Triage

[High Speed Chaser]

Not sure where to post this but I need some tips on triage.

What are the most vital things when establishing who need needs priority, especially when dealing with multiple casualties 3+ with few personnel trained to help.

Thanks
HSC

 

[GR1N53N]

We use the START system. It's pretty simple. See link for a flowchart.

http://emsstaff.buncombecounty.org/inhousetraining/start/start_overview3.htm

 

[WuLabsWuTecH]

Use your instincts. You can tell the difference between an "Oh S***" case that will need a lot of your help and someone whos hurt but won't die while you're taking care of the other.

At least with the 3+ i assume a MCI but not like 20 or 100 people or more. If so, start using those triage tags.

 

[Melclin]

As far as what we've learnt at uni and what Ambulance Victoria thinks about the matter: There are three levels of time critical patients. http://www.rav.vic.gov.au/Media/doc...1105-14424820-4dd6-410c-a550-bebdec9571b3.pdf

It's all a bit convoluted but its got a nice table of things to know about trauma triage - like what the injuries are that you really should worry about and vital sign limits that are some cause of concern.

I'm not sure the START system is a good one to go with. I think major casualty situations where you need to be that harsh and people are that badly injured are rare (explosions, building collapses, bus crashes), and in that situation hopefully someone with your level of experience would not have nasty responsibility of deciding how to triage plonked on their shoulders. Would I be correct in thinking you were getting more at everyday stuff (for example getting called to an argument outside the G, with one guy sitting on the ground bleeding from his forehead, another guy clutching his chest, and a third screaming in pain and holding his broken arm, and ten people screaming at no one in particular, and help is 7 minutes away)?

As far as medical goes: suspected AMI, AAA (I don't think the St.Johns literature covers them at all, probably worth a trip to wiki), severe stroke, Severe sepis/meningococcal, and undiagnosed pain are the first worries are top of the list. If it could be any of them, then the pt takes priority (In the above scenario, the guy clutching his chest comes first - possible AMI).

The problem you have (I assume) is that St.John's MFRs don't appear to be given the same tools of triage as ambos etc. I joined St. Johns a little while ago and I'm confused at the new way of prioritizing things based on a lack of available equipment (BP, pulse ox) for triaging.

Assuming, the worst until you can prove that its not, is a good rule of thumb for pretty much anything, but then I understand you can't go calling CODE 6 (that's ambulance backup right?) for every grazed knee that comes to the tent.

 

[DV_EMT]

30, 2, Can do?

thats the acronym for the the Start Triage. Look at the sheet and you'll see what I mean.

 

[Ridryder911]

For the U. S. there is a new standard that will soon be replacing the START method. It is similar but a little different, ironically it is from the Center of Disease Control (CDC) and was discussed yesterday on a live webcasts from JEMS.

Here is a link, it will be up for to listen for encore performance soon.

http://www.jems.com/webcasts/decide_to_save_lives.html