Triage

[Malthouse]

Some of you will know what this is, a few will have had the displeasure of carrying it out. This topic is not for the feint hearted. Nor is it "first aid" really.

But for those who want to know...

Used only where the number of injured people is greater than the resources can cope with, it is perhaps a very relevant skill in the event of the SHTF.

Triage is a method used by medical and rescue professionals to decide who to spend their time on. It is a cold and brutal concept, but it has been proven time and time again to work. The way the pros do it is slightly more complex, but here I have assumed you are on your own dealing with many hurt/trapped people.


Step one is to call out for anyone who can walk, to move to a relatively safe/sheltered spot. Here they can be assessed by anyone with basic first aid skills, often this is one of the casualties themselves.

Step two is to move quickly from each injured and immobile person in turn, with the emphasis on quickly. The aim here is to identify the injuries that you can do something about. You are looking for breathing, if they are not breathing then adjust their position and see of they improve. You are also looking for how well their heart is circulating blood, the methods used will vary with your skills. If they are breathing and showing signs of good circulation, then flag them up as needing assistance. Then move on.

Step three after covering all of the casualties and flagged up the ones that can be helped, you now make sure someone is doing so. If it is only you then you have to ignore the others. If you have first aiders who can help (again possibly walking wounded themselves) then delegate.

[mallie99]

My SOH watches Greys Anatomy and there was something interesting on an episode the other day... Someone had triaged victims of a major incident and used a sharpie pen to put information on the exposed skin of patients. I thought this was interesting, partly as I always carry a sharpie pen with me anyway...

The episode had the person in question writing vital signs on the patients, without any real charts and method of transferring that information with the patients I thought it was a handy thing, though not everyone can read BPM and Blood Pressure... But anything (such as name, patient ID (make one up, start with 1), allergies, pain scale, alertness, known injuries) would help everyone in such a situation.

[damaralenoire]

It is these sort of exercises that you get to practice at St John Ambulance. Very worth while getting the practice of that mindset

[Yorkshire Andy]

I had this argument with our First aid at work trainer...



he set a car accident scenario at night i was the first person to stop... 3 casualty's one man sat in his car with abdominal injuries groaning in pain and bleeding.. chid in the back screaming child in the back of car and a woman (an anni) laid unresponsive in the road..

i made "the car" safe got the guy in the car to apply pressure himself with a dressing having first told him to keep still and not move his head or neck...

child was "uninjured" from what you could see and was happily screaming..

So moved onto the anni not breathing so set to work on that



I was told i had done the wrong thing as i should have stayed with the first casualty i came across as the man in the car eventually became unconscious

[Malthouse]

Speaking as a first aid instructor, based on your description, you did it right. You checked everyone out then took action.

Had you been told about triage and to use it? If so then resus is a waste of your time. But in training you cant assume a cpr manikin is a lost hope, I like to swap them for real people and see who notices

[Yorkshire Andy]

No, No mention of Triage, All i was told about the Annie was that she had been hit by the car and was unconscious and not breathing...


Also the first "do not put yourself at risk scenario"


involved another debate on how a laptop could electrocute the first aider when the "victim" was unconscious holding angina medication and had knocked a cup over into the laptop..


Then again it cant beat the Nutty Health and safety woman on a risk assessment course who was convinced that a Cat 2 diffuser was fitted in the class room to catch the glass to prevent injury if the florry tubes explode

[Malthouse]

No, No mention of Triage, All i was told about the Annie was that she had been hit by the car

Yup, bang on in that case. In First Aid we want to deal with the unconscious casualty first.

Were you trained in and been in an appropriate role for that scenario, then dealing with the abdo injury was probably the priority. But the point is, you dealt with the scene according to your training and as you saw fit. All good!

[Yorkshire Andy]

You incorporated the drunken tramp / bloke sleeping on the street in your training

they got the grizzly guy to lay on the floor wrapped in a wool blanket...


and sent people in one by one.....

"you have just found this man laying in the street do what you need to do"


3/4 of the group didnt even follow the DRAB......


half of them were "calling" 999 before even doing a basic assessment and this was on day 3.....


when you tested for a Response he was told to twitch and shout BOO

[cpslashm]

Excellent topic - wouldn't know where to begin.

Better find out.

[Survivalist85]

On the very basic first aid training i received with the military we were taught to write on people. If you had already given them morphine then they get a big black M on their forehead so to let the medics know when they turn up. same with blood pressure or other important info.