Responding to Emergencies

1. Responding to Emergencies Triage

2. Basic Principles • Stay __________________ • Assess the ___________________ • _____________________________ • Obtain ____________________ to treat the victim • Try to determine what happened • Practice ___________________________________

3. ________________________________________________________________________________________________________________________________________________________________________________ Basic principles • Enlist help of __________________ • _____________________ the victim • Don’t discuss the victim’s ____________________ with observers at the scene • Don’t give the victim anything to _______________

4. Good Samaritan law • _______________________________________________________________________________________________________________________________________________

5. triage • Process of deciding which victims should be treated first based ________________________________________________________________________________________________________________

6. Triage • In a ____________________________ you can’t commit to “one-on-one” care • You have to be quickly assess the victims – _________ sec or less per patient • Very limited treatment is provided: • ______________________________ • _______________ with finger sweep • _____________________________________________________________

7. Primary and Secondary Triage • Secondary triage - ________________ process that takes place after the patient has been moved to a treatment/holding area awaiting transport. • Primary triage - 1st contact-________________________________________________________________________

8. triage • Triage separates the injured into 4 groups: • _______________________________ (critical patient) • _______________________________ (serious patient that could wait until all reds have been transported ) • _________________ (ambulatory; minor injuries) • ______________________________ (expectant)

9. 4 things to think about… • Ability to _______________________________________ • _______________________________________________ • _______________________________________________ • _______________________________________________

10. BEGIn…. • Clear out all __________________________ victims • ask for victims who can hear you and are able to walk, to walk toward you • Once they walk toward you – designate a place for them to go & have someone tag them ___________________ • Rest of the patients require MORE triage – • 3 steps, assess: • ________ (respiratory effort) • ________ (pulses/perfusion) • ________ (mental) • They will be tagged red, yellow, or black

11. Step 1: Respiratory Effort • If victim is not breathing– _______________________________ • If they start breathing = tag __________________ • If they don’t start breathing = tag _______________________ • If victim is breathing >________ or <_______= tag _________ • If victim is breathing normal ________________ = go to step 2 airway 3 steps: They will be either red, yellow or further ambulatory patients as you Breathing >30 or <10 = tag Deceased/expectant (black) for the “greens” to stage. “START” OUR POLICY Primary and Secondary START – Step 1 START – Focus on tagging the patients Respiratory Effort Something To Think About.... The “Greens” Triage The “START” System of Triage The “START” System of Triage 4 things to think about ... BEGIN... Keep in mind that in a larger scale event,   Primary triage using START Triage, evaluate victims Once they walk toward you – Simple Triage and Rapid     Not breathing – manually open their  patients may be spread out over a large ambulatory patients Clear out all –tag ) ( and assign them to one of the Treatment designate a place for them to go START Ability to follow directions and walk  1 contact st  area or even on several floors or rooms in a Green following four categories: Secondary triage RED BLACK        direct them to the area that you selected Rest of the patients require MORE triage – black. In this type of situation, you may encounter building. progress. They are still tagged green –   Someone needs to tag them green       keep them informed Someone needs to stay with them &      Breathing normal 10-30 = step   R P M Assign triage category R the patient has been moved to a Walking wounded/minor (green) Delayed (yellow) Immediate (red) ongoing process that takes place after treatment/holding area transport. P M Fire Department located at Hoag Memorial Hospital in Newport Beach, CA the staff members of the Newport Beach    The method was developed in 1983 by If they start breathing - tag If they don’t start breathing – tag ulses/perfusion espiratory effort ulses/perfusion espiratory effort ental status ental status Easy to use Focus is on signs/symptoms Fast RED go to next awaiting

12. Step 2: pulses/perfusion • Check for _________________________ pulse or capillary refill • If radial pulse _____________ or cap refill >2 seconds = tag ____________ • If radial pulse _____________ or cap refill < 2 seconds = go to step 3

13. Step 3: mental status • Assess whether or not the victim can follow a simple _______________________, say to the victim: “Squeeze my hand” • If the victim can follow a simple command = tag _________________________ • If the victim cannot follow a simple command = tag _______________________

14. Treatment area • Patients should be separated as tagged

15. morgue • Tagged _______________________ • Establish an area away from other patients • It should be a secure area away from on-lookers, media, etc. • Accessible for you and coroner staff