MCI + Triaging Flashcards
What is a Multiple Casualty Incident (MCI)?
Any incident that exhausts the available resources within a 15 minute travel time.
What are the types of Multiple Casualty Incidents?
- Natural Disaster
- Terrorism
- Domestic Terrorism
- Daily Life Events
What is an example of a Natural Disaster?
Examples include earthquakes, hurricanes, and floods.
What is an example of Terrorism?
Examples include bombings and mass shootings.
What is an example of Domestic Terrorism?
Examples include attacks motivated by political or social agendas within a country.
What are Daily Life Events in the context of MCIs?
Examples include traffic accidents or mass casualty incidents at public events.
What types of training are mentioned?
Mandatory training and specialized training (i.e. CBRN).
What is the Incident Management System?
An international system adopted by Ontario as the new ‘Gold Standard’ for emergency management and business continuity.
What is replacing the old system of ‘Site Command’?
The Incident Management System.
What does the Incident Management System provide?
A common system for all agencies to coordinate response.
Which agencies use the Incident Management System?
Fire, Police, EMS, and Public Utility agencies.
What are the characteristics of the Incident Management System?
It is flexible and scalable, used on both small and large incidents.
What is Triage?
Triage is a process used to quickly identify the most serious victims in any situation, determining the order in which patients receive care.
What is the origin of the term Triage?
Derived from the French term ‘trier’ meaning ‘to choose or select.’
First used medically by Napoleon’s surgeon, Baron Dominique Jean Larrey.
What is the purpose of Triage?
To do the greatest good for the largest number of casualties with the available resources.
When is Triage needed?
When the number of patients and/or the severity of injuries exceeds local resources, such as in mass casualty incidents (MCIs), disasters, or emergencies.
What are the limitations of care in Triage?
Normal standards of care are not applied, and full resuscitative efforts may be delayed or denied for some patients until adequate resources are available.
What are the initial interventions in Triage?
Opening the airway, controlling severe hemorrhage, and categorizing patients.
What is the first core principle of Triage?
Absolute, Not Relative: Patient conditions are judged against absolute criteria for criticality.
What is key to Triage identification?
Utilize MOH (Ministry of Health) triage tags to avoid confusion, prevent repeated assessments, and ensure all patients are accounted for.
What is the importance of coordinated transportation in Triage?
Patient distribution must be equal among receiving facilities to avoid overloading.
What do Triage tags indicate?
Tags clearly define patient priority.
What does a RED Triage tag signify?
Immediate/Emergent condition: Life-threatening injury or illness that must receive care within 30-60 minutes.
Examples include respirations < 8-10 or > 28-30, significant hemorrhage, unresponsive patients.
What does a YELLOW Triage tag signify?
Urgent condition: Potentially life-threatening injury or illness where care can be delayed for 2-3 hours without jeopardizing outcome.
Examples include non-life-threatening fractures and controlled moderate bleeds.
What does a GREEN Triage tag signify?
Delayed/Minor condition: Non-life-threatening injuries or illnesses where an extended delay in care will not threaten outcome.
Examples include ambulatory patients and minor cuts.
What does a BLUE Triage tag signify?
Deceased/Expectant condition: No chance of survival or insufficient resources for resuscitation.
Examples include patients meeting Code 5 criteria.
What is the START Triage method?
The Simple Triage and Rapid Treatment (START) system is used to triage adult patients quickly.
What is the first step in the START Triage method?
Determine if the patient is able to walk. If yes, categorize as GREEN (Delayed).
What do you do if a patient is not breathing in the START method?
Open the airway. If still no breathing, categorize as BLUE (Deceased). If breathing resumes, categorize as RED (Immediate).
What is the focus of secondary triage and reassessment?
Recheck all patients after initial triage and update triage priorities if the condition changes.
Who oversees triage operations in incident management?
The Incident Commander oversees triage operations.
What is a real-world example of Triage in action?
The Sandy Hook Elementary School shooting highlighted the importance of triage in mass casualty incidents.
What is the goal of Triage?
Maximize survival by prioritizing care.
What triage category does a patient with weak carotid pulse and shallow breathing at 6 breaths per minute fall under?
RED (Immediate/Emergent):
Respirations < 8 breaths/min.
Unresponsive with a weak pulse.
