Triage question.

[SC Bird]

We just finished the first week of class. The first class was full of introductions, EMS history, basic intro into the stressful lives of EMS, and well being of an EMT. Second class was our A.H.A. BLS/CPR certification.

Note: We have not gone over triage yet in our class. This was just a discussion between another EMT-student and myself.

While browsing over the first two chapters, there was a "Ambulance Calls" section that described this scene.
"You are dispatched to a rollover vehicle crash with three known patients. All other ambulances are out on calls; you and your partner will likely not receive assistance for at least 15 minutes. One patient has obvious head trauma, but is still breathing. Your other two patients are conscious but have significant injuries. A crowd is gathering and watching your every move. What do you do?"

The key in the back states that you have to triage your patients and treat the critical patients who will benefit the most from your care which will "likely prevent you from engaging in any sort of care for the patient who has the open head injury."

Just curious as to ya'lls take on this answer and could perhaps elaborate some for me and the other student who disagreed somewhat on the "textbook answer".

-Matt

 

[Epi-do]

The idea behind triage is to best utilize the resources you have available in the most efficient and effective manner possible. Therefore, you must quickly look at each of the patients and determine which one(s) you can do the most for with what you have.

Since your quote from the key mentions an open head injury, I am guessing that in your textbook there is more information regarding the injuries of each of the patients. Without that additional information, it is hard for me to say exactly how I would triage the patients. Given the fact that the one patient does have an open head injury, I would have to agree with your book. I believe I would move on to another patient that I can do more for and that will have a better chance of survival. Which of the other two patients that may be, I couldn't say without additional details.

Where I am at, we use START triage to determine who gets what type of help and when they get it during any situation where resources are limited for any reason. Here is a flow chart that explains it.

 

[rgnoon]

Without knowing what the nature of the other two patient's "significant injuries", it could be hard to say. But look in the back of your book and see if you can find info on START (just try not to get wrapped up in lessons that are far ahead). MCI stuff is toward the end of the class, and for a good reason. It's important to know what you can do, and how much you can help a pt, before you decide which patients you can't help without denying care to other patients that you can help more. (I'm sorry, I realize that sounds horribly convoluted.)

Out of curiosity, what text are you using in your class? Maybe I can look at the question.

EDIT: Sorry Epi-do. I just realized that you said the same thing. I guess that just drives the point home!

 

[SC Bird]

We are using the AAOS Emergency: Ninth Edition.

That question was out of the workbook, and there was no other patient info given (through the question or the answer in the key). Hence the discussion between myself and the other student, but with us not having covered triage yet I wanted to post on here to simply "pick your brains".

I tended to agree with the book. Obviously, on scene assessment could/would bring a better evaluation and therefore a more accurate triage. But when I read the question, I took "obvious head trauma" as significant trauma and possible open head wounds...therefore a smaller chance of survival; while the other student said she would go immediately to treating the head wound patient.

I argued that I may be able to treat at least one of the other two patients and stabilize them for transport, while I may not be able to do very much for "significant head trauma"...

Once again, just looking to pick everyone's brains on this...am I thinking along the "correct" lines?

-Matt

 

[Emtgirl21]

We are using the AAOS Emergency: Ninth Edition.

That question was out of the workbook, and there was no other patient info given (through the question or the answer in the key). Hence the discussion between myself and the other student, but with us not having covered triage yet I wanted to post on here to simply "pick your brains".

I tended to agree with the book. Obviously, on scene assessment could/would bring a better evaluation and therefore a more accurate triage. But when I read the question, I took "obvious head trauma" as significant trauma and possible open head wounds...therefore a smaller chance of survival; while the other student said she would go immediately to treating the head wound patient.

I argued that I may be able to treat at least one of the other two patients and stabilize them for transport, while I may not be able to do very much for "significant head trauma"...

Once again, just looking to pick everyone's brains on this...am I thinking along the "correct" lines?

-Matt

"The greatest good, for the greatest number, in the shortest amount of time."