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Health Science Core Chapter 8 Disaster: Preparedness, Hazards, and Prevention Broward County Triage Broward County Inc PowerPoint Presentation
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Health Science Core Chapter 8 Disaster: Preparedness, Hazards, and Prevention Broward County Triage Broward County Incident Command. Chapter 18: Disasters: Preparedness. Disaster. An unexpected event that causes great damage and depletes or exhausts currently available resources

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Presentation Transcript
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Health Science CoreChapter 8 Disaster: Preparedness, Hazards, and PreventionBroward County TriageBroward County Incident Command

Revised: August 2007

disaster
Disaster

An unexpected event that causes great damage and depletes or exhausts currently available resources

  • Earthquakes
  • Hurricanes
  • Floods
  • Tornadoes
  • Airplane accident
  • Hazardous waste

accident

Revised: August 2007

triaging terms
Triaging Terms
  • Triage - To sort or prioritize care for a group of patients
  • Assessment – evaluation of the patient
  • Objective – Information obtained from observing the patient
  • Subjective – Information obtained from the patient
  • The goal of triage – Prompt and efficient patient care

Revised: August 2007

disaster preparedness
Disaster Preparedness

1. Disaster preparedness has become a recognized specialty which requires cooperation of many agencies.

2. Proper preparation takes:

  • Foresight
  • Thought
  • Planning
  • Experience is the best teacher

Revised: August 2007

disaster basic guidelines
Disaster Basic Guidelines
  • Remain calm
  • Know who the designated person in charge of you
  • Keep agency telephone lines clear for official business
  • Communicate and cooperate with other workers
  • Always speak in a firm voice but a caring tone

Revised: August 2007

occupational safety
Occupational Safety
  • OSHA – Occupational Safety and Health Administration – agency that develops safety standards and establishes maximum levels of exposure to many hazardous material.
  • NIOSH – National Institute for Occupational Safety and Health – Investigates requests of unsafe working conditions and how they relate to employee illnesses.

Revised: August 2007

hospital hazards
Hospital Hazards
  • Anesthesia – gases used to cause loss of sensation and/or consciousness caused by the administration of drugs
  • Radiation and chemotherapy – toxic substances that can have a high risk of developing tissue damage
  • Asbestos – fireproofing material in old construction
  • Always read the label and mixing instructions before using any chemicals

Revised: August 2007

hazard communication hazcom
Hazard Communication / HazCom

Program that protects employees from the dangers of chemicals and medical gases.

  • Employee training
  • Written program
  • Material Safety Data Sheets
  • Warning Labels

Revised: August 2007

slide11
What is an MCI ?

Any Incident Which Overwhelms the Capabilities of the First Arriving Unit (s).

Revised: August 2007

predetermined response
Predetermined Response
  • Amount of resources that will automatically be issued based on the number of patients
  • First responding unit will notify dispatch center the MCI Level
  • There are 5 Levels of response

Revised: August 2007

mci level 1 response 5 10 victims
4 ALS Transport Units

2 Suppression units

1 Shift Supervisor

1 EMS Supervisor

MCI Level 1 Response (5-10 Victims)

Revised: August 2007

mci level 2 response 11 20 victims
6 ALS Rescue Units

3 Suppression Units

2 Shift Supervisors

2 EMS Supervisors

MCI Level 2 Response(11-20 Victims)

Revised: August 2007

mci level 3 responses 21 100 victims
8 ALS Transport Units

4 Suppression Units

3 Shift Supervisors

3 EMS Supervisors

1 Operations Chief

1 Command Vehicle

1 Supply Trailer

MCI Level 3 Responses(21-100 Victims)

Revised: August 2007

slide16
MCI LEVEL 4 Response

(101-1000 Victims)

  • 5 MCI Task Forces (25 units)
  • 2 ALS Transport Unit Strike Teams (10 units)
  • 1 Suppression Unit Strike Team (5 units)
  • 2 BLS Transport Unit Strike Teams (10 units)
  • 2 Mass Transit Buses
  • 5 Shift Supervisors
  • 3 EMS Supervisors
  • 1 EMS Chief
  • 1 Operations Chief
  • 1 Command Vehicle
  • 2 Supply Trailers
  • 1 Communications Trailer

Revised: August 2007

slide17
MCI LEVEL 5 Response

(Over 1000 victims)

  • 10 MCI Task Forces (50 units)
  • 4 ALS Transport Unit Strike Teams (20 units)
  • 2 Suppression Unit Strike Teams (10units)
  • 4 BLS Transport Unit Strike Teams (20 units)
  • 4 Mass Transit Buses
  • 10 Shift Supervisors
  • 6 EMS Supervisors
  • 2 EMS Chiefs
  • 2 Operations Chief
  • 2 Command Vehicles
  • 4 Supply Trailers
  • 1 Communication Trailers

Revised: August 2007

first arriving unit procedure

First Arriving Unit Procedure

Revised: August 2007

slide19
First Arriving

A. Unit Officer will establish “COMMAND”

1. Size-up and estimate number of victims

2. Request MCI level response

3. Identify a Staging Area

Revised: August 2007

slide20
First Arriving

4. Initiate triage with crew members and initial crews

a. Perform START or JumpSTART Triage

b. Prioritize victims

  • RED (Immediate)
  • YELLOW (Delayed)
  • GREEN (Minor)
  • BLACK (Non-salvageable)

