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Prevention
Level Purpose Example
Primary Prevention Prevent the problem before it occurs Vaccinations, education
Secondary Screening tests, early
Early identification and treatment
Prevention intervention
Prevent complications and improve Rehabilitation, relapse
Tertiary Prevention
functioning prevention
Norms: Accepted patterns of behavior within a society.
Crisis
Definition
A crisis is a time-limited response lasting 4–6 weeks to overwhelming stress.
What initiates a crisis?
Internal or external demands perceived as a threat to physical or emotional functioning.
Precipitating event
• Stressful
• Unusual or rare
Types of Crisis
Maturational Crisis
Normal developmental transitions.
,Examples:
• Leaving home
• Graduating
• Becoming an adult
• Marriage
• Parenthood
Situational Crisis
Unexpected stressful event threatening biopsychosocial integrity.
Examples:
• Divorce
• Job loss
• Serious illness
• Death of spouse
Adventitious Crisis
Unexpected disasters affecting individuals or entire communities.
Examples:
• Flood
• Hurricane
• Earthquake
• Terrorism
• Mass shootings
PMH-APRN becomes part of the community disaster response.
Goal of Crisis Intervention
Return the person to their pre-crisis level of functioning.
,PMH-APRN Role During Crisis
Assess:
• Suicide risk
• Homicide risk
• Self-injury
Evaluate:
• Coping skills
• Perception of problem
• Support systems
Assess biologic needs:
• Sleep
• Eating
• Hygiene
Assess psychological status:
• Emotions
• Coping
Assess social functioning:
• Family
• Community
• Social supports
Disaster
A disaster is a sudden ecological or human-made event requiring outside assistance for both
physical and psychological needs.
Mass Casualty Incident (MCI) Triage
Expectant (Black)
Survival unlikely
, Examples:
• Massive head injuries
• High spinal cord injuries
• 60% burns
• No pulse
• No BP
• Fixed pupils
• Agonal respirations
Treatment:
• Comfort care
Immediate (Red)
Life-threatening but survivable with rapid treatment.
Examples:
• Airway obstruction
• Tension pneumothorax
• Shock
• Hemothorax
• Open fractures
• 15–40% burns
Delayed (Yellow)
Serious injuries but treatment can safely wait.
Examples:
• Stable abdominal wounds
• Soft tissue injuries
• Facial injuries without airway compromise
• Eye injuries