Triage Guideline Golden Hour - The Period

Transcript

TRIAGE GUIDELINE Golden Hour - the period of time in which the treatment of the patient in shock or with traumatic injuries is most critical. The period of time is generally thought to be the first 60 minutes after the injury. One or more of the following triage locations may be established: 1. Arts Centre Studio B, C, D 2. Cafeteria 3. Gymnasium 4. Carpentry Shop 5. Any classroom with large windows Incident Commander First person to arrive at scene becomes the Incident Commander ▪ Assumes and announces command ▪ Ensure area is safe (ensure valves have been shut off) ▪ Identifies patient needs and resources ▪ Three major components: ▪ extricate ▪ triage (treat) ▪ transport ▪ Once Campus Manager arrives he will take over the role of Incident Commander ▪ Designate an assistant ▪ Delegates to Triage Officer and Transport Officer ▪ Ensures disaster response kits, first aid supplies and maps are obtained ▪ Facilitates with RCMP and Fire Department and Ambulance Triage Officer The second person to arrive at the scene becomes the Triage Officer. ▪ Coordinates Triage Team (use fan out list to call first aiders) as members arrive ▪ Be prepared to sort and prioritize casualties using the universal 60 second assessment (consciousness, breathing, hemodynamic status) ▪ Be prepared to aid 30-40 casualties. On-site first aid and emergency medical care will be supplemented by Red Deer Ambulance Services. ▪ Only the Triage Officer should have triage tags ▪ Ensure four collection areas are set up: ▪ immediate transport (red) ▪ secondary transport (yellow) ▪ walking wounded (green) ▪ Morgue (black) ▪ All casualties are colour-coded using triage tags: ▪ RED - high priority, most urgent ▪ YYEELLLLOOW W - medium priority ▪ GREEN - low priority, non urgent ▪ BLACK- lowest priority, dead (must be transported to hospital to determine need for autopsy) RED - high priority High priority casualties are those who have serious injuries or medical problems. Their chance for survival depends on prompt and efficient medical care. In this category are the following: ▪ Cardiac arrest ▪ Airway and breathing problems (respirations are greater than 30 per minute) ▪ Deep shock - no radial pulse present, cold clammy skin, capillary refill greater than 2 seconds ▪ Uncontrollable bleeding or severe blood loss ▪ Open chest or abdominal wounds ▪ Severe head injuries ▪ Diabetic state (with complications) ▪ Poisoning ▪ Abnormal birth situation in which there is an arm or leg present ▪ Unconscious ▪ Burns involving respiratory track ▪ Several major fractures YELLOW - medium priority Second priority casualties are those for whom treatment and transportation can be delayed while more seriously injured persons are cared for. These injuries include: ▪ Fractures (as long as any associated serious bleeding can be controlled) ▪ Back injuries -even those with spinal cord damage-can be detained on the scene as long as they are carefully immobilized and protected against further injury. ▪ Burns ▪ Spinal column injury ▪ Moderate blood lose ▪ Conscious with head injury GREEN - low priority Low priority casualties are those who should be cared for when all other persons have been treated and prepared for removal. In this group are: ▪ Minor fractures and wounds ▪ Contusions/abrasions ▪ Minor burns. BLACK - lowest priority Deceased casualties - evidence of death is categorized as PRESUMPTIVE (an assumption based on available information) and POSITIVE (when no doubt exists as to the person’s death). Also in this category are: ▪ Persons already dead ▪ First Aiders will assess and treat all casualties within the scope of their training Transportation Officer ▪ Controls traffic and ensures traffic flow ▪ Directs ambulance movement and ensures paramedics wait in the vehicle ▪ All vehicles check in at Staging Area ▪ Delegate tasks as necessary ▪ Ensure casualties are tracked (triage tag numbers and destination including mode of transportation i.e. ambulance, taxi) First Aiders Meet at the Health Centre or Casualty Collection Centre, and report to the Occupational Health Nurse ▪ First Aiders will assess and treat all casualties within the scope of their training. Casualty Recording Person Transportation Officer Casualty Count Person