Disaster and Multi-Casualty Triage

LEARNING OBJECTIVES Describe the key elements of Triage Understand the basic principles of the START method of triage

Working Multiple- or Mass-Casualty Incidents Report to the incident commander before going to work Do a proper size up Clearly and accurately report the situation

Working Multiple- or Mass-Casualty Incidents Note the following: Approximate number of patients Numbers that you've triaged into the four levels Additional assistance required Other important information

TRIAGE French word for SORT Concept of triage:  Method of quickly identifying victims: who have immediately life-threatening injuries who have the best chance of surviving

Triage Tags Delayed care / can delay up to three hours Urgent care / can delay up to one hour Immediate care / life- threatening

Simple Triage And Rapid Treatment (START) Developed by Hoag Hospital & the Newport Fire Department (Newport Beach, CA) Helps prepare to quickly organize resources to handle multi-casualty emergencies

Simple Triage And Rapid Treatment ( START) system to triage multiple victims in 30 seconds or less based on three primary observations (RPM):  Respiration  Perfusion  Mental Status

First Step in START Tell all the people who can get up and walk to move to a specific area If they can get up and walk, they are probably not at risk of immediate death Tag them -

Second Step in START Begin by moving from where you stand Move in an orderly and systematic manner through the remaining victims Stopping at each person for a quick assessment and tagging The stop at each patient should never take more than one minute

START REMEMBER: Your job is to find and tag the patients -- those who require immediate attention Examine, correct life-threatening airway, breathing problems, tag and MOVE ON!

Triage in Hazardous Materials Incidents Responders must protect themselves from injury and contamination IF THERE IS ANY SUSPICION OF A HAZARDOUS MATERIALS SPILL - STAY AWAY! REMEMBER: Contaminated patients will contaminate unprotected rescuers!

VIDEO CLIP

SUMMARY Understand the principles and operations behind the casualty sorting system START system is an excellent and easily understood triage or casualty sorting method Participate in periodic community disaster drills so that skills and capabilities can be tested and improved

SUMMARY You Should Know: Your role at multiple- or mass-casualty incidents How to use the START system How to recognize a hazardous materials placard

SUMMARY You Should Practice: Using the START system during a simulated multiple- or mass-casualty incident

REMEMBER Triage is:  Method of quickly identifying Victims who have immediately life-threatening injuries And who have the best chance of surviving Key elements of the START triage system:  Respiration  Perfusion  Mental Status

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