EMTecBOB
Forum Probie
- 27
- 0
- 0
In START Triage, a victim is tagged red if they are breathing more than 30 per minute. - Why is this considered an "immediate" threat to life?
START Triage...
- Thread starter EMTecBOB
- Start date
JPINFV
Gadfly
- 12,681
- 197
- 63
Think for a minute. Why do you breath? How do you breath? How does the molecules exchanged during breathing get moved around the body? How does the body compensate if any of that goes wrong?
OP
OP
EMTecBOB
Forum Probie
- 27
- 0
- 0
I understand that it is out of norm. I was just wondering why someone with no other obvious signs of life threats, would be tagged red just because they were breathing fast. After all, if I had just been in a traumatic event, I might be breathing fast without a dent in the fender.
akflightmedic
Forum Deputy Chief
- 3,895
- 2,573
- 113
Would you still be breathing that fast 6-10 minutes (urban...much longer for rural or remote) later when EMS arrives? If so, then there is a problem, hence the red tag.
Summit
Critical Crazy
- 2,696
- 1,314
- 113
START is kinda silly. Just think of it as
"insufficient respiration" (rate and/or depth) = RED
Because you might not really be stopping to take a rate in a real triage situation.
Also, peripheral cap refill is a horrible measure for most patients in many environments. Try central cap refill (like gums).
"insufficient respiration" (rate and/or depth) = RED
Because you might not really be stopping to take a rate in a real triage situation.
Also, peripheral cap refill is a horrible measure for most patients in many environments. Try central cap refill (like gums).
OP
OP
EMTecBOB
Forum Probie
- 27
- 0
- 0
OK...it is now making more sense to me. And you guys make great points....not walking, breathing fast? Could be something really bad going on, after all, even shock kills.
What got me to thinking about this was the fact that > 30/min respiration's seemed to be so arbitrary. But I was not thinking about it in the context of a traumatic event with a significant MOI.
Thanks guys
Keep warm, keep safe, don't keep the EMT's awake.
What got me to thinking about this was the fact that > 30/min respiration's seemed to be so arbitrary. But I was not thinking about it in the context of a traumatic event with a significant MOI.
Thanks guys
Keep warm, keep safe, don't keep the EMT's awake.
Shishkabob
Forum Chief
- 8,264
- 32
- 48
Everyone dies from shock.
OP
OP
EMTecBOB
Forum Probie
- 27
- 0
- 0
That is a good observation. If I remember correctly, on my dads full death certificate, it listed step by step what caused death...ending in cardiogenic shock. - It all comes down to the pump stopping, or having nothing left to pump...which also causes it to stop.
Shishkabob
Forum Chief
- 8,264
- 32
- 48
Well that just made me depressed.
OP
OP
EMTecBOB
Forum Probie
- 27
- 0
- 0
It used to get me too, now I just think about all the good times. - BTW, hug em while you got em.
MusicMedic
Forum Captain
- 499
- 0
- 0
Yeah i agree, my dad died of a suspected MI earlier this year
we didnt get an autopsy so they didnt list the steps of what happened
JPINFV
Gadfly
- 12,681
- 197
- 63
Any hard cutoff level is, by its nature, arbitrary.
zmedic
Forum Captain
- 480
- 0
- 16
There is a reason that START is used, because it is a standard system so that everyone is trained the same way. You can disagree with their exact criteria, but if that's the system that your service is using you better be doing it by the book. You don't want to be in court explaining "oh, I know START uses cap refill, but I decided to use my own way of checking perfusion for making the patient a red." People straying from the protocols is why there is such variety in how the exact same patients are triaged by different people.
The protocols are cut and dried and simple for a reason, so you don't have to think much when you have 30 injured an are trying to assess each in less than a minute.
Oh, and keep count of how many of each color you've tagged. It pisses me off when my students just tagged 20 people and have no idea how many reds and yellows they have. (The others I'm less worried about. Greens are "do I need a bus or two" and there will be plenty of time to count the black tags later.
The protocols are cut and dried and simple for a reason, so you don't have to think much when you have 30 injured an are trying to assess each in less than a minute.
Oh, and keep count of how many of each color you've tagged. It pisses me off when my students just tagged 20 people and have no idea how many reds and yellows they have. (The others I'm less worried about. Greens are "do I need a bus or two" and there will be plenty of time to count the black tags later.
zmedic
Forum Captain
- 480
- 0
- 16
There is a reason that START is used, because it is a standard system so that everyone is trained the same way. You can disagree with their exact criteria, but if that's the system that your service is using you better be doing it by the book. You don't want to be in court explaining "oh, I know START uses cap refill, but I decided to use my own way of checking perfusion for making the patient a red." People straying from the protocols is why there is such variety in how the exact same patients are triaged by different people.
The protocols are cut and dried and simple for a reason, so you don't have to think much when you have 30 injured an are trying to assess each in less than a minute.
Oh, and keep count of how many of each color you've tagged. It pisses me off when my students just tagged 20 people and have no idea how many reds and yellows they have. (The others I'm less worried about. Greens are "do I need a bus or two" and there will be plenty of time to count the black tags later.
The protocols are cut and dried and simple for a reason, so you don't have to think much when you have 30 injured an are trying to assess each in less than a minute.
Oh, and keep count of how many of each color you've tagged. It pisses me off when my students just tagged 20 people and have no idea how many reds and yellows they have. (The others I'm less worried about. Greens are "do I need a bus or two" and there will be plenty of time to count the black tags later.
Summit
Critical Crazy
- 2,696
- 1,314
- 113
Sure... a triage protocol developed for us by Californian urban firefighters 3 minutes from the ER is what we should be using during a rural Colorado winter 3 hours from a trauma center just so we can all be standardized. :wacko:
Our protocols are viewed by guidelines and many things get fuzzy in an MCI.
Our protocols are viewed by guidelines and many things get fuzzy in an MCI.
zmedic
Forum Captain
- 480
- 0
- 16
That's not what said. If start doesn't fit well with your local situation your medical director should chose something else. But if as a department it's been decided that you are going to do START, than you should be doing start as it is written.
It's percisely because things get "fuzzy" at an MCI that systems like START have very clear algorythms, because you don't have to think as much or make as many on the fly decisions. Yes, things will get messed up, and people will tweak the triage enough on their own. But I don't think people should be planning on going into a future MCI and making up their own triage criteria on the fly.
It's percisely because things get "fuzzy" at an MCI that systems like START have very clear algorythms, because you don't have to think as much or make as many on the fly decisions. Yes, things will get messed up, and people will tweak the triage enough on their own. But I don't think people should be planning on going into a future MCI and making up their own triage criteria on the fly.