Field Care Audit - April 2014 START Triage

48 %
52 %
Information about Field Care Audit - April 2014 START Triage
Health & Medicine

Published on October 23, 2014

Author: DocMontey

Source: slideshare.net

Description

April 2014 - RMH Field Care Audit on MCI's and START Triage

1. Off to a good s.t.a.r.t. Trauma Triage and Mass Casualty Incidents V. Bonales, M.D. RMH PreHospital Care Medical Director HCEMCC Paramedic Coordinator

2. Mass Casualty Incident Any incident that overwhelms the available resources 9/11 Two person EMS crew arriving at scene with three victims

3. Mass Casualty Incident First unit on scene declares MCI When additional units start en route, first unit starts triage Usually involves setting up an Incident Command System Triage, Treatment, Transport

4. Mass Casualty Incident Triage everyone according to START Treatment of manageable injuries Transport in order of priority and for definitive care

5. - Assess and control the accident scene - Tamponade external hemorrhage with direct pressure - Protect the spine after blunt trauma - Extricate the patient - Supplement inspired O2 - Stabilize long bone fractures

6. S.T.A.R.T. Simple Triage And Rapid Treatment/Transport

7. Triage Principles

8. Triage Principles Triage – Fr. trier = to sort Napoleon’s surgeon Larrey established the ambulance corps and a method of setting priorities for the evacuation of war casualties - he picked up the war wounded that could be saved by quick intervention (ie. amputation) - other surgeons quickly bandaged those that could go back and fight

9. Triage Principles Civil War: Formal establishment of military field ambulance service Surgeons continued the practice of collecting those who could benefit from immediate medical intervention

10. Triage Principles WWI and WWII Increased use of field medics and the “buddy system” Increased use of antibiotics Aid stations and surgical hospitals moved

11. Triage Principles Korean War MASH units and helicopters helped to further decrease the number of battlefield casualties This was further improved upon in the Vietnam conflict where death rates decreased from 30% to 24% Afghan and Iraq war casualty rates now 10%

12. Triage Principles

13. Triage Principles START Triage Team of two can assess an average of one patient every 30 seconds. 40 casualties, two triage teams will take approximately 10 minutes to accurately assess Only treatment rendered by the triage team open a patient’s airway by head tilt /neck lift by insertion of an OPA apply direct pressure to stop an obvious bleed or by elevating the extremities.

14. Triage Principles START by those who STARTed it…

15. START Triage

16. Assess, Treat, (use bystanders) When you have a color STOP - TAG - MOVE ON minor Move Walking Wounded decease d NO RESPIRATIONS after head tilt* immedia te Breathing but UNCONSCIOUS Perfusion Capillary refill > 2 or NO RADIAL PULSE Control bleeding Mental Status Unable to follow simple commands delayed Otherwise REMEMBER: Respirations < 30 Perfusion < 2 Mental Status - Can Do

17. Triage Principles · Evaluate patient using START · Tear off the bottom of the tag · Tear off a tracking slip and place it in the kit · Attach tag to the patient with a tie · Give tracking slips to the Triage Officer

18. Triage Principles A lot of GREEN helps… but goes fast.

19. Triage Principles Be like Visine… … Get the Red OUT!

20. Triage Principles Don’t let YELLOW mellow… re-assess!!

21. Triage Principles IMMEDIATE-by-mechanism Depending on their injury Age Medical history

22. Triage Principles 16 year old with bleeding scalp lac. 17 year old with no spontaneous respirations or pulse 35 year old with foreign body 47 year old with open tib-fib fracture

23. Triage Principles 30 year old with dislocated ankle 5 year old who seems confused and won’t talk 24 year old with broken finger 38 year old with no heartbeat and no spontaneous respirations

24. Triage Principles 19 year old with burns to soles of feet 29 year old with no visibile injuries 7 year old with no pulses and no spontaneous breaths after 2 rescue breaths 36 year old with penetrating trauma and a swelling belly

25. Assess, Treat, (use bystanders) When you have a color STOP - TAG - MOVE ON minor Move Walking Wounded decease d NO RESPIRATIONS after head tilt* immedia te Breathing but UNCONSCIOUS Perfusion Capillary refill > 2 or NO RADIAL PULSE Control bleeding Mental Status Unable to follow simple commands delayed Otherwise REMEMBER: Respirations < 30 Perfusion < 2 Mental Status - Can Do

26. Questions??

Add a comment

Related presentations

Related pages

CANADIAN TRIAGE AND ACUITY SCALE (CTAS) NATIONAL GUIDELINES

disposition. The Canadian Triage and Acuity Scale (CTAS) attempts to more accurately define patients
Read more

Canadian Triage and Acuity Scale (CTAS) / Prehospital CTAS ...

Canadian Triage and Acuity Scale (CTAS ... Triage patients according the type and severity ... open the presentation and start looking through ...
Read more

(ESI) -Emergency Severity Index Web Site

Emergency Severity Index, Version 4: Implementation ... to level 5 (least resource intensive). The ESI is unique among triage tools, by ...
Read more

Guidelines for Field Triage of Injured Patients ...

National Expert Panel on Field Triage of Injured Patients. Membership as of December 2011. Chair: Gregory J. Jurkovich, MD, Harborview Medical Center ...
Read more

Areas of ESI algorithm - (ESI) -Emergency Severity Index ...

Appendix B. ESI Triage Algorithm, v. 4 ©ESI Triage ... The algorithm and the contents of the DVD set and implementation handbook may be ...
Read more

Triage Home - Triage Central Limited

Triage operates a number of programmes on behalf of the Government which support people in ... April 23, 2014 After three years of unemployment due ...
Read more

Triage Education and ED Consulting - Triage First

Triage First, as the recognized authority regarding emergency department triage education, was instrumental in developing and sustaining momentum (and ...
Read more

Triage | Define Triage at Dictionary.com

How 9/11 Made Journalists Part of the Story Allison Gilbert May 17, 2014 . I often wonder if I ... Triage is used on the battlefield, ...
Read more

Triage | Definition of Triage by Merriam-Webster

... the process of deciding which patients should be treated first based on how sick or seriously injured…triage in a sentence. ... April Words of the ...
Read more