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Colin Smart Multiple Casualty Triage in Pre-hospital Care. OUTLINE. Understanding the multiple casualty scene Triage Background Practical application. UNDERSTANDING THE MULTIPLE CASUALTY SCENE. To produce the largest number of survivors from a multiple casualty incident. OUR AIM.
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OUTLINE • Understanding the multiple casualty scene • Triage Background • Practical application
To produce the largest number of survivors from a multiple casualty incident OUR AIM
THE HUMAN FACTOR "We have to remember that when dealing with large scale MCI, we are sending the least experienced people to perform the duties of triage and treatment in the first few minutes. With the adrenaline that is released as the rescuers go into the scene, triage has to be something that can overcome the loss of fine motor skills and tunnel vision that is common with an adrenaline release. A true MCI is not something that we are able to truly train for. Until a rescuer has experienced the real thing, there is no guarantee for success. “Captain Mike Fletcher Paramedic Supervisor Williamson Medical Center
THE INITIAL PROBLEM Casualties Resources
THE OBJECTIVE Casualties Resources
THE OBJECTIVE Casualties Resources
THE OBJECTIVE Casualties Resources
THE OBJECTIVE Casualties Resources
THE OBJECTIVE Casualties Resources
THE OBJECTIVE Casualties Resources
THE OBJECTIVE Casualties Resources
TIME IS IMPORTANT It is well established that the patient's chances of survival are greatest if they receive definitive care within the shortest period of time possible after a severe injury.
TIME WHAT IS THE PROBLEM ?
Casualties Resources + = Maximum survivors
TRIAGE “Large scale triage is the hardest job anyone in pre-hospital care will ever do”. A.J Heightman, Mass Casualty Incident Management. A practical approach to solving complex operational dilemmas.
WHY? To get the right patient in the right place at the right time.
WHEN? Casualties exceed the number of skilled rescuers.
HOW? With a system which is; • Dynamic • Quick • Safe • Reproducible
OUTCOME ? • Numbers & Severity • Directs next resources • Starts effective control
TRIAGE TASKS ? My Call Sign Exact location Type of incident Hazards Access / Egress Number of casualties Emergency svs. Req. Rapid Interventions Communicate the Decision Make the Decision Manage the Uninjured My Call Sign Exact location Type of incident Hazards Access / Egress Number of casualties Emergency svs. Req. Situation Report Count Casualties Pick a safe route Handover Information
IT’S A JOB FOR TWO Team Member 2 Talks to / Occupies Uninjured Prepares equipment Watch for hazards Plans route Records information Provides moral support Team Member 1 Applies rapid treatment Makes triage assessment Provides moral support
PAEDIATRIC TRIAGE Children are involved in multiple casualty incidents. The over prioritizing of children will take valuable resources away from more seriously injured adults. Children decompensate rapidly Triage systems based on adult physiology will not provide accurate triage.
RIGHT SKILLS www.smartdnet.com
Remember the human factor Time and resource management are critical Plan your triage on good evidence and practical application Triage equipment should be within a system and not stand alone. SUMMARY