5. Direct walking wounded to one location

Revised: August 2007

operational groups
1. Triage

2. Treatment

3. Transport

4. Staging

Operational Groups

Revised: August 2007

other possible operational groups
Other Possible Operational Groups

1. Medical Branch

2. Landing Zone

3. Extrication

4. Hazmat

5. Rehabilitation

6. Safety

7. PIO

8. Medical Intelligence

Revised: August 2007

start triage
START Triage

Revised: August 2007

initial triage
Locate and direct all walking wounded

Assign someone to keep green group together

Assess non-ambulatory

Use colored ribbons tied to upper extremity

Borderline use higher priority tag

Initial Triage

Revised: August 2007

secondary triage procedure
Secondary Triage Procedure
  • Perform during Treatment phase
  • Use DMS All Risk Triage Tag
  • Trauma criteria will apply

Revised: August 2007

adult start triage rpm
Adult START Triage RPM

Respirations

Perfusion

Mental

Revised: August 2007

respirations
Respirations
  • Less Than 30/minute – Go To Perfusion
  • Over 30/Minutes – RED Tag
  • No Respirations – Open Airway:
    • Breathing – RED Tag
    • Not Breathing – BLACK Tag

Revised: August 2007

perfusion
Perfusion
  • Radial Pulse present or Capillary Refill is < 2 seconds -

Go To Mental Status

  • No Radial Pulse or Capillary Refill > 2 Seconds – RED Tag

Revised: August 2007

mental status
Mental Status
  • Follows Simple Commands & AAOX3 –

GREEN

  • Does not follow commands, not AAOX3 or is Unconscious – RED Tag
  • Depending on Injuries – YELLOW Tag

Revised: August 2007

start flow chart
START Flow Chart

Revised: August 2007

pediatrics jump start triage
Pediatrics Jump START Triage

Revised: August 2007

jumpstart triage
Triage system adapted for pediatrics < 8 years old, which use a modify version of evaluating:

Respiration

Perfusion

Mental Status

JumpSTART Triage

Revised: August 2007

respiration
Rate between 15 and 45 BPM –

Go to Perfusion

Rate over 45 BPM or under 15 BPM – REDTag

No Respiration –

Open Airway and remove any obstruction

Still no breathing, than check radial or pedal pulse

No pulse - BLACK Tag

Pulse present Give 5 respirations –

Breathing begins – RED Tag

No breathing – BLACK Tag

Respiration

Revised: August 2007

perfusion1
Peripheral pulse present –

Go to Mental Status

Peripheral pulse absent –

RED Tag

Perfusion

Revised: August 2007

mental status1
Assess child with AVPU Scale

(Alert, Verbal, Painful, or Unconscious)

If unconscious or only responds to painful stimuli –

RED Tag

If child is alert or responds to verbal stimuli assess for further injuries -

YELLOW Tag or GREEN Tag

Mental Status

Revised: August 2007

jumpstart flow chart
JumpSTART Flow Chart

Revised: August 2007

all risk triage tags
All Risk Triage Tags

Revised: August 2007

slide42

Contaminated Section

  • Must remove if patient is not contaminated
  • If strip is not remove patient is considered contaminated.

Revised: August 2007

slide43
Contaminated Section
  • When the patient’s cloths are removed, the strip should be placed in the bag for evidence

Revised: August 2007

slide44

Front

Back

1 watch, 2 rings, and 1 wallet

  • Personal Property Receipt
  • Patient valuables in plastic bag

Revised: August 2007

slide45

Personal Property Receipt

Revised: August 2007

slide46

Front

HMW

R19

Back

John Smith

  • Patient Ground Transport Tracking Tag
  • Removed by Transport Officer for patient tracking

Revised: August 2007

slide47

X

X

X

Mark 1

  • Chemical Exposure Symptoms and Treatment
  • Salivation
  • Lacrimation
  • Urination
  • Defecation
  • G.I. Distress
  • Emesis
  • Miosis

Revised: August 2007

slide48

X

X

X

28

X

  • Patient Assessment
  • Decontamination
  • Area of injury
  • WMD type

Revised: August 2007

slide49

11:30 180/78 120 14

11:30 Normal Saline KVO

  • Vital Signs
  • Documenting B/P, Pulse, Respiration, and IV solution

Revised: August 2007

slide50

Triage Category

  • Remove all of the tags distal to desires color and half of the color.
  • Above is Yellow Tag

Revised: August 2007

slide51

X

X

X

X

START Triage Method

Revised: August 2007

slide52

John Smith

14801 SW 27 Street

Miramar FL 33027

Personal Information

Revised: August 2007

references
References
  • Stevens, Kay, and Garber, Debra. Introduction to Clinical Allied Healthcare. 2nd ed. Clifton Park, New York: Thomson Delmar Learning, 1996.
  • Jones and Bartlett Publishers. (2004). Florida Regional Common EMS Protocols, Sudbury, MA: Jones and Bartlett.

Revised: August 2007