Mass Casualty Triage*: Sorting and prioritizing injured victims for treatment and transport(*-TRIAGE: a French word meaning to "sort" by priority or life-threatening nature of injury)Many injured victims are present in the scenario. In order to expedite treatment to those most seriously injured, and avoid wasting resources on less seriously injured, a system of rapid "triage" or sorting has been developed called "Special Triage and Rapid Transport" or START. Victims can be quickly evaluated by emergency medical personnel. Initial findings such as vital signs (pulse rate, blood pressure, respiration, level of consciousness) are recorded on the triage tag, and then rechecked periodically thereafter to monitor the victim's status and to RETRIAGE* if their conditions becomes worse, or improves later. Responders are accountable for the identity and security of all victims present in the area of the incident. Such persons will not be allowed to leave the area until they are properly identified, evaluated, treated, transported to a medical treatment facility and/or medically cleared for release. Show NON-PRIORITY VICTIMS:Priority 4 (Blue) Those victims with critical and potentially fatal injuries or illness are coded priority 4 or "Blue" indicating no treatment or transportation. It is important to note that victims of mass casualty incidents (MCI) who are still presenting some vital signs but may have life-threatening or potentially fatal injuries, may be classified as "unsalvageable" by the Triage officer. Although this is a very difficult decision, it is necessary when many casualties require more resources than may be available. It is axiomatic that committing resources to save the life of a person who is most likely to live if cared for promptly, outweighs committing resources to victims who probably will not survive even if such resources are administered. In ordinary emergencies where only a few victims are injured, it is possible for responders to devote sufficient resources to critically injured patients, and to attempt to save their lives by extraordinary medical support and rapid transportation (when possible) to a level 1 or 2 Trauma Center. Such patients often still succumb to their injuries, even after extensive care in hospitals. Priority V (Black) Victims who are found to be clearly deceased at the scene with no vital signs and/or obviously fatal injuries are classified as deceased or priority 5 (Black) in the triage coding system.MEDICAL COORDINATIONA Triage Officer coordinates the assignment of Triage Teams of emergency medical first responders who quickly evaluate and tag patients. Then as sorting continues, first responders are sent in to treat the victims according to tag code. * -RETRIAGERetriage occurs when the status of a patient changes either to a worse condition or if they improve to a less life-threatening level. The previous code is crossed out after evaluation, and the new code and vital signs are listed on the triage tag. Patients who have been initially moved to a specific transportation area would then be moved to a greater or lesser priority transportation area after retriage has been concluded. PERIMETERS: Controlling the access to and from the scene of the eventOuter Perimeters: Controlling access to and from the scene Law enforcement officers are needed to set up a perimeter around the scene to prevent pedestrians and vehicles from entering or driving through hazardous areas. The perimeter may be as large as is necessary to keep spectators away, and permit emergency vehicles to enter and leave without being impaired by "looky-loos" who flock to the scene to see "what's going on." Curiosity of on-lookers can greatly impede rapid response of emergency vehicles by clogging roadways, parking in access points, and failing to yield to emergency vehicles. Most of all, spectators may enter an area which poses serious or fatal hazards due to fire, chemical spill, downed power lines, explosions, etc. Double "Funnel" for victim transport Law Enforcement responders working with medical responders will establish a "perimeter" around the scene of the Mass Casualty Incident, often called a "HOT ZONE" An outbound funnel point will be identified as a safe area through which to remove victims to a second perimeter or zone where they are placed in their appropriate "staging" area according to triage coding. No one is allowed through the perimeter of the "HOT ZONE" to avoid misplacing or unsafely moving victims without authorization. Other factors which may affect the establishment of the "HOT ZONE" include hazardous materials spills, fire, downed power lines, dangerous or unstable structures or vehicles. SCENE SAFETY: protecting the rescuers and victims The Safety Officer supervises the overall operation in terms of safe conduct of rescue, fire suppression, evacuation, hazardous materials control, etc. If a safety officer observes a potentially dangerous situation which may kill or injure a rescuer or victim, he has authority to cease or modify the operation to prevent further risk.MASS CASUALTY INCIDENTS: exercise simulations save lives in real m.c.i. events!Conclusion:Many first responders can quickly and effectively work together under a unified command system which is universally used and understood, to save lives, and minimize risk of injury and property damage. By exercising such responses in realistic field simulations such as a "mass casualty incident" rescuers become more proficient and capable in real situations. Return to 1994 Mock DisasterWhat are the colors for triage?RED: (Immediate) severe injuries but high potential for survival with treatment; taken to collection point first. YELLOW: (Delayed) serious injuries but not immediately life-threatening. GREEN: (Walking wounded) minor injuries.
What are the 4 categories of triage in a mass casualty situation?In both SALT and START , responders classify each victim involved in a mass casualty incident into the following categories for treatment needs:. Green (minimal). Yellow (delayed). Red (immediate). Black (dead). What does the Red tag in the hospital mean?Red tag: A red tag indicates the most urgent treatment need. The individual has suffered life-threatening injuries but has a chance for survival if he or she receives immediate medical attention.
Which of the following tags indicates the least critical of patients in a triage situation?Yellow tags - (observation) for those who require observation (and possible later re-triage). Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances.
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