Diaster triage??

If I remember it right, if it's in a situation where help is accessible like in a hospital E.R., you prioritize the patients using the ABCs.

But in a disaster situation where seconds count and help is inaccessible, you prioritize the ones that can be saved fast which is the most logical thing to do in a time of crisis.

The rationale of this is that you will be saving more victims in a grim situation, rather than waste all your time and effort to only one victim who has a slim chance of surviving in a very difficult situation.

in a disaster or mass casualty incident patients are triaged to determine severity of injury and assign a treatment priority. the simple triage and rapid treatment (start) is one method of doing this, and is the one that i am most familiar with. when using the start system patients are classified as follows:

the start program states that you spend less than 30 seconds on each patient and in reality you should be able to spend considerably less than this. once you determine the patients classification you do not need to assess further, move on to the next patient. the important point to remember is that if you are assigned to triage then you are not going to be treating anyone (other than simple airway positioning in an apneic patient).

to begin, you ask those patients that are capable of walking to move to a specific area. these patients will be classified green tag at this time. remember, after you triage the remaining patients that these folks need to be assessed as well.

after clearing out the walking wounded you need to triage the remainder of the patients by assessing respirations, perfusion, and mental status.

begin by assessing respirations. if the patient is apneic perform a manual airway maneuver and reassess. if the patient is still apneic he/she is classified black tag. if the patient is breathing and the respiratory rate is greater than 30 he/she is classified red tag. if respirations are less than 30 you next assess perfusion status.

perfusion status is assessed by either evaluating the patient's radial pulse or capillary refill time. personally i would use radial pulse in an adult, however technically either is acceptable. if the radial pulse is absent or capillary refill time greater than 2 seconds the patient is classified red tag. if the radial pulse is present or capillary refill time less than 2 seconds you next assess mental status.

if the patient does not follow simple commands he/she is classified red tag. if the patient does follow simple commands he/she is classified yellow tag.

you might find the following links helpful.

in a disaster or mass casualty incident patients are triaged to determine severity of injury and assign a treatment priority. the simple triage and rapid treatment (start) is one method of doing this, and is the one that i am most familiar with. when using the start system patients are classified as follows:

green tag: minor

yellow tag: delayed

red tag: immediate

black tag: dead/expectant

the start program states that you spend less than 30 seconds on each patient and in reality you should be able to spend considerably less than this. once you determine the patients classification you do not need to assess further, move on to the next patient. the important point to remember is that if you are assigned to triage then you are not going to be treating anyone (other than simple airway positioning in an apneic patient).

to begin, you ask those patients that are capable of walking to move to a specific area. these patients will be classified green tag at this time. remember, after you triage the remaining patients that these folks need to be assessed as well.

after clearing out the walking wounded you need to triage the remainder of the patients by assessing respirations, perfusion, and mental status.

begin by assessing respirations. if the patient is apneic perform a manual airway maneuver and reassess. if the patient is still apneic he/she is classified black tag. if the patient is breathing and the respiratory rate is greater than 30 he/she is classified red tag. if respirations are less than 30 you next assess perfusion status.

perfusion status is assessed by either evaluating the patient's radial pulse or capillary refill time. personally i would use radial pulse in an adult, however technically either is acceptable. if the radial pulse is absent or capillary refill time greater than 2 seconds the patient is classified red tag. if the radial pulse is present or capillary refill time less than 2 seconds you next assess mental status.

if the patient does not follow simple commands he/she is classified red tag. if the patient does follow simple commands he/she is classified yellow tag.

you might find the following links helpful.

simple triage and rapid treatment

cert los angeles - simple triage and rapid treatment (start)

start for emergency nurses

fantastic summary!!!!!!!!!!!!!!!