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Emergency: Triage
ER: Triage
53
Anatomy
01/04/2012

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Term
With Military Triage, those with the __ serious wounds may be the first treatment priority. The goal is to get as many soldiers back into action as possible.
Definition
least
Term
With Civilian Triage, those with the most __ but realistically ___ injuries are treated first.
Definition
- most serious
- realistically salvageable
Term
In both models of triage, those with __ injuries are given lowest priority.
Definition
lethal
Term
Goal in disaster setting:
Definition
do the greatest good for the greatest number. maximize survival. UTILITARIAN RULE.
Term
Triage is a dynamic process in which __ minute assessments are performed and repeated.
Definition
one
Term
Levels of Triage:
Definition
- 0-Expectant-Black- patients have lethal injuries and will die despite treatment
- 1- Immediate- Red- Patients have life-threatening injuries that probably are survivable if treated immediately
2- Delayed- Yellow- Patients require definitive tmt, but no immediate threat to life exists, can wait for tmt without jepoardy
3-Minimal-Green- Patients have minimal injuries, are AMBULATORY, and can self-treat or seek later tmt
Term
Minor lacerations, contusions, and abrasions:
Definition
3-Minimal-Green
Term
Minor extremeity fractures
Lacerations with controlled hemorrhage
Burns less than 25% of body
Definition
2-Delayed-Yellow
Term
Tension pneumothorax
Respiratory distress
Major internal hemorrhage
Airway injuries
Definition
1-Immediate-Red
Term
Immediate response to tension pneumothorax:
Definition
Needle decompression: large bore needle into the 2nd intercostal space at the midclavicular line, put rubber valve calking around it so it can open/close
Term
Devastating head injuries
Major 3rd degree burns over most of body
Destruction of vital organs
Definition
0-Expectant-Black
Term
what is included in 1 minute exam during triage:
Definition
- airway
- breathing
- circulation (perfusion)
- mental status
Term
START Triage- adults
JumpSTART triage- children
Definition
Term
Patient is not breathing, you reposition airway and they start breathing, what category:
Definition
1-Immediate-Red

See slide 15 of Triage lecture for good diagram
Term
Patient is breathing at greater than 30 rpm, what category?
Definition
1-Immediate-Red
Term
Patient is breathing at less than 30 rpm, what now?
Definition
- Check perfusion
Term
Patient is breathing at less than 30 rpm, when you check perfusion, their capillary refill is greater than 2, what now?
Definition
1-Immediate-Red
Term
Patient is breathing at less than 30 rpm, capillary refill is less than 2, what now?
Definition
check mental status
Term
Patient is breathing at less than 30 rpm, their capillary refill is less than 2 seconds, and when asked to perform simple exams the cannot. What now?
Definition
1-Immediate-Red
Term
Patient is breathing less than 30 rpm, their capillary refill is less than 2 seconds, and when asked to perform simple commands they can. what now?
Definition
2-Delayed-Yellow
Term
In a child, according to the JumpSTART triage model, if they are not breathing, but have a pulse, you should perform __ __ __. If they are still apneic, they are in the __ category, if they start to breathe, they are in the __ category.
Definition
- 5 rescue breaths
- 0-expectant-black
- 1-immediate-red
Term
If the respiratory rate is less than __ rpm or greater than __ rpm, they should be in the __ category.
Definition
- less than 15 rpm
- greater than 45 rpm
- 1- immediate- red
Term
If someone has a respiratory rate between 15 and 45, but does not have a palpable pulse, what category are they in?
Definition
1-Immediate- Red
Term
all walking wounded:
Definition
3- minimal- green
Term
how can you check perfusion?
Definition
radial pulse and capillary refill
Term
Patient is breathing less than 30 rpm, when you check perfusion there is no radial pulse, what now?
Definition
- control bleeding
- 1- immediate- red
Term
Patient is breathing less than 30 rpm, there is a radial pulse, what now?
Definition
assess mental status
Term
The Initial assessment and treatment of each patient is accomplished within 30 seconds. Initial treatment is limited to correcting immediate life-threatening conditions (i.e. opening an airway and controlling severe bleeding)
Definition
Term
first thing you do when arrive at a disaster scene?
Definition
make sure the scene is safe, then direct walking wounded (green) away from scene to predetermined eval and tmt area
Term
Where do you start once you know surrouding is safe?
Definition
patient closest to you
Term
ALL green pts must be individually assessed in __ __.
Definition
secondary triage
Term
Who should be assessed first in secondary triage?
Definition
children that were carried there and thus did not prove they could walk
Term
what does AVPU stand for?
Definition
- Alert
- Verbal
- responsive to Pain/Posturing
- Unresponsive
Term
child is breathing b/w 15 and 45 and has a palpable pulse. they are unresponsive to pain and are abnormally postured and unconscious, what do you tag them as?
Definition
1-Immediate-Red
Term
child is breathing b/w 15 and 45 no palpable pulse:
Definition
1-Immediate-Red
Term
child is breathing b/w 15 and 45, pulse is palpable, they are alert and respond to voice and pain.
Definition
2- Delayed- Yellow
Term
For __ children due to young age or disability, use the __ methond.
Definition
nonambulatory
JumpSTART
Term
Unambulatory child due to age or disabilities, if they meet __ red criteria tag them as red.
Definition
any
Term
There is no widely recognized civilian MCI triage tool used in the US for any of the NRBC agents.

Definition
Term
with WMD, must consdider __
Definition
decontamination
Term
example of biosurveilance tool:
Definition
First Watch Program
Term
Some agents cause __ that allow for prediction of outcome based on presenting signs/symptoms.
Definition
toxindromes
Term
__ _ is limiting factor in MCI triage.
Definition
resource availability
Term
In order for MCI triage to work toward its goal, all victims must have equal importance at the time of primary triage. No patient group can receive special consideration other than that dictated by their physiology.
Definition
Term
This pt cannot move or feel legs, respirations are 24, radial pulse of 100, awake and oriented, how would you triage this patient?
Definition
2-Delayed-Yellow
Term
Blood soaked shirt, respiratons 36, capillary refill less than 2 seconds, awake and oriented. How would you triage?
Definition
1-Immediate-Red (b/c respirations are greater than 30)
Term
Minor abrasions on forehead, respirations 16, cap refill less than 2 seconds, very slow in recalling his name and whereabouts. How would you triage?

Definition
1-Immediate-Red b/c head injury
Term
Pt has no apparent injuries, Unconscious, respirations are 20, cap refill less than 2 seconds. How would you triage?

Definition
1-Immediate-Red
Term
PT lying quietly on floor, unconcsious, not breathing, cap refill more than 2 seconds, what is the first thing you would do?
Definition
reposition airway
Term
PT lying quietly on floor, unconcsious, not breathing, cap refill more than 2 seconds, what is the first thing you would do?
- Reposition the airway, adjust head position
Still doesn’t start breathing, how would you triage?
Definition
0-Expectant-Black
Term
In triage, what does RPM stand for?
Definition
respirations
perfusion
mental status
Term
Give example of circumstances in which you could provide medical treatment during the initial triage?
Definition
- not breathing
- bleeding profusely
Term
Give example of circumstances in which you could provide medical treatment during the initial triage?
Definition
- not breathing
- bleeding profusely