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Triage: Handling Mass Casualty Situations

Added Dec 05, 2013 •

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Medical triage is the key to doing the most good for the most people whenever there are more victims than rescuers, resources are limited and time is critical. This training video provides an overview of the medical triage process and portrays the steps that CERT members need to follow to provide victims the most effective lifesaving support available until professional responders arrive on scene. This video will support the materials presented in the CERT Basic Training course Unit 3: Disaster Medical Operations Part 1. CERT trainers will be able to use the material presented in the video to start a dialogue about the potential challenges CERT members may face.

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many of us would be fortunate to never experienced a mass casualty incident however the situation occurs where there are many casualties with limited First Response capability may be needed to **** triage and treat victims for Community emergency response team team of professionally trained community volunteers ready to help when called upon to save lives and property  mass casualty situations can be overwhelming do you know what to do when faced with more victim turn the available resources can handle the key to helping an overwhelming number of victims is a process called triage  triage is a French term that means to soar triage is used in situations where there are more victims and Rescuers there are limited resources time is critical cert members will triage victims to distinguish among those who need immediate care you can wait those who are dead when you use triage you're trying to possible  the goal of triage is to identify victims who are having problems with three killers they are breathing problems excessive pleading are shocked and to treat these victims immediately for these conditions  triage begins at the end next site as soon as victims are located victims are sorted into three categories based on their conditions three categories are and media I delayed D or dead victims triage is immediate priority have a life-threatening injury involving air bleeding or shock that must be treated immediately to save the person's life  victims triage of delayed have injuries which do not immediately Starlight the victim needs care but that care can be delayed while other victims with life-threatening injuries are triage and treated victims triaged as dead or not breathing after 2 attempt to open the airway unfortunately in a mass casualty situation there is not enough what time or resources to perform CPR other victims from receiving immediate life-saving treatment certain member may have to do but if you're tied up doing CPR you cannot treat other people who may live if they receive immediate treatment  as victims are initially tree last rescuer should treat those with life-threatening injuries as they are found all victims will then be taken to a designated medical treatment area organizing a medical treatment area is covered in a future lesson when conducting triage you must protect yourself and your buddy your buddy must do the same if you don't protect yourself and your buddy you can what help any victims and can actually make the situation worse by becoming a victim triage precautions include avoiding hazardous Ariel's avoiding unsafe situations wearing your safety equipment wearing gloves either latex or non-latex when treating victim changing or sterilizing gloves between victims basic safety equipment includes gloves Google's dust mask preferably one labeled n95 helmet and Boots  each Time We Touch Inuvik your gloves must be cleaned to avoid cross-contamination you do not want to contaminate your next victim with your previous victims blood or body fluids can prevent cross-contamination by changing gloves or sterilizing gloves if changing gloves remember that the outside of both clouds is contaminated you do not want to touch the outside of either glove with bare skin to remove the first glove pinch the outside of the glove near the stop Edge remove the glove by turning inside out hold it in the second gloved hand to remove the second glove tuck to bear inside the top of the glove be careful to avoid touching the outside contaminated surface of the glove with bareSkin remove II let's turning inside out  be sure to dispose of the gloves properly  cert member should have a supply of clean glove in their kit what happens if fresh gloves are not available you can sterilize used gloves by dipping them in a solution of one part household bleach 10 parts water be careful not to immerse the gloves as a contaminated bleach water will enter the top of the glove and contaminate your hand the bleach Lucian will be effective as long as it smells like bleach  when the smell is gone it's time to mix a fresh batch of the solution there are six steps to conducting triage step one size up the situation and make a plan step to conduct voice triage  step 3 follow a systematic route step for triage and tag each victim ID or dead step five treat eye victims immediately step 6 document triage results there are several methods to tag and keep track of how many victims you triage into each category you can put a piece of tape with i d or dead on the victim forehead to count how many victims are in each category Market triage form or place a piece of tape on your leg with categories I Dr dead  place a tally mark for each victim triage in each category some jurisdictions will use triage tape tags with green for walking wounded yellow for delayed red for immediate and black for dead if you use triage tape put a tape for each triage to victim in your pocket so you can track numbers of victims later the size of a situation stop look around and listen take the time to gather information such a type of incident number of victims lay of the land and risk factors you'll need this information to make decisions and develop plans for you can your buddy ICD 9 or 10 people  I don't see any turn off I don't see any chemical spills a seamless safe okay great let's move to that area over there we can have our walking wounded over there think about you and your buddies safety capabilities and limitations be realistic