1. Disaster Triage Decisions  Remember the point of primary triage  To sort patients to determine who is the most critical and who is less critical  Need to do the greatest good for the greatest number  Disaster triage is not routine daily triage where you do the best for each individual

2. Other Important Considerations: Incident Command or Charge Nurse   See as much as you can in 30 seconds   Process what you see and hear   THINK- Don’t Panic   Paint as accurate a picture as you can with your report Your first 5 minutes will determine how the incident will go: Remember that emotions are contagious FIELD HOSPITAL WORKING TOGETHER

3. Other Important Considerations: Scene Safety – Field and ED

4. Other Important Considerations: Incident Command   When EMS calls with multiple patients from one incident, consider activating the Multiple Patient Plan for Region X   What resources do you need to activate to recruit to the ED?   Where are your guidelines for the hospital disaster plan?   Check the notebooks by the EMS radio

5. Other Injury Considerations: Injuries from Blasts   Primary Blast Injury   Lungs, intestine and tympanic membrane most severe   Secondary Injury   Most common type of injury seen   Tertiary injury   From the blast wind and propels victim

6. Other Injury Considerations: Crush Injuries

7. Review: Incorporating pediatrics into planning  1. Equipment  Jump Bag with pediatric sized equipment/supplies  2. Triage  Method to the madness and not just kids first  3. Decontamination Considerations Considerations  4. Drills/ Exercises  Utilize children or dolls, mannequins, soda bottles, etc with scenarios

8. After a critical event, rescue workers often struggle to get back to their daily lives and deal with their experience.

9. “Handling It”  It can be difficult to “bounce back” after a traumatic event  Difficulty coping  Difficulty feeling back to normal But…. No one should feel alone in this process or that one has to get thru this completely on their own

10. There are resources out there to help…  Access mental health resources/professionals that are available through your employer/organization  The American Psychological Association Help Center http://helping.apa.org  Substance Abuse and Mental Health Services Administration’s (SAMHSA) Mental Health Services Locator Information available at:  Substance Abuse and Mental Health Services Administration’s (SAMHSA) Mental Health Services Locator Information available at: http://www.mentalhealth.samhsa.gov/databases/ http://www.mentalhealth.samhsa.gov/databases/  Mental Health Resources http://www.luhs.org/depts/emsc/

11. Adapt…… And Serve

13. References and Acknowledgements The Pediatric Disaster Triage: Utilizing the JumpSTART Method training module was developed through assistance from: 1. AHRQ Decontamination of Children video ahrqpubs@ahrq.gov 2. Children’s Memorial Hospital, Chicago 3. Hopkins J and Jones C, Disturbing Legacy of Rescues: Suicide, USA Today 9/22/2003 4. Illinois EMSC Pediatric Disaster Preparedness Guidelines http://www.luhs.org/emsc 5. Newport Beach Fire & Marine Rescue and Hoag Hospital for the use of START triage 5. Newport Beach Fire & Marine Rescue and Hoag Hospital for the use of START triage www.start-triage.com www.start-triage.com 6. Lou Romig, MD (Miami Children’s Hospital) for use of JumpSTART Triage materials http://www.jumpstarttriage.com 7. Paula Willoughby DeJesus, DO, MHPE (Assistant Commissioner, Chicago Fire Department) for provision of several photographs Funding Sources Illinois EMSC and Assistant Secretary for Preparedness & Response (ASPR) Hospital Preparedness grant funding supported in part the development of this training module. The Chicago Department of Public Health and a Health Resources & Services Administration (HRSA) Hospital Preparedness grant supported development of the original training module in 2007.