Triage © BASICS Education March 2019

Triage - objectives Understand the nature of triage Describe where triage is carried out

Triage Why Where When Who

C.S.C.A.T.T.T. Triage Treatment Transport Triage, from the French to sieve or to sort

Triage - aims Right patient Right place Right time Right transport

Triage - dynamic system First look – on scene Casualty Collection Point – identified locations around the ship Evacuation Medical centre Evacuation from ship

Triage - priorities P T Description Colour 1 Immediate Red 2 Urgent Yellow 3 Delayed Green 1 hold Dead 4 Expectant Blue White/Black

Triage - Priority 1 (Immediate) Casualties who require immediate life-saving interventions T1

Triage - Priority 2 (Urgent) Casualties who require surgical or other interventions within 2 - 4 hours T2

Triage - Priority 3 (Delayed) Casualties whose treatment may be safely delayed for >4 hours T3

Triage - Priority 4 (Expectant) Casualties whose injuries are either so severe that they are unlikely to survive, or whose treatment would compromise the care of others Highest level decision T4

Triage Decisions need to be made quickly safely reproducibly

Triage Sieve On-scene first look Can they walk? No interventions EXCEPT : opening the airway/recovery position tourniquet Can they walk? “If you can walk go over there”

BREATHING? when airway opened Triage sieve Y PRIORITY 3 (Delayed) WALKING? N N BREATHING? when airway opened DEAD Y Y RESPIRATORY RATE <10 >30 PRIORITY 1 (Immediate) 10 - 30 >120 PRIORITY 2 (Urgent) PULSE RATE <120

Paediatric Triage Tape OPTIONAL SLIDE

Triage Sort Follows Triage Sieve Triage Revised Trauma Score (TRTS) Reassesses clinical priorities Allows a senior clinician to input as well Triage Revised Trauma Score (TRTS) GCS Systolic BP Respiratory rate

Triage labelling Indicates that triage has been done Indicates the current triage priority Forms part of the patient records

Triage Labelling OPTIONAL SLIDE

Alternatives? Simple alternatives coloured sticky tape Coloured clothes pegs big pen The only absolute requirement is that everyone must understand the system

Identifying the T4 category EXPECTANT T3 expectant T3

Triage Questions?

Triage - summary Triage is the first step in medical support Triage is dynamic Triage sieve quickly assigns priorities Triage sort refines the priorities Triage labels indicate current priority

Carnival UK Immediate Care Course