The 58-year-old patient presents to the emergency department of a community hospital complaining of worsening back pain that started a few days ago. He states, “I thought maybe I had slept wrong and gotten a spasm, but I’m not sure. I didn’t fall or get hit or anything. The ibuprofen I took definitely didn’t help.” His blood pressure is 174/96 mmHg and heart rate is 96 bpm. He reports being out of his antihypertensive medication for the past week while he was out of town. Other history is notable for arthritis in the hands and a 44-pack-year smoking history. He drinks socially but denies illicit drug use. A pulsating abdominal mass is noted; otherwise, his assessment is benign. The nurse advocates for which treatment option? 

The nurse is caring for a patient of apparently sound mind who has a chronic severe wound infection on his forearm. Amputation of the limb below the elbow is the recommended course of treatment for this patient, but he refuses to allow the procedure. Despite an understanding of the risks and benefits of the procedure as well as of refusing the procedure, the patient refuses the amputation. Which management is the most appropriate?

Which patients are seen first in the hospital following a mass casualty event?