HomeMy WebLinkAboutSOG 203.01V Reviewed 5-2015 Multi-Casualty Triagei. Goal
The goal of this policy is to define the standard of care for triage to be used in multi -casualty
incidents.
Il. Definitions
A. Multi -Casualty Incident — an incident in which the immediate medical needs of all
patients cannot be met by the medical resources available at that time.
B. START — acronym for the Simple Triage and Rapid Transport triage system.
III. Protocol
A. BF/R personnel will employ the START system to assist with prioritizing and managing
multi -casualty events.
B. The first arriving medical personnel will clear the area of "Walking Wounded" by
instructing them to move to a designated area.
1. These patients will be evaluated (using the parameters described below) once
the remaining patients have been assessed.
C. Those patients that remain after "clearing out" the walking wounded will immediately be
evaluated using the following system:
1. All patients are evaluated using three parameters:
a. Ventilation
b. Perfusion
c. Neurological Status
2. Assessment of these parameters will result in the patient being assigned to one
of three categories:
a. Dead/Non-salvageable
b. Critical/Immediate
c. 11 O-kyed
3. The assessment of each patient should take no longer than 60 seconds.
End r -se o ts:
Darioush Kavaspoul,
ICM -
Medical Director BEMSBFRS
522
Date Signed
4. The assessment of each parameter should be performed as follows:
a. Ventilation:
1) If adequate, move on.
2) If inadenuate, attempt to improve ventilation using basic
maneuvers such as removal of debris and positioning.
3) The patient is then classified as follows:
i. No respiratory effort = Dead/Non-salvageable
ii. Respiratory rate > 30 OR Requires airway assistance =
Critical/Immediate
iii. Respiratory rate < 30 = DeLayed
b. Per fusion:
1) The provider may use either capillary refill or the radial pulse to
evaluate this component. The patient is classified as follows:
patient is then classified as follows:
i. CR > 2 seconds OR No radial pulse
Critical/Immediate
ii. CR < 2 seconds OR Palpable radial pulse =
Go to next Assessment
a Neurological.
1) The assessment of the patient's level of consciousness will result
in classification as follows:
i. Unconscious OR Altered level of consciousness=
Critical/Immediate
ii. Normal level of consciousness = llehi € d
D. Once patients have been initially categorized as Immediate, Delayed, or Dead, the First
Responder responsible for triage shall complete a second, more detailed assessment of
the patients and assign individual, numeric priorities to each patient.
1. These individual priorities must be constantly updated (the patients re-
assessed.) by the Triage Officer.
2. Resources will be allocated per the priority designations above.
E. During multi -casualty incidents that involve lightning strike or electrocution, patients
who present in cardiopulmonary arrest should receive best priority. Survival rates with
rapid ACLS intervention for these injury types are high enough to warrant directing
resources to these patients.
Medical Director's Initials Il
Date IV jr
SOG 203.0 IV — Multi -Casualty Triage Page 2 of 2