Triaging Flashcards
MCI
Mass Casualty Incident
a lot of people victimized by good disaster
Mass Casualty Incident
Triage (4 rights)
Process of which places the right patient in the right place at the right time to receive the right level of care
Triage
the cornerstone of good disaster management in terms of judicious use of resources
Triage
● Process of prioritizing which patients are to be treated first
Conceptual Categories change depending the _____
venue
○ every day prioritization of patients in the emergency department
● HOSPITAL DAILY TRIAGE
○ when the ED is stressed by a large number of patients but is still able to provide care to all victims
● INCIDENT TRIAGE
○ employed when local emergency services are overwhelmed to the point that immediate care cannot be provided to everyone who needs it
● DISASTER TRIAGE
○ similar to disaster triage,
● TACTICAL MILITARY TRIAGE
military mission objectives rather than traditional civilian guidelines drive the triage and transport decisions
● TACTICAL MILITARY TRIAGE
doing the greatest good for the greatest number
Disaster Triage
Who will you help first the person needing BLS or the person penetrated by a poll? (outside)
BLS
Who will you help first the person needing BLS or the person penetrated by a poll? (inside)
BLS
Who will you help first the person who can’t walk but has no fatal wound or the person needing BLS? (outside)
Cant walk
Who will you help first the person who can’t walk but has no fatal wound or the person needing BLS? (inside)
BLS
4 Types of Conceptual Categories
● HOSPITAL DAILY TRIAGE
● INCIDENT TRIAGE
● DISASTER TRIAGE
● TACTICAL MILITARY TRIAGE
2 types of triage
● PRIMARY
● SECONDARY
○ On scene prior to rescue and transfer
● PRIMARY
○ Incident dependent either prior to, during or upon arrival to hospital
● SECONDARY
Critical-life threatening
EMERGENT
RED
Major illness/injury- tx within 20 mins-2 hours
URGENT
YELLOW
Minor injuries; walking wounded- tx may be delayed 2 hours or more
NONURGENT/ walking wounded/ minor
GREEN
Dead or expected to die
EXPECTANT
BLACK
Compromised airway, shock, hemorrhage
EMERGENT
RED
Open fracture, chest wound
URGENT
YELLOW
Closed fracture, sprain, strain
NONURGENT/ walking wounded/ minor
GREEN
Massive head injury, extensive full-thickness burns
EXPECTANT
BLACK
If in the HOT ZONE, treat FIRST
EMERGENT
RED
If in the HOT ZONE, treated after RED
URGENT
YELLOW
First one to go out the HOT ZONE
NONURGENT/ walking wounded/ minor
GREEN
If the patient didn’t survive after BLS
transfer and mark as black
immediate
EMERGENT
RED
delayed
URGENT
YELLOW
minor walking wounded
NONURGENT/ walking wounded/ minor
GREEN
deceased
EXPECTANT
BLACK
where can you find the tags?
chest and forehead
3 Disaster Triage Protocols
- MASS TRIAGE
- START system
- JumpSTART system
pediatrics; commonly used
JumpSTART system
adults; commonly used
START system
general population
MASS TRIAGE
MASS TRIAGE
M- MOVE
A- ASSESS
S - SORT
S –SEND
● Providers instruct victims to move to safety (Class III; walking wounded)
● Ask victims to move a limb
M- MOVE
● ABC assessment
A- ASSESS
● Sort into 4 categories
S - SORT
● Sent to hospitals for treatment
S –SEND
4 Mass Triage Categories
I - Immediate (RED)
D - Delayed (YELLOW)
M - Minimal (GREEN)
E - Expectant (BLACK)
● Not able to move limbs as requested but have open airways
I - Immediate (RED)
● unable to move limbs, has breathing and pulse
I - Immediate (RED)
● able to move limbs, has breathing and pulse
D - Delayed (YELLOW)
● Able to move the scene as requested
M - Minimal (GREEN)
● No airway, respiration or circulation
E - Expectant (BLACK)
T or F: Do not spend 2 mins in one patient
True
RPM
R-Respiration
P-Pulse
M-Movement
R: >30 sec
P: > 2 secs (capillary refill)
M: does not obey commands
Critical
R: 30 secs
P: < 2 secs
M: obey commands
Urgent
R: not breathing
Expectant
have critical assessment
Class 1, 2, 4
have critical assessment
Class 1, 2, 4
JumpSTART was created to meet the unique needs of assessing children
less than 8y/o
should be used if the victim look like a child
JumpSTART
should be used whenever the victim looks like a young adult or older
START
3 purposes of JumpSTART
a. To optimize the primary triage of injured children in the MCI setting
b. To enhance the effectiveness of resource allocation for all MCI victims
c. To reduce the emotional burden on triage personnel who may have to make rapid life-or-death decisions about injured children in chaotic circumstances
