that anger, he didn’t have to go through what the medical staff had to go through. The heat, the loss of power, the knowledge that not everyone will make it, and the lack of clean water, food, and medical supplies would make anyone’s job difficult.
    Did the priority system for evacuating patients fit within accepted triage practices? The staff that made that decision did not study the priority system for evacuating patients. Triage has many different theories of practice. Memorial/Lifeline triage practice was as follows: 1’s. The first evacuated: reasonably good health could sit or walk. #2 Those who were sicker and needed assistance. #3 evacuated last based on Dr. judgment and DNR. Accepted practices would triage the sickest first and the least sick last. Although, as stated before, there are nine accepted models of triage. Why or why not? In a normal situation, with resources available, the sickest get care first. In this situation, I would have tried to get the greatest number of significant first, and then critically ill could be accompanied with medical staff. A utilitarian approach the best? I personally feel that the practical approach is the best. The greatest good, for the greatest amount of most significant.
    Discuss the difficulties inherent to practicing triage medicine. The problem with triage medicine is that things cannot always be seen in triage. Underlying conditions could end up costing a life if not treated or diagnosed quickly. An example would be a severe stomachache seen in the ER. Stomachache comes last when met with a gunshot, knife wound, heart attack, or stroke. Six hours in an ER, that person may have an appendix that ruptured. I triage all the time in my job. Thankfully, it is in a school, and the issues are not as severe as in a hospital. Sometimes, something does appear small, and it is an iceberg.
    Which approach is best for Organ Sharing? In my opinion, the best practice that won’t be popular is the one with the least comorbidity, no alcohol or drug use, and financially continuing with any necessary treatments and follow-ups. Therefore, agreeing with the approach that the ones that should get the organ will be the ones that will benefit medically from receiving them.

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