Field triage

Tzong-Luen, W., Chi-Ren, H. (2005). Appraisal of field triage in mass casualty incidents in Tapei. Annals of Disaster Medicine, 3(2), 69-75. 

The SAVE triage was developed to direct limited resources to the subgroup of patients expected to benefit most from their use. The SAVE assesses survivability of patients with various injuries and, on the basis of trauma statistics, uses this information to describe the relationship between expected benefits and resources consumed. Because early transport to an intact medical system is unavailable, this information guides treatment priorities in the field to a level beyond the scope of the START methodology (Benson et al., 1996). 

Field trauma triage systems currently used by emergency responders at mass casualty incidents and... 

In the hospital or at the scene of a mass chemical contamination, nurses may be asked to accurately decide which patients need care, in what order should they receive care, and in situations of severely constrained resources, who should not receive care at all. This is an extremely difficult scenario for the nurse and will create personal emotional distress. This type of disaster triage is best practiced in field exercises and drills prior to participation in a real event (Veenema, 2003). 

Figure 1. The principles of triage in the EMT point and Field hospital for nerve agent casualties which used in the ASSISTEX-I...

There was a Triage officer at the entry point of Field hospital (Expert in Mass Casualties Management) who was responsible to re-triage the patient as well as two other medical doctors one of them expert in Intensive care to supervise the treatment of patients with severe exposure or traumatic injuries in the ICU and another one to supervise the treatment of casualties in other wards of... 

An important activity in the medical operation of the exercise was Triage of chemical casualties, the Iranian Medical team used an standard procedure for triage (primary and secondary) in the EMT point and field hospital as well. 

B. Instruct field evacuation teams to transport casualties to an uncontaminated area. Resistant or disoriented individuals should be restrained in the triage area after they have been given the necessary first aid. 

Field management of a contaminated casualty or of a casualty in a contaminated environment is cumbersome and manpower-intensive. In front of each medical care facility, from battalion aid station to field hospital, there must be a casualty-receiving station if casualties are contaminated, or if casualties are entering from a contaminated area. In this station, casualties are (a) triaged, (b) given the emergency care that can be provided with both casualty and medical care provider encapsulated in protective garments, (c) decontaminated, and then (d)... 

Triage is not a static process but a dynamic one that occurs at every echelon of medical care, preferably several times. The first triage is done by the field medic or unit lifesaver when he encounters an injured soldier in the field. The medic first decides whether anything can be done for that soldier to save life or limb. If the answer is no, the medic moves on, perhaps after administering an analgesic. More commonly, the medic decides that care is indicated. Can the medic provide that care on the spot to return the soldier to duty quickly Can the care wait until the battle is less intense or an ambulance arrives Or must the care be given immediately if the casualty is to survive In the latter case, the medic will do what is possible to return the casualty to the medical facility. 

At the first echelon of medical care, the chemical casualty is contaminated and both he and the triage officer are in protective clothing. Furthermore, the first medical care given to the casualty is in a contaminated area, on the hot or dirty side of the hotline at the emergency treatment station (see Figure 13-1 in Chapter 13, Field Management of Chemical Casualties). This is unlike the clean side of the hotline at any echelon of care where casualties are decontaminated before they enter, or un-... 

---