Reference Handout for Disaster Medicine - PowerPoint PPT Presentation

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Reference Handout for Disaster Medicine

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Reference Handout for Disaster Medicine Triage RESCUER PPE: Exam Gloves New Each Victim OR Sterilize (10% bleach) Helmet Goggles N95 Face Mask TRIAGE PROCESS: – PowerPoint PPT presentation

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Title: Reference Handout for Disaster Medicine


1
Reference Handout for Disaster Medicine
Triage
  • SAVING LIVES
  • Airway (Head-Tile/Chin-Lift)
  • Bleeding (Pressure/Elevation)
  • Shock (Keep Warm/Lie Down)
  • TRIAGE STEPS
  • Stop, Observe, Think
  • Voice Triage First
  • Be Systematic
  • Evaluate/Tag All Victims
  • Treat I On The Spot
  • Document Findings
  • TRIAGE CATEGORIES
  • (I) Immediate
  • (D) Delayed
  • (M) Minor
  • (DEAD) Dead ( Deceased)
  • RESCUER PPE
  • Exam Gloves
  • New Each Victim
  • OR Sterilize (10 bleach)
  • Helmet
  • Goggles
  • N95 Face Mask
  • TRIAGE PROCESS
  • Can Victim Walk?
  • Victim Breathing?
  • Respiration Rate?
  • Blanch Test
  • Responsive?

- twice
Respiration lt 30/min Blanch Test lt 2 sec Mental
Status Responsive
2
Disaster Medical Operations Triage
  • CERT Supplemental Training
  • Module 1

3
Module Objectives
  • Specify killers requiring immediate treatment
  • Review how to open airway, control bleeding, and
    treat for shock
  • Conduct triage under simulated disaster
    conditions

4
Importance of Quick Action
  • Immediate Death within minutes result of severe
    trauma, not breathing, shock
  • Immediate Death within several hours result of
    excessive bleeding
  • Delayed Death in several days or weeks result
    of infection

Provide greatest good for greatest number by
conducting START (Simple Triage And Rapid
Treatment)
5
Importance of Quick Action
  • Emergency medicine killers
  • Airway obstruction
  • Bleeding
  • Shock
  • First priority of medical operations
  • Open airway
  • Control excessive bleeding
  • Treat for shock

6
How to Approach a Victim
  • Be sure victim can see you
  • Identify yourself
  • Your name and CERT Volunteer
  • Request permission to treat, if
    possible
  • (unconscious permission)
  • Respect cultural differences

7
What Do You Think?
  • What is the most common airway obstruction?

Student Manual pg 3-5 3-6
  • What is the most obvious sign of arterial
    bleeding?

Student Manual pg 3-9
  • What does it mean if a victim cannot follow
    simple commands, such as Squeeze my hand?

Student Manual pg 3-15
8
Head-Tilt/Chin-Lift Review
  • Only the head is manipulated to avoid spine
    injury
  • Listen and feel for breathing
  • If none, try second time before giving up

9
Types of Bleeding
  • Arterial bleeding
  • Bleeding from artery spurts
  • Venous bleeding
  • Bleeding from vein flows
  • Capillary bleeding
  • Bleeding from capillaries oozes
  • Bleeding from head abundant flow
  • Direct pressure elevation will stop most
    bleeding of any type

10
Shock
  • Ineffective circulation of blood in body
  • Shock can lead to unconsciousness and death
  • Maintain body temp with blanket under victim plus
    covering

11
Triage
  • Immediate (I) Victim has life-threatening
    injuries (airway, bleeding, or shock)
  • Delayed (D) Injuries do not jeopardize victims
    life treatment can be delayed
  • Minor (M) Walking wounded and generally
    ambulatory (use as assistants?)
  • Dead (DEAD) No respiration after two attempts
    to open airway

12
Triage Concept
  • Process for helping many victims
  • Victims are evaluated quickly
  • Victims are sorted by urgency of treatment they
    need
  • Victims are set up for immediate or delayed
    treatment
  • Minor injured
  • may be used
  • to help move
  • or assist

13
Triage Steps
  • Step 1 Stop, Look, Listen, and Think
  • Step 2 Conduct voice triage
  • Step 3 Follow systematic path around
  • Step 4 Evaluate each victim and tag
  • Check airway and breathing
  • Check circulation and bleeding
  • Check mental status (shock)
  • Step 5 Treat I victims immediately
  • Step 6 Document triage results

