1 triage pakistan icitap. learning objectives define triage know the principles of triage know the...
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Learning Objectives Define triage
Know the principles of triage
Know the categories of triage
Know what is mass casualties (MASCAL)
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Introduction As Police Officers, you will be need to
know how to triage victims from injuries resulting from accidents, combat and blast injuries
These victim must be treated at a medical facility as soon as possible
A knowledge of first aid can often mean the difference between life and death
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Triage
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French: “to sort”
The sorting of casualties by order of priority
Triage applications
Terrorist attacks Urban Mass Casualty Incidents Natural disasters
Principles of Triage
Greatest good for the greatest number of casualties
Employ the most efficient use of available
resources
Return personnel to duty as quickly as
possible6
Plan Ahead
Secure a plan or Standard Operating Procedure (SOP) to mitigate Triage and MASCAL's
Identify areas of responsibility, evacuation and treatment procedures, communications, and other essential procedures
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Let the Most Experienced Lead
The Operator with the greatest medical training and experience should be Triage leader, regardless of rank or position
Do not allow petty power concerns get in the way of good casualty care
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Triage Categories
Immediate (Category I)
Delayed (Category II)
Minimal (Category III)
Expectant (Category 0) (Dead or Dying)
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Immediate/Category I/Category I
The highest priority, referring to the urgent nature of the casualty
Implies the need (within minutes to an hour) intervention to save life, limb, or eyesight
Not all critically ill or injured casualties are Immediate
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Triage Examples of immediate victims who need immediate
care:
Bleeding that is not controllable except with a tourniquet
Airway or Respiratory problems not easily fixable or maintainable for a long period of time
Weak, thready pulse (signs of shock)
ALOC (altered level of consciousness)
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Delayed/Category II
Second priority referring to the need for treatment (usually surgery) that is required but can wait for a few hours
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TriageExamples of victims that may have delayed treatment:
Airway or Respiratory problems that have been fixed and are maintainable for a period of several hours
Bleeding that has been controlled Amputees with bleeding controlled with tourniquet
Pulse rate has returned to normal after short IV therapy
Brief period of unconscious or ALOC, now following commands
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Minimal/Category III
Those casualties with minor problems requiring medical attention, but whose condition is unlikely to deteriorate over the next several hours to days
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TriageExamples of victims that may need minimal treatment:
Victims with no CBA or mental status problems
Lacerations with controlled bleeding
Strains, sprains, abrasions
Simple extremity bone fractures
Femur, pelvis, spinal, facial fractures are NOT
included in this category15
Expectant/Category 0
Last category, where casualties are so gravely ill or injured that survival is unlikely
These casualties are expected to die
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Triage
Examples of victims that are expectant:
Separation of pt from any vital organ
Respiratory arrest No breathing after opening airway
Cardiac arrest
Massive head injury17
Do Not Second-Guess
Trust your medical instincts
Do not go back to re-triage until all casualties have been triaged
Remember the goal, the greatest good for the greatest number of casualties
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Triage
Mass casualty (MASCAL) situations occur when the number of casualties exceeds the available medical capability to rapidly treat and evacuate them
MASCAL’s overwhelm the available medical resources and require the use of Triage to set casualty priorities
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Triage
The actual number of victims required before a MASCAL situation is declared changes from situation to situation depending upon the availability of medical resources
Technically, a MASCAL situation occurs if a medic has more than one seriously injured victim to be cared for at one time
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Start Triage
If patient is in the Immediate (Category I) upon your initial assessment:
Treat only for uncontrolled bleeding or to correct airway blockage before moving on to next patient
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Start triaging wherever you happen to be at the time:
First - clear the walking wounded using verbal instructions
Direct them to the treatment areas for detailed assessment and treatment
These Patients are triaged MINOR
Starting Triage
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Triage for RPM (Respiration/Pulse/Mental Status)
Respiration's :
If none - open the Airway Still none present? - Deceased Restored?- Immediate care (triage)
Respiration present? Above 30 – Immediate care (triage) Below 30 - Check pulse
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Pulse:
Is Radial Pulse Absent ? Immediate care (triage)
Is Radial Pulse Present?
Check Mental Status
Triage for RPM (Respiration/Pulse/Mental Status)
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Mental Status:
Can Not Follow Simple Commands (Unconscious or Altered LOC)
Immediate care (Triage)
Can Follow Simple Commands Delayed care (Triage)
Triage for RPM (Respiration/Pulse/Mental Status)
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Patients are systematically moved to treatment areas where more detailed assessment and treatment are conducted
Triage
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Summary
Triage is a method of sorting casualties by order of priority
The overriding principle of Triage is the “greatest good for the greatest number of victims”
Requires training and experience to perform well
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