Disaster Triage

Question 1

What is triage?

Answer 1

The sorting of pts by the seriousness of their condition and likelihood for survival

Question 2

What is the MASS triage model?

Answer 2

Move, Assess, Sort , Send

Proven means to handle large number of casualties in a mass casuistry incident (MCI)

Question 3

What is the basis of the MASS triage?

Answer 3

Glasglow Coma Scale (GCS)

Question 4

What does the Move step 1 mean in MASS?

Answer 4

Group ambulatory patients
Anyone who can response and move, do
Minimal initial groups for those people

Question 5

What does Move step 2 mean in MASS?

Answer 5

The group that cannot walk but can follow commands, delayed initial group

Question 6

What does the Assess in MASS mean?

Answer 6

Group - identify location of who is left and unable to respond
Proceed immediately to pts and deliver like-saving interventions
Immediate initial group

Question 7

Who should be assessed first?

Answer 7

The immediate group

Question 8

What should be done in Assess for immediate pts?

Answer 8

Open airways, stop bleeding, give antidote

Question 9

What does Sort mean in MASS?

Answer 9

Sort pts based on individual assessment, continue treatment based on condition

Question 10

Who do you start with in the Sort section?

Answer 10

Delayed groups

Question 11

What are the ID-me groups?

Answer 11

Immediate, Delayed, Minimal, Expectant, Dead

Question 12

What should be done with triage tags?

Answer 12

Tag pt directly, maybe improvise, write on pt if not other option

Question 13

What should be done after all pts have been tagged?

Answer 13

Count immediates, tell incident commander

Take immediates to collection points for urgent transport

Question 14

What does the send mean in MASS?

Answer 14

Traditional sequence of immediate, delayed, minimal, expectant
Transport and release of all living pts
Be resourceful

Question 15

What should be done with dead pts?

Answer 15

Should not be moved or sent, ID remains, crime scene investigation, preserve evidence

Question 16

Treatment on scene should continue until:

Answer 16

All pts are transported, resources unavailable, comfort is care
Document - tags, medical records

Question 17

What should be done in treatment?

Answer 17

Decontaminate, ABC’s, supportive, consider pre-existing conditions, specific treatments
Risk to provider

Question 18

What are some special considerations?

Answer 18

Aggravation of pre-existing conditions, dirt, debris and gross contamination , environment conditions, walking wounded and worried well

Question 19

Which nerve agents require immediate treatment?

Answer 19

Vapor exposure - tabun, sarin, soman

Liquid exposure - VX

Question 20

What is the number one cause of death in a nerve agent crisis?

Answer 20

Hypoxia

Question 21

What generally happens in a cyanide incident?

Answer 21

Most will significant exposure will die

Question 22

Are their specific therapies for choking, blister or lacrimator agents?

Answer 22

No

Question 23

If there is a biological event, who is cared for first?

Answer 23

The sickest, outcome still poor

Question 24

What should be done for treatment in a trauma care situation?

Answer 24

Airway with cervical spine immobilization, breathing, circulation with hemorrhage control

Question 25

When and how would you observe a crush injury?

Answer 25

Common after structural collapse, sustained compression of large muscle beds
Presents with redness, blistering, tenderness, bruising, hypotension, shock, paralysis

Question 26

What is crush syndrome?

Answer 26

Reperfusion injury

Occurs after extrication, restoration of circulation flushes toxins in to blood, profound shock and cardiac arrest

Question 27

What should be done to treat a crush injury?

Answer 27

Early, aggressive resuscitation, IV fluids ASAP

Management of extremity, treatment of electrolyte abnormalities