Triage PDF

Triage  Objectives Upon completion of this lecture the participant will be able to: Define triage and explain when it is appropriate for use. Explain purposes of triage. Discuss types of triage. Categorize the triage status of patients utilizing the START triag...

Triage  Objectives Upon completion of this lecture the participant will be able to: Define triage and explain when it is appropriate for use. Explain purposes of triage. Discuss types of triage. Categorize the triage status of patients utilizing the START triage system  Triage [French, from trier, to sort, A method of quickly identifying victims who have immediately life-threatening injuries AND who have the best chance of surviving.  TRIAGE “Large scale triage is the hardest job anyone in pre-hospital care will ever do”.  TRIAGE WHEN ? Casualties exceed the number of skilled rescuers.  THE OBJECTIVE Casualties Resources  Why Triage and Tag? Sorting of patients to provide for the survival of the most patients Assignment of resources in the most efficient method Most severe survivable injuries receive rapid treatment  Types of Triage Primary – On Scene prior to movement Secondary – Incident dependant, probably prior to or during transport  TRIAGE CODING Priority Treatment Color Immediate 1 RED Urgent 2 Yellow Delayed 3 Green Dead 0 Black Triage Protocol (START)  PRIMARY TRIAGE The Scene  PRIMARY TRIAGE The first attempt at balancing EMS resources and casualties / injured  PRIMARY TRIAGE Determining whether there is an airway and breathing  PRIMARY TRIAGE If breathing, at what rate & is it good enough?  PRIMARY TRIAGE They have an airway, and are breathing. Are they circulating blood sufficiently? Circulatory Check…  PRIMARY TRIAGE A B C Mental Status START (Simple Triage And Rapid Treatment)  START EXERCISE Female, 30’s, walking Male, teens, walking, confused Male, teens, you open airway, does not breathe Male, 20’s, holding left ankle, cannot walk, RR 20, CRT 1, responds to instructions  START EXERCISE Female, 30’s, walking Male, teens, walking, confused Male, teens, you open airway, does not breathe Male, 20’s, holding left ankle, cannot walk, RR 20, CRT 1, responds to instructions  START EXERCISE Female, 60’s, fracture LL leg, cannot walk, RR 25, CRT 1, obeys commands Male, 30’s, you open airway, does not breathe Male, 50’s, you open airway, does not breathe  START EXERCISE Female, 60’s, fracture LL leg, cannot walk, RR 25, CRT 1, obeys commands Male, 30’s, you open airway, does not breathe Male, 50’s, you open airway, does not breathe SECONDARY TRIAGE  SECONDARY TRIAGE Purpose – Determine among like priority category, higher priority patient When does it happen? – Generally on extended duration events – If treatment areas are established, there will likely be a need for Secondary Triage before transport SECONDARY TRIAGE From Triage to Treatment Areas Incident Triage Treatment Immediate Search & Triage Urgent Rescue Team(s) Delayed Morgue From Treatment to Definitive Care Treatment Transport Definitive Care Immediate Ambulances H Ambulances, H Urgent Ambulettes, Buses, etc H Delayed Appropriate Facility  Hospital Triage System Emergent Urgent Nonurgent  I) Emergent Categories Definition Time Example needed Those that are life requires Cardiac arrest. threatening , but treatment Airway obstructions. likely to be immediately Hemorrhage with shock amenable to rapid or within 15 Complicated delivery. intervention that to 30 minutes Seizure does not require an. Asthma inordinate amount Acute bleeding or acute of resources. pain. Depressed level of consciousness.  II) Urgent Categories Definition Time needed Example Those conditions serious illness or Complex long bone that are serious and injury that must fracture. if not treated in be attended to, Bleeding controlled timely manner , are but wait of up to with a pressure likely to deteriorate 2 hours dressing. to become critical. Acute psychiatric problem High fever with other vital signs stable  III) Nonurgent Categories Definition Time Example needed conditions that conditions - Minor laceration which can wait that can require sutures. without wait more - Minor joint trauma which likelihood of than 2 requires an X- ray for deterioration. hours. diagnosis. - Request for medication refills. - Chronic conditions that are stable Such as preexisting skin rash