Triage station

Triage Station. Help separate people to be vaccinated by directing them to the holding area for the appropriate station ... 

Warm/Dirty Adjacent to the hospitai, usuaiiy near the Emergency Department (remote to the reiease site) Hospitai decontamination area. This area needs a source of water (coid ciimates require a warm water source) for decontamination and barriers to controi entrance and exit from the area, which must be tightiy controiied. Personnei working in this area (first receivers) have potential to be exposed to the contaminant(s) and, therefore, must wear the appropriate level of PPE (level C minimum). At the entrance to the Warm Zone is the initial triage station. All ambulance and walk-in cases must enter the facility after going through this triage station. Victims who are clearly not contaminated skip the Warm Zone and enter the Cold (Clean) Zone directly. All others proceed into the Warm Zone for decontamination. 

The entry point is a clearly demarcated area into which all casualties arrive. Ambulances unload casualties at this point, and ambulatory casualties report to this point. The entry and exit roads must also be clearly marked. Organic (ie, intrinsic) staffing in this area may be minimal, and all casualties arriving at this area will be sent to the triage station. The Triage Station... 

At the time of the attack, there were no established measures to deal with chemical weapons, decontamination was not undertaken, and no antidote was administered at the sites of the attack. During the initial critical hours when doctors could have played an important role, none were present at the sites of the attack. At the request of the Tokyo Fire Department, a total of 73 medical staff - 47 doctors, 23 nurses and three clerks - were dispatched to 4 subway stations for triage and emergency treatment (Chigusa, 1995). However, because they reached the stations after 9 00 am, they did not provide emergency medical treatment such as tracheal intubation. 

The triage officer sorts each casualty into one of the four triage categories immediate, minimal, delayed, or expectant (Exhibit 13-1). At lower echelons of care, the triage officer may be a senior medic (who may also be the staff at the emergency treatment station) at higher echelons, he may be a physician s assistant, dentist, or physician. 

The triage officer will send casualties (a) back to duty, (b) to the emergency treatment station, (c) to the decontamination area, or (d) to the dirty evacuation area. 

In the most forward MTF, the emergency treatment station will likely be staffed by the same senior medic who functions as the triage officer. At higher echelons of care, a physician s assistant or physician might staff this station. 

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)... 

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-... 

In the event of significant numbers of live casualties, the ambulance service will appoint officers to coordinate communications, the casualty clearing station, ambulance parking and loading as well as personnel safety and triage. 

Officers responsible for triage in the bronze area (primary triage ojficers) and at the casualty clearing station (secondary triage ojficers) will be appointed by the ambulance service. 

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