0071643192.pdf

EMS AND DISASTER MEDICINE^902

Disaster Triage

A means of assigning priority of treatment for the injured; must be an ongoing

process

SIMPLETRIAGE ANDRAPIDTREATMENT(START)

(See Table 20.7.)

■ For routine multicasualty triage

■ Green category =those able to walk away from the scene.

■ Each remaining victim undergoes a quick assessment of respirations, per-

fusion, and mental status.

■ Red=need for immediate care (eg, severe mental status changes, HR > 120

or capillary refill >2 seconds or RR >30).

■ Yellow =not Red or Green, delayed care appropriate.

■ Black=unsalvageable or dead.

SECONDARYASSESSMENT OFVICTIMENDPOINT(SAVE)

■ For catastrophic numbers of casualties, to identify patients who may benefit

from field intervention

TABLE 20.6. Phases of Disaster Preparedness

PHASE

Mitigation Activities to lessen impact of a potentialevent

Preparedness Identifying resources, training, drills

Response

Activation Notification for response

Organization of incident command post

Assessment of event

Implementation Scene: Search and rescue, triage and transport,

definitive management

ED: Coordinating treatment

Recovery Scene withdrawal

Debriefing

Return to normal operations

TABLE 20.7. Multicasualty Triage Categories

Black (“Dead”) Unsalvageable or dead

Red (“Immediate”) First priority

Yellow (“Delayed”) Second priority

Green (“Minor”) Walking wounded

In disaster triage, a patient

who is unsalvageable is triage

category “black.”

A disaster triage category

“red” patient requires

immediate care.