14
Triage Pitfalls
  • Poor team sizeup, organization, or goal
  • Indecisive leadership
  • Too much focus on one injury
  • Treatment (rather than triage) performed

15
Rescuer Safety During Triage
  • If hazmat or terrorist event is suspected, CERT
    members DO NOT respond
  • Evacuate as safely as possible
  • ALWAYS wear PPE
  • Helmet Goggles
  • N95 face mask
  • Work gloves
  • Sturdy shoes or boots
  • Non-latex exam gloves

16
What Do You Think?
Triage Evaluation
  • Victims will be shown and symptoms listed
  • You determine which category they are in
  • Press Enter to show book solution

Like this
17
Triage Evaluation
  • Victim 1
  • Bleeding from legs
  • Unresponsive
  • After two attempts to open airway, still not
    breathing

Dead
18
Triage Evaluation
  • Victim 2
  • Can walk and talk
  • Bleeding from left arm
  • Blanch test lt 2 sec
  • Respiration 25/min

Minor
19
Triage Evaluation
  • Victim 3
  • Bleeding from left arm
  • Conscious but wont follow commands
  • Respiration 38/min

Immediate
20
Triage Evaluation
  • Victim 4
  • Responds to voice triage
  • Bleeding from right arm and left leg
  • Respiration 26/min
  • Blanch test lt 2 sec

Minor
21
Triage Evaluation
  • Victim 5
  • Bleeding from head and left
    shoulder
  • Follows commands
  • Respiration 30/min
  • Complains of chest pain
  • Blanch test gt 2 sec

Immediate
22
Triage Evaluation
  • Victim 6
  • No bleeding
  • Leg pain and unable to walk
  • Breathing 20/min
  • Pulse 108 bpm

Delayed
23
Triage Evaluation
  • Victim 7
  • Bleeding from head
  • Responds to voice triage
  • Breathing 30/min
  • Blanch test lt 2 sec

Delayed
24
Triage Evaluation
  • Victim 8
  • No bleeding
  • Deformity to left wrist
  • Respiration 23/min
  • Blanch test lt 2 sec

Delayed
25
Triage Evaluation
  • Victim 9
  • Bleeding from leg with bone visible
  • Follows all commands
  • Respiration 29/min
  • Blanch test 2 sec

Immediate
26
Triage Evaluation
  • Victim 10
  • No bleeding
  • Complains of back pain
  • Follows all commands
  • Respiration 20/min
  • Blanch test 2 sec

Minor
27
Triage Evaluation
  • Victim 11
  • Abrasions on torso
  • Airway is clear
  • Does not follow commands
  • Respiration 17/min
  • Blanch test gt 5 sec

Immediate
28
Triage Evaluation
  • Victim 12
  • Can move all limbs
  • No bleeding found
  • Does not follow commands
  • Respiration 22/min
  • Blanch test 3 sec

Immediate
29
Triage Evaluation
  • Victim 13
  • Minor head bleeding
  • Airway seems clear
  • Does not follow commands
  • Respiration 30/min
  • Blanch test lt 2 sec

Immediate
30
Triage Evaluation
  • Victim 14
  • Minor bleeding from arm obviously pregnant
  • Complains of back pain
  • Follows all commands
  • Respiration 26/min
  • Blanch test lt 2 sec

Delayed
31
Triage Evaluation
  • Victim 15
  • Right leg bleeding
  • Complains of severe pain in leg
  • Follows all commands
  • Respiration 20/min
  • Blanch test 3 sec

Delayed
32
Triage Evaluation
  • Victim 16
  • No bleeding
  • Deformity in left leg
  • Crying does not follow commands
  • Respiration 26/min
  • Blanch test 2 sec

Immediate
33
Triage Evaluation
  • Victim 17
  • No bleeding visible
  • Unresponsive child
  • No respiration after head tilt and retry
  • Blanch test gt 5 sec

Dead
34
Triage Evaluation
  • Victim 18
  • Minor bleeding
  • Deformed right wrist
  • Follows all commands
  • Respiration 28/min
  • Blanch test 2 sec

Delayed
35
Module Summary
  • You should now be able to
  • Identify primary 3 killers
  • Apply techniques to open the airway, control
    bleeding, and treat for shock
  • Safely conduct triage in a disaster
  • Immediate
  • Delayed
  • Minor
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