Disaster Triage Question

[waterdrifter]

Hey all!

I have a quick questions if any of you would be so kind to answer.

My nursing program is holding a disaster drill and I am on the triage team. We had a discussion about triaging individuals and how to properly do so using the START algorithm.

If we had a patient who was ambulatory but was confused or stuporous, would they still be considered a green tag? I think they would be but one member of my group is adamant that they wouldn't be. My rationale is that we are using the algorithm, and that if they can walk, they would be green -- there is nowhere else to go from there on the algorithm without jumping steps.

Any insights? I can't exactly find any info in the literature regarding this specific type of scenario.

[MunoRN, RN]

Is the patient confused but able to follow simple commands?

[TigraRN]

All walking wounded would be tagged green. We were really trained to see if they can walk and move over, the next steps would be respirations, perfusion, mental status. That confused patient would be reassessed by the nurse in the green area once again and upgraded to yellow/red as necessary, but as far as initial triaging, they would be "green".

[Ouss]

With START you identify green tagged patients by the asking : Any one that can stand up and walk to do that, if your patient was able to understand this statement then they are not confused thus the green tag. A confused patient will remain in his/her place and further evaluation will be required in order to rule out traumatic brain injury and that is done by asking simple questions ( date, time, name.....

[Guest219794]

Hey all!

I have a quick questions if any of you would be so kind to answer.

My nursing program is holding a disaster drill and I am on the triage team. We had a discussion about triaging individuals and how to properly do so using the START algorithm.

If we had a patient who was ambulatory but was confused or stuporous, would they still be considered a green tag? I think they would be but one member of my group is adamant that they wouldn't be. My rationale is that we are using the algorithm, and that if they can walk, they would be green -- there is nowhere else to go from there on the algorithm without jumping steps.

Any insights? I can't exactly find any info in the literature regarding this specific type of scenario.

START is meant to do the most good for the most people. It is not perfect.

I think that the whole point is that by keeping things simple, more will survive. If rescuers are expected to do a more complex assessment, (Well, they follow simple commands, but falter with complex reasoning....) fewer will survive.

A non weight bearing ankle sprain will be yellow, while an early tension pneumo will be green. Clearly bad priorities but, if you take the time to fully asses these two and get them properly sorted, you will have used too much time. What about the guy that needed a simple airway intervention, but didn't get it while you were working on those other two?