Requires immediate care.
What is the triage category for a patient walking around with minor abrasions and no complaints?
GREEN (Delayed/Minor):
Ambulatory with minor cuts/abrasions.
No immediate threats to life.
What triage category is assigned to a conscious man with a significant open fracture to his right femur?
YELLOW (Urgent):
Potentially life-threatening fracture.
Can tolerate a delay of 2-3 hours for definitive care.
What category do you assign to a woman who is pulseless, apneic, and unresponsive after airway repositioning?
BLUE (Deceased/Expectant):
No breathing after airway repositioning.
Meets criteria for VSA (Vital Signs Absent).
What triage category is appropriate for a 10-year-old boy with a gunshot wound to the abdomen and a respiratory rate of 32 breaths/min?
RED (Immediate/Emergent):
Life-threatening injury.
High respiratory rate indicating potential shock.
How do you categorize a teacher who is unconscious with no palpable pulse and shows no signs of respiration?
BLUE (Deceased/Expectant):
No breathing or pulse after airway repositioning.
Meets criteria for expectant/deceased.
What is the triage category for a teenage girl with a superficial wound to her left leg who is crying and walking around?
GREEN (Delayed/Minor):
Ambulatory with a minor injury.
No immediate threat to life.
What triage category should you assign to a staff member with a gunshot wound to the chest, breathing at 28 breaths/min?
RED (Immediate/Emergent):
Life-threatening injury.
Abnormal pulse and altered mental status.
What category does a man pulled from rubble with no spontaneous respirations fall under?
BLUE (Deceased/Expectant):
No breathing after airway repositioning.
No viable signs of life.
How do you categorize a woman with a head injury who is conscious but confused?
RED (Immediate/Emergent):
Head injury with altered mental status.
Weak pulse indicates possible shock.
What triage category do you assign to a young girl with a fractured arm who is able to walk and communicate clearly?
GREEN (Delayed/Minor):
Ambulatory with a non-life-threatening fracture.
No immediate risk to life.
What triage category is assigned to a man with a crushed pelvis who is conscious, has a respiratory rate of 22 breaths/min, and a strong radial pulse?
YELLOW (Urgent): Potentially life-threatening injury. Delay of 2-3 hours will not threaten survival.
What triage category do you assign to a victim near a bomb blast with severe burns covering more than 70% of their body, barely conscious, with a weak pulse and respirations of 10 breaths/min?
RED (Immediate/Emergent): Life-threatening condition with potential for survival. Requires immediate intervention.
What is the triage category for a patient found 20 meters from a bomb blast, walking and talking with small lacerations?
GREEN (Delayed/Minor): Ambulatory with minor cuts and abrasions. No immediate threat to life.
What is the correct triage category for a man with bilateral leg amputations who is unresponsive, has a respiratory rate of 34 breaths/min, and a weak radial pulse?
RED (Immediate/Emergent): Life-threatening injuries. High respiratory rate and altered mental status.
What category should a man with severe respiratory distress and chemical burns to his face and neck be placed in?
RED (Immediate/Emergent): Severe respiratory distress. High risk of airway compromise.
What is the triage category for a worker with mild eye irritation and a headache who is walking independently and has stable vital signs?
GREEN (Delayed/Minor): Ambulatory with minor complaints. No life-threatening symptoms.
What triage category is appropriate for a worker lying supine, unresponsive, with no visible respirations after repositioning the airway?
BLUE (Deceased/Expectant): No respirations after repositioning. VSA criteria met.
What is the triage category for a woman trapped under debris, unresponsive, with no radial pulse and a capillary refill > 2 seconds?
RED (Immediate/Emergent): Absent pulse or delayed capillary refill. High risk of death without immediate care.
What category do you assign to a man with an obvious closed femur fracture who is conscious, breathing normally, and has a strong radial pulse?
YELLOW (Urgent): Potentially serious injury. Can tolerate a delay in care.
What is the appropriate triage category for a child who is crying, has minor cuts, and is walking toward you?
GREEN (Delayed/Minor): Ambulatory with minor injuries. No immediate threat to life.
Why is it important to follow absolute criteria in mass casualty situations rather than comparing patients to one another?
Triage is absolute, not relative. Patients must be judged based on their condition alone.
