A Nursing Triage Line Connects Residents to Care During Emergencies
By South Carolina Department of Health & Environmental Control (Anna Bleasdale)
In South Carolina, one of the most frequent challenges we face as a state is preparing for natural disasters, specifically hurricanes (though in the past, we have also experienced significant flooding and ice storms.) In 1997, an AD HOC Committee was developed to address sheltering and Special Medical Needs Shelters. This committee was comprised of several state agencies, as well as community partners, including South Carolina Emergency Management Division (SCEMD), Department of Health and Environmental Control (SC DHEC), Department of Social Services (SC DSS), the South Carolina Hospital Association (SCHA), the American Red Cross (ARC), the South Carolina College of Emergency Physicians (SCCEP), and the South Carolina chapter of the Emergency Nurses Association (SCENA). Emergency Support Function (ESF) #6 was designated as the support structure for Mass Care and coordinates the needs through state agencies and community partners. SC DSS takes the lead role to coordinate general population mass care operations, while SC DHEC is the lead state agency that coordinates and operates medical needs shelters. Medical needs shelters are available across the state for individuals who may require electricity or refrigeration in the event of an emergency, since typically, general population shelters do not have generator backup. Over the years, SC DHEC has adapted its sheltering processes to ensure the safety and well-being of residents of South Carolina and to provide an easier access to sheltering.
One of the most recent changes to the sheltering process was the addition of the Nursing Triage Line, managed by SC DHEC nursing staff. SC DHEC’s agency Director can elect to open the Nursing Triage Line as a general resource for the public, and it is readily opened when a state of emergency is declared. The toll-free number is then broadcasted on local news stations, the radio, and on SC DHEC’s external website. In the event of a natural disaster, residents can call the triage line and receive general information featured on the South Carolina Emergency Management Division website (https://www.scemd.org/) and be screened for medical needs sheltering.
As a public health nurse, I am required to respond in the event of a natural disaster or state of emergency and have assisted with triage operations for several years. Other agency staff are also called upon to assist, such as social workers, to provide additional support to residents, and administrative staff, to assist with supporting overall triage operations. Typically, callers are nervous and scared, and trying to determine what their next steps should be, so my primary goal is to ensure callers feel supported and have a plan after the call, especially when preparing for a natural disaster. The triage nursing staff refer to the most up-to-date emergency guidance, maintain a list of operating Red Cross shelters, and can direct the caller to the nearest shelter. If the caller has unique circumstances, such as needing assistance with transport to the nearest shelter, a pet, or other need, the triage nurse communicates with the Agency’s Incident Command Center, who will work with the Red Cross or local partners to ensure the caller’s needs are addressed. Another role of the triage nurse is to screen individuals for Medical Needs Sheltering. If the caller has a need of refrigeration or electricity due to a medical need, the triage nurse collects their information, including basic demographics, transportation needs, supplies that will need to be transported, medications that the individual may be taking, and caregiver information. Once all information is obtained, the nurse approves admittance to one of DHEC’s Medical Needs Shelters (often in a hospital facility). Once the triage nurse has approved the caller for DHEC sheltering, the information is then routed to the local regional team operating the shelter for follow-up.
My experience in working the Nursing Triage Line has been positive. I am always proud of the collaboration and resources provided during these stressful times. I have witnessed our Director of Nursing working with the Incident Command Center and a local medical supply company to have emergency oxygen tanks delivered to a shelter for a resident who did not have supply tanks in reserve. I have also observed, countless times, collaboration with local EMS teams to assist with transportation to and from a shelter. SC DHEC truly approaches natural disasters as an “all hands-on deck” approach and has a strong support system in place for residents.
One of the greatest lessons I have learned in working the triage line is to always have an emergency plan in place. As I assist residents who are concerned about safety, anxious, and unsure of what to do, it solidifies the need for me to have a strong personal plan in place so that I can better serve residents in South Carolina without worry or additional stress. As the SC CYSHCN Director, my team and I also plan to implement new strategies for the program to ensure our clients have an emergency plan in place and can identify steps to take in the event of an emergency.
One of the key points in South Carolina’s emergency preparedness plan is communication and collaboration. The triage line is a readily available, widely known and broadcasted resource that South Carolinians can rely on in the event of a disaster or pandemic to provide accurate and up-to-date information. I would recommend the use of a communication system that is easily accessible for individuals to use to address concerns or questions, as it has proven to be an invaluable and trusted resource in South Carolina.
The story and summary above were collected as part of a project supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) under grant number 5 NU38OT000296-05-00, a cooperative agreement between AMCHP and the Center for State, Tribal, Local, and Territorial Supports (CSTLTS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.