In triage, nurses must make quick decisions because the patients who are admitted to triage are in very serious conditions that are life-threatening. However, if a bunch of different patients come into triage, they can’t all be assessed at one time. There are just not enough health care staff to go around. If a triage nurse has four patients.
There is a 2-month old infant with bulging fontanels and is crying. Another is the teenager with a singed beard and an elderly client who has liquid brown colored stools. The middle-aged client has pain every now and then behind the right scapula.
None of these patients seem to have any life-threatening problems. The most life-threatening would be the teenager because he could have problems breathing.
This client is in the greatest danger with a potential of respiratory distress. Any client with singed facial hair has been exposed to heat or fire in close range that could have caused serious damage to the interior of the lungs. Note that the interior linings of the lungs have no nerve fibers so the client will not be aware of swelling.
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