Medical Triage Principles

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Questions and Answers

What factors should influence decisions regarding the best destination for each patient?

How far it is safe for them to travel and availability of necessary facilities (correct)

Recommendations from family members and preferences of the patient

The patient's ability to self-transport and their financial resources

The distance from the accident site and mode of transport available

Which of the following is NOT a component that must be arranged in field hospitals?

Ventilators

Blood bank

Operating rooms

Entertainment facilities (correct)

What does an adequate supply of essentials in field hospitals typically include?

Surgical instruments and patient health records

Intravenous fluids, dressing supplies, and oxygen (correct)

Nutritional supplements and rehabilitation gear

Psychological support tools and physical therapy equipment

What is the purpose of conducting a quick retriage in patient management?

To ensure safety against a second accident during transport Signup and view all the answers

What type of care is provided for patients with minor injuries in field hospitals?

Cleaning wounds, dressing them, and providing simple pain relief Signup and view all the answers

What is the primary focus of damage control surgery (DCS)?

Only life- and limb-saving surgeries Signup and view all the answers

Which of the following is NOT a part of damage control surgery protocols?

Performing cosmetic surgeries Signup and view all the answers

What is essential to prevent during the transfer of patients?

Second accidents Signup and view all the answers

Who should undertake triage to ensure effective decision-making?

Someone with seniority and experience Signup and view all the answers

When is triage necessary to be conducted?

Before evacuation, in the field, and at the hospital Signup and view all the answers

Which of the following describes the condition that should be addressed by DCS?

Compartment syndrome Signup and view all the answers

What is important for establishing an efficient triage area?

Large, undamaged structures for sheltering wounded Signup and view all the answers

In which type of medical facility is damage control surgery primarily performed?

Field hospitals Signup and view all the answers

What facilities should be included in a good triage area?

Separate areas for patient holding and emergency treatment Signup and view all the answers

What is a crucial factor to ensure before transferring a patient in DCS?

Control of hemorrhage Signup and view all the answers

How can emergency life-saving measures influence the triage process?

They can assist the decision-making process. Signup and view all the answers

Why is the removal of devitalized tissue important in damage control surgery?

To prevent contamination Signup and view all the answers

What should be done to ensure the patient’s stability during evacuation?

Avoid unnecessary movement Signup and view all the answers

Which of the following assessments is critical during triage?

Assessment of airway, breathing, and circulation Signup and view all the answers

What conditions are preferred for providing triage?

Good water supply, lighting, and ease of access Signup and view all the answers

In the event of hazardous materials, what should a triage area include?

Decontamination areas Signup and view all the answers

What is the primary indication for a limb being unlikely to survive after vascular repairs?

If vascular repair is delayed beyond 4–6 hours Signup and view all the answers

What is the median incubation period for tetanospasmin to manifest symptoms?

7 days Signup and view all the answers

What condition describes the arching of the whole body due to spasms?

Opisthotonus Signup and view all the answers

Which aspect of management is crucial for facial injuries to ensure good results?

Careful debridement followed by delayed primary closure Signup and view all the answers

What is the term for painful spasms of facial muscles that indicate early symptoms of tetanospasmin?

Risus sardonicus Signup and view all the answers

What significant outcome may occur if laryngeal muscle spasms are prolonged?

Respiratory collapse Signup and view all the answers

What response is inhibited due to the action of tetanospasmin at the neuromuscular junctions?

Neurotransmitter release Signup and view all the answers

What preventive measure is emphasized for managing facial injuries with gross contamination?

Timely debridement Signup and view all the answers

What is the purpose of performing a fasciotomy in cases of compartment syndrome?

To relieve pressure from swelling in muscle compartments Signup and view all the answers

In what setting should amputations for devitalised limbs typically occur?

At field hospitals without delay Signup and view all the answers

Why is lavaging with a pressurized system controversial during wound care?

It may cause further tissue trauma and spread debris Signup and view all the answers

What initial care is emphasized for patients with non-life-threatening injuries?

Specific management including irrigation and removal of debris Signup and view all the answers

What is a critical step in managing wounds with extensive cavitation?

Enlarging the wound longitudinally for better access Signup and view all the answers

Why should damaged major vessels be repaired if feasible?

To prevent the need for amputation Signup and view all the answers

What is the purpose of copious irrigation with normal saline after anaesthesia?

To clean the injured area and remove debris Signup and view all the answers

What type of injuries may require specialized care and transfer to appropriate facilities?

Complex hand injuries and major facial injuries Signup and view all the answers

Study Notes

Triage Procedures

Triage must be conducted by experienced senior personnel for critical decisions.
Continuous assessment required in the field, prior to evacuation, and upon hospital arrival.
Injured individuals should be collected in undamaged shelters with access to water, lighting, and transportation.
Designate separate areas for patient holding, emergency care, and decontamination.

Emergency Measures

Life-saving treatments should be performed alongside triage, aiding decision-making.
Initial assessments focus on airway, breathing, and circulation.

Field Hospitals

The choice of field hospitals (tented vs. modular) depends on the situation and available facilities.
Modern facilities must include radiograph capabilities, operating rooms, and essential monitoring equipment.
Quick retriage is vital to adapt to changing patient conditions during transport.
Avoid 'second accidents' by ensuring safe transfer and treatment protocols.

Essentials for Casualty Evacuation

Regular reassessment of injured individuals to prioritize care.
Select suitable medical facilities for patient transfers.
Ensure necessary supplies accompany patients, including fluids, dressings, and medications.

Damage Control Surgery (DCS)

DCS focuses on performing only life-saving and limb-saving surgeries in field hospitals.
Goals include controlling hemorrhage, securing airways, and addressing compartment syndromes.
Infection prevention includes extensive tissue cleaning and dead tissue removal.

Initial Care for Non-Life-Threatening Injuries

Minor injuries management involves wound cleansing, dressing, sutures, and splinting fractures.
'Walking wounded' patients can typically receive antibiotics and pain relief before discharge.

Complex Injuries Management

Major injuries necessitate specialized care, often requiring transfer to advanced facilities.
Surgeons should prioritize debridement and vascular repairs to enhance limb salvage rates.

Facial Injuries

Management follows principles of debridement and delayed closure due to cosmetic and functional significance.
Even in late-presenting infections, careful debridement allows for good outcomes.

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Description

This quiz covers essential principles of medical triage, emphasizing the importance of senior personnel in making critical decisions. It examines the requirements for effective triage in dynamic clinical situations involving injured patients.