Practical Exercise Andrew L. Garrett, MD Richard V. Aghababian, MD Practical Exercise Andrew L. Garrett, MD Richard V. Aghababian, MD Pediatric Disaster Life Support

Purpose  One of the goals of PDLS is to provide you with tools to better take care of children during a disaster  Triage is not a difficult process technically, but the stress of performing triage in the field can not be done in the classroom  One of the goals of PDLS is to provide you with tools to better take care of children during a disaster  Triage is not a difficult process technically, but the stress of performing triage in the field can not be done in the classroom

Scenario  As we are teaching this segment, a moderate earthquake strikes this region

Scenario  During the shaking, a schoolbus full of children and some adults swerves off of the road, down an embankment, and comes to rest in a parking lot. It has rolled over at least once.

Request for Volunteers  You are asked to join a quickly formed medical team to assist down the street  There is a hospital with a small emergency room just down the street  You have access to one ambulance, which can carry two patients  You are asked to join a quickly formed medical team to assist down the street  There is a hospital with a small emergency room just down the street  You have access to one ambulance, which can carry two patients

Accident Scene  There were reportedly 16 students and one driver  Many of the students are off of the bus  There was a fire after the crash  Fire and EMS personnel are removing patients

Your Mission  Triage the patients that are being deposited in the parking lot by fire department and EMS personnel  Categorize them as RED, YELLOW, GREEN, or BLACK  When you are done, tell the Loading Officer the order to transport to the hospital or place them at a treatment area at the school  Triage the patients that are being deposited in the parking lot by fire department and EMS personnel  Categorize them as RED, YELLOW, GREEN, or BLACK  When you are done, tell the Loading Officer the order to transport to the hospital or place them at a treatment area at the school

Patients on Scene

Time  Identifying the sickest patients needs to be done quickly  Triage should take less than seconds per patient  Slower while you are learning…  Keep moving as much as possible  Identifying the sickest patients needs to be done quickly  Triage should take less than seconds per patient  Slower while you are learning…  Keep moving as much as possible

No. 12 AGE: 10 years INJURIES: head injury MENTAL STATUS: awake AMBULATORY: no RESP. RATE: 28 PALPABLE PULSES: yes Each patient will have a number and a description of their injuries and vital signs

Make a List  In a disaster you will probably not have preprinted forms  Use a number or a triage tag to identify each patient  Make a list for the Loading Officer  Number on Patient  Triage Category (color)  Disposition (load them now, hold them on site for the time being)  In a disaster you will probably not have preprinted forms  Use a number or a triage tag to identify each patient  Make a list for the Loading Officer  Number on Patient  Triage Category (color)  Disposition (load them now, hold them on site for the time being)

Triage Identification  Colored tape or tags can be used, or a simple list can be made

Group Patients by Color A colored cloth, or a flag, or sign can help identify treatment areas on scene