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Emergency Medicine > MCI & Triage > Flashcards

MCI & Triage Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What does a MCI do?

A

Overwhelms resources (equipment, rescuers, facilities) available in a system or area

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2
Q

Types of Mass Casualty Incidents

A

Natural disasters
Technical hazards
Civil-Political

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3
Q

Examples of Natural Disaster MCIs

A 
Extreme heat/cold
Fires
Floods
Earthquakes
Tropical storms and hurricanes
Tornados
Epidemics
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4
Q

Examples of Technical Hazard MCIs

A 
Building collapse
High rise incidents
Hazardous materials incidents
Transportation accidents
Major industrial accidents
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5
Q

Examples of Ciliv-Political MCIs

A

Civil disobedience: demonstrations, strikes, riots
Criminal or terrorist incidents: mass shootings, hostage situation, explosive, chemical, biological, nuclear
Military attack on the US

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6
Q

What does an incident management system allow?

A

Effective control, direction, and coordination of response resources

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7
Q

Influencing Factos of an Incident Management System

A

Magnitude of event

Available resources

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8
Q

Components of Magnitude of Event

A

Number of patients
Area
Boundaries: open or closed

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9
Q

Components of Available Resources

A

Response and support personnel
Vehicles and equipment
Facilities

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10
Q

Categories of Mass Casualty Incidents

A

Expanded medical incident
Major medical incident
Disaster
Catastrophe

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11
Q

Define Expanded Medical Incident

A

Prehospital resources adequate

Hospital capacity adequate

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12
Q

Define Major Medical Incident

A

Multi-jurisdictional and regional EMS response

Regional allocation of patients to hospitals

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13
Q

Define Disaster

A

Overwhelms local, multi-jurisdictional, and regional mutual aid
Requires assistance from state, interstate, or federal resources

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14
Q

Define Catastrophe

A

Overwhelms local, multi-jurisdictional, regional and state resources
Interstate and federal resources needed
Local resources concentrate on own survival

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15
Q

Goals of MCI Management

A

Greatest good for greatest number
Scarce resource management
Don’t relocate disaster

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16
Q

Components of Doing the Greatest Good

A

Make the best of possible use of available resources
Salvage the most patients as possible
NO heroic resuscitation
Concentrate on those we can save

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17
Q

Components of Resource Management

A

Call for extra resources early
Prepare for delays
Use command hospitals to coordinate with other hospitals and transportation decisions

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18
Q

5 S’s of MCI

A 
Safety assessment
Scene safety
Send information
Setup
START
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19
Q

Safety Assessment of MCI’s

A 
Fire
Electrical hazard
Flammable liquids
Hazardous materials
Other life threats and hazards to rescuers
20
Q

Scene Safety of MCI’s

A

Type of incident
Approximate number of patients
Severity of injuries
Area involved and access

21
Q

Send Information of MCI’s

A

Contact dispatch with survey information
Request resources and mutual aid
Notify command hospital

22
Q

Setup of MCIs

A 
Medical group supervision
Triage
Treatment
Transportation
Extrication
Staging
Medical supply
Medical communications
23
Q

First EMS Provider Setup

A

Establishes medical group
Directs triage of all patients
Assigns resources as available
Key functions running

24
Q

Transport Decisions in Setup

A

Patient prioritization
Destination facilities
Transportation resources

25
Q

What does START stand for in MCIs?

A 
S: simple
T: triage
A: and
R: rapid
T: treatment
26
Q

Define Triage

A

To sort

Separates patients needing rapid care

27
Q

Problems with Triage

A

Reliance on specific diagnosis to put patients in categories

Too slow

28
Q

Ideal Triage System

A 
Simple
No advanced skills
No specific diagnosis
Easy to do
Rapid and simple life-threatening intervention
Easy to teach and learn
29
Q

What is the START system based on?

A

RPM
R: respirations
P: perfusion
M: mental status

30
Q

Virginia Triage Tag System

A

Red: immediate
Yellow: delayed
Green: minor
Black: dead

31
Q

Conditions for a Red Tag

A

Poor respiration, perfusion, mental status

Severe burns

32
Q

Conditions for a Yellow Tag

A

Burns

Major or multiple bone or back injuries

33
Q

Conditions for a Green Tag

A

Minor painful, swollen deformities
Minor soft tissue injuries
“Walking wounded”

34
Q

Conditions for a Black Tag

A

Deceased

Non-salveable

35
Q

START First Steps

A 
Begin where you stand
Move all who can walk
Move in a pattern
Assess using START and place tags
Keep count of casualties
Provide MINIMAL treatment
Keep moving
36
Q

Respiration Assessment: Open Airway

A

Black: doesn’t breath
Red: starts to breath

37
Q

Respiration Assessment: Breathing

A

Red: RR >30
Next: RR less than 30
Maintain airway

38
Q

Perfusion Assessment: Radial Pulse

A

Red: absent
Next: present
Stop gross hemorrhage

39
Q

Mental Status Assessment: Commands

A

Red: doesn’t follow commands
Yellow: follows commands

40
Q

Purpose of Treatment

A

Identify specific injury
Categorize patients
Prioritize for transport

41
Q

Treatment: Reassessment and Tagging Complete

A

On way to treatment
In treatment area
In ambulance

42
Q

Secondary Triage Within Initial Triage Groups

A

More subjective

Based on specific condition and experience

43
Q

Secondary Triage of Red Tagged Patients

A

Life threatening injury
Risk of asphyxiation or shock
High probability of survival
Can be stabilized

44
Q

Secondary Triage of Yellow Tagged Patients

A

Potentially life threatening
Severely debilitating injury
Can stand a delay in treatment and transport

45
Q

Secondary Triage of Green Tagged Patients

A

Non life threatening injuries

Minimal care with minimal risk

46
Q

Secondary Triage of Black Tagged Patients

A

Deceased at site, en route to treatment area, or in treatment area
Unresponsive with no circulation

47
Q

Reverse Triage

A

Lightening injuries
Dead treated first
High potential for respiratory arrest

Emergency Medicine (17 decks)

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