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alyarmouk GENERAL HOSPITAL EMERGENCY DEPARTMENT DR. MOHAMED ALMUSAWIE T.O.T

alyarmouk GENERAL HOSPITAL EMERGENCY DEPARTMENT DR. MOHAMED ALMUSAWIE T.O.T EMERGENCY MEDICINE. TRIAGE SORTING OF THE VICTIMS ACCORDING TO THEIR INJURIES AND THE AVAILABLE RESOURCES TO TREAT THEM. . A=airway & c.s. protection . B=breathing

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alyarmouk GENERAL HOSPITAL EMERGENCY DEPARTMENT DR. MOHAMED ALMUSAWIE T.O.T

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  1. alyarmouk GENERAL HOSPITAL EMERGENCY DEPARTMENT DR. MOHAMED ALMUSAWIE T.O.T EMERGENCY MEDICINE

  2. TRIAGESORTING OF THE VICTIMS ACCORDING TO THEIR INJURIES AND THE AVAILABLE RESOURCES TO TREAT THEM

  3. . A=airway & c.s. protection . B=breathing . C=circulation & bleeding control . D=disability . E=exposure

  4. AIM Your aim at any multiple casualty Should be to produce the largest Number of survivors

  5. TRIAGE WHEN? CASUALTIES EXCEED THE NUMBER OF SKILLED RESCUERS

  6. TRIAGE . French word meaning sorting . The golden hour: need a utilitarian approach to maximize resource use . A system of sorting patients according to need when resources are insufficient for all to be treated . A dynamic process.

  7. TRIAG . This step is required medical care And transportation becomes available . Anatomical v/s physiological triage . Simple vs. advanced triage . In advanced triage. medical personnel may decide that some seriously injured people should not receive advanced care because they are unlikely to survive.

  8. S.T.A.R.T. {simple triage and rapid treatment} . Has been {2003}taught to California emergency workers for use in earthquakes .4categories: _minor: can delay up to three hours _delayed urgent care/can delay up to one hour _immediate care/life-threatening _deceased no care required

  9. IMMEDIATE The patient will die if not treated immediately . e.g.: sever chest injury with air way obstruction .

  10. DELAYED URGENT The patient needs management but can wait for a time e.g.: fracture or a wound

  11. MINOR Can be managed by the rescues only

  12. EXPECTED When you cannot help him in the scene or there is no hope from referring him at once especially in large numbers of injuries, and transport depends on priorities

  13. TRIAGE . France:urgence medico-psychologique . Simplified S.T.A.R.T. _those lying on the ground silently should be prepared immediate transportation _Those injured lying on the ground but screaming are injured whose transportation can be delayed _the walking wounded need help less urgently

  14. ADVANCED TRIAGE .on scene where the causalities are found: better be simple triage .pre-hospital: in the casualty clearing Station;RTS:for medical personnel: used in western Europe Need GCS and RR

  15. MIMMS:TRIAGE SIEVE PR:9&less,30more: IMMEDIATE If 10-29,look at CR -If>2:immediate, Otherwise -urgent WALKING PRIORITY 3 DELAYED Y N N BREATHING DEAD AFTER AIRWAY OPINING Y RESPIRATORY RATE PRIORITY 1 IMMEDIATE 9 OR LESS 30 OR MORE > 2 SEC 10 _ 29 CAPILLARY REFILL PRIORITY 2 URGENT < 2 SEC

  16. GCS • GCS … POINTS • 15 _ 13 … 4 • 12 _ 9 … 3 • 8 _ 6 ... 2 • 5 _ 4 … 1 • 3 … 0 • SYSTOLIC PRESSURE • SBP … POINTS • > 89 … 4 • 76 _89 … 3 • 50 _75 … 2 • 1 _49 … 0 • 0 _ 0 … 0 Revised trauma score Score: 0 _ 12 • SCORES • 3 AND LESS : MORGUE • 3 _ 10 IMMEDIATE • 11 URGENT • 12 DELAYED • RESPIRATORY RATE • RR … POINTS • > 29 … 4 • 20 _29 … 3 • 6 _ 9 … 2 • 1 _ 5 … 1 • 0 ………… 0

  17. QUESTIONS ?

  18. THANK YOU

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