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Colin Smart Multiple Casualty Triage in Pre-hospital Care.

Colin Smart Multiple Casualty Triage in Pre-hospital Care. OUTLINE. Understanding the multiple casualty scene Triage Background Practical application. UNDERSTANDING THE MULTIPLE CASUALTY SCENE. To produce the largest number of survivors from a multiple casualty incident. OUR AIM.

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Colin Smart Multiple Casualty Triage in Pre-hospital Care.

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  1. Colin Smart Multiple Casualty Triage in Pre-hospital Care.

  2. OUTLINE • Understanding the multiple casualty scene • Triage Background • Practical application

  3. UNDERSTANDING THE MULTIPLE CASUALTY SCENE

  4. To produce the largest number of survivors from a multiple casualty incident OUR AIM

  5. THE HUMAN FACTOR "We have to remember that when dealing with large scale MCI, we are sending the least experienced people to perform the duties of triage and treatment in the first few minutes. With the adrenaline that is released as the rescuers go into the scene, triage has to be something that can overcome the loss of fine motor skills and tunnel vision that is common with an adrenaline release. A true MCI is not something that we are able to truly train for. Until a rescuer has experienced the real thing, there is no guarantee for success. “Captain Mike Fletcher Paramedic Supervisor Williamson Medical Center

  6. THE INITIAL PROBLEM Casualties Resources

  7. THE OBJECTIVE Casualties Resources

  8. THE OBJECTIVE Casualties Resources

  9. THE OBJECTIVE Casualties Resources

  10. THE OBJECTIVE Casualties Resources

  11. THE OBJECTIVE Casualties Resources

  12. THE OBJECTIVE Casualties Resources

  13. THE OBJECTIVE Casualties Resources

  14. TIME IS IMPORTANT It is well established that the patient's chances of survival are greatest if they receive definitive care within the shortest period of time possible after a severe injury.

  15. TIME WHAT IS THE PROBLEM ?

  16. Casualties Resources + = Maximum survivors

  17. TRIAGE Background

  18. TRIAGE “Large scale triage is the hardest job anyone in pre-hospital care will ever do”. A.J Heightman, Mass Casualty Incident Management. A practical approach to solving complex operational dilemmas.

  19. WHY? To get the right patient in the right place at the right time.

  20. WHEN? Casualties exceed the number of skilled rescuers.

  21. HOW? With a system which is; • Dynamic • Quick • Safe • Reproducible

  22. OUTCOME ? • Numbers & Severity • Directs next resources • Starts effective control

  23. TRIAGE Practical Application

  24. TRIAGE TASKS ? My Call Sign Exact location Type of incident Hazards Access / Egress Number of casualties Emergency svs. Req. Rapid Interventions Communicate the Decision Make the Decision Manage the Uninjured My Call Sign Exact location Type of incident Hazards Access / Egress Number of casualties Emergency svs. Req. Situation Report Count Casualties Pick a safe route Handover Information

  25. IT’S A JOB FOR TWO Team Member 2 Talks to / Occupies Uninjured Prepares equipment Watch for hazards Plans route Records information Provides moral support Team Member 1 Applies rapid treatment Makes triage assessment Provides moral support

  26. PRIMARY TRIAGE

  27. PAEDIATRIC TRIAGE Children are involved in multiple casualty incidents. The over prioritizing of children will take valuable resources away from more seriously injured adults. Children decompensate rapidly Triage systems based on adult physiology will not provide accurate triage.

  28. UPDATE ON METHODS

  29. MAKING A SYSTEM THAT WORKS

  30. FUNCTIONAL EQUIPMENT

  31. RIGHT SKILLS www.smartdnet.com

  32. EMBEDDED CORRECTLY

  33. MAKING A SYSTEM THAT WORKS

  34. Remember the human factor Time and resource management are critical Plan your triage on good evidence and practical application Triage equipment should be within a system and not stand alone. SUMMARY

  35. THANK YOU

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