decide if you will approach the scene if you decide to approach plan how you will do it make sure that each member of the team knows the plan and his or her job and carrying it remember size up is a continuous process conditions may change and you will need to constantly evaluate them and change your plan for your safety come to our voices for the Emergency Response Team Real help you after signs that conductive voice triage asking who won the can walk to come to the sound of your voice you was walking wounded to assist you or have them eggs at the area pick a spot where you want The Walking wounded be sure the area is free of Hazards after you lied entify the area in a loud voice call out Emergency Response Team you can walk come towards my voice direct them to the safe area  these survivors are tagged D for delayed solo one person from this group to tag the others d  it is important that these ambulatory survivors stay in one area ask one or more of the survivors to help keep all the ambulatory victims in the same area until additional help arrives now you are ready to triage those who remain it is important that you don't miss anyone start where you stand start with the closest victim use the systematic pattern you decided on in your plan my name is David to tell I'm at the emergency response team how to see here she is over there way you talking to us she's breathing Superman we're going to be going to be helping you out you're doing well you're doing well  they're going to go on  I think he's turn it off triage each victim tag everyone using I-4 immediate D4 delayed or dead treat immediate and I victim needs immediate attention for life-threatening conditions you'll need the first check Airway breathing second check bleeding circulation third check mental status treat all I've victims for the three killers tag as I before continuing triage that is open the airway stop excessive bleeding and treat for shock remember that only these life-threatening conditions should be treated during the initial triage as we go through these procedures you will recognize Tim from the previous lesson do not try these treatment procedures until you have received classroom Hands-On training at arm's length from the victim shake the person's shoulder and Shout can you hear me if the person does not respond check Breathing by opening the airway using the head tilt chin lift method look listen and feel for air exchange if the victim is not breathing tried open the airway Again by repositioning it if the victim is not breathing after two tries opening Airway tag the victim dead and move on to the next if the victim is breathing check the victim's breathing rate  if breathing is faster than 30 breaths per minute which is one breath every 2 seconds tag the victim I maintain the airway by placing something under the victim's neck control bleeding and treat for shock before moving on to the next victim if the patient's breathing is below 30 breaths per minute and normal check for bleeding this step has two parts controlling bleeding and checking circulation  first if the victim has is there bleeding apply direct pressure and elevation to control bleeding then tag the victim as I  after controlling bleeding or if there is severe bleeding check circulation using what is known as the blanch test the blanch test is used to check how quickly capillaries refill to perform this test press on an area of skin until normal skin color is gone  a good place to do this is the palm of the hand the nail beds can also be used let's go and time how long it takes for normal skin color to return a capillary refill time longer than 2 seconds indicates poor circulation and shock the blanch test is not valid in children mental status should be used as the main indicator shock in children  if the environment is too dark to see The Blanche test you can check for a radial pulse in the wrist no radio pause indicates poor circulation and shock tag the person I if you feel a radial pulse check their mental status checking mental status is the next step in triage to check the mental status asked the victim to follow a book command such as squeeze my hand if the victim is unable to follow simple and basic commands tag I if the victim can follow simple command is breathing under 30 breaths per minute and pass the Blanche test tag the person D for delayed we know that this person not have Airway circulation or shock problems at the moment  now let's practice triage so are you okay are you okay  I want to turn my back and straighten his leg out please on the count of three one two three someone else is there a way okay shallow breathing  will take a cap refill now is low cap refill look like he's in shock go ahead and put a towel under his angle almost sick one underneath of neck Meaghan Rath that'll let me watch the next person please can you help me Miley okay I'll tell him with Emergency Response Team and we're here to help Julian  tell me your hand calculate refill slow  games to play to get into shock remember Selena when she can for shock who did Legoland sorry man we got to owl LOL hey I think we need to tag her medium got a text are you okay can you hear me was taken down here to the farm how are you in a 5K what's the new way to breathing system yeah he responds in there on the leg hey can we take a rain delay can you melt a glue stick when performing triage if the victim fails any of the test for one of the three killers breathing problems severe bleeding or shock the status is I if the victim pass is all tests he or she can wait for delayed treatment tag the person D everyone gets a tag Remember All Eyez get Airway management bleeding control treatment for shock before you and your buddy move to the next victim  after triage victims in an area document what you've done record the number of victims by an ID or dead category and their locations this documentation will be important for your team if you move the victims to a central medical treatment area and will help other responders when they arrived on the scene medical triage is the key to doing the most good for the most people Whenever there are more victims and Rescuers resources limited and time is critical follow these steps and you will provide victims the most effective life-saving support available

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