Chapter 21: Emergency & Disaster Nursing

Emergency nurses utilize systematic triage methodologies, particularly the Emergency Severity Index five-level classification system, to prioritize patient care based on acuity levels and resource allocation requirements. The primary survey framework follows the ABCDEFG protocol, addressing airway management with cervical spine stabilization, breathing assessment including pneumothorax decompression, circulation evaluation with hemorrhage control and fluid resuscitation, neurological disability screening using AVPU and Glasgow Coma Scale assessments, environmental exposure management, complete vital sign documentation with family integration, and comprehensive monitoring with comfort measures. The secondary survey expands evaluation through detailed history collection using MIST and SAMPLE mnemonics, systematic head-to-toe physical examination including FAST ultrasound protocols, posterior surface inspection via logroll techniques, and continuous reassessment using VIPP methodology. Environmental emergencies encompass thermoregulatory disorders including heat-related illnesses progressing from heat cramps through heat exhaustion to life-threatening heatstroke, cold-related injuries including superficial and deep frostbite with hypothermia classifications, and submersion injuries involving hypoxia, aspiration pneumonia, and acute respiratory distress syndrome. Toxicological emergencies require systematic approaches to decontamination, absorption reduction, elimination enhancement, and antidote administration with poison control center coordination. The chapter addresses violence recognition and intervention strategies, including intimate partner violence screening, elder abuse identification, child maltreatment detection, human trafficking recognition, and specialized sexual assault nurse examiner protocols for forensic evidence collection and victim advocacy in emergency department settings.