So, How Did You Do? As a segue from the exercise to the PPT, this slide could be projected on the screen as the students find their seats after the simulated.

So, How Did You Do? As a segue from the exercise to the PPT, this slide could be projected on the screen as the students find their seats after the simulated self-triage exercise.... Or it can be deleted... It’s just a place holder... NACCHO

2006 Advanced Practice Centers for Preparedness Training Conference
MCI Triage: 2006 Advanced Practice Centers for Preparedness Training Conference Sub graphics (copyright problems?) Kelly to send Ronna new pics v NACCHO

Why Am I Here? How do I decide? ...TRIAGE
In a disaster, needs exceed resources More patients than providers Difficult choices must be made Who receives care now? Who does not? How do I decide? ...TRIAGE NACCHO

Triage and Public Health Competencies
Sub with graphic from NRP? CDC & CUSN-CHP (2002). Bioterrorism & Emergency Readiness: Competencies for All Public Health Workers, p. 12 NACCHO

Objectives Define “Triage” Identify goals of MCI triage
Implement “MASS” Triage Classify MCI victims by “ID-me” categories Toss last item? NACCHO

In a Perfect World... All “we” have to do is take care of them!
First responders respond to scene Patients are triaged in the field HazMat handles decon in the field Sickest patients arrive with EMS: Already sorted and tagged Already decontaminated Already partially treated All “we” have to do is take care of them! NACCHO

What REALLY Happens... “Chaotic” phase: 15-25 min
No EMS, no scene leader 80% of minimally injured self-transport They arrive at closest hospitals: NO TRIAGE NO DECONTAMINATION NO MEDICAL INTERVENTION Check viability of pics (copyright?) NACCHO

Another Awful Thought... Hospital as “Hot Zone” Or....
It’s your “off “day Or… Flu Pandemic, Bioterrorism… NACCHO

Triage: Definition Sorting of patients by seriousness of condition and likelihood of survival [Self-explanatory] NACCHO

Triage: Goals Primary Goal: Secondary Goal:
Greatest good for the greatest number of possible survivors Secondary Goal: Relief of suffering Depend on available resources NACCHO

Triage Systems Multiple triage systems in use
Various methods using tags, categories, colors, symbols Familiarize yourself with your agency’s system and PRACTICE it IDEAL = one uniform system used by all agencies in the field & at hospitals Add examples of the various triage systems list by name There are several different modern triage systems in use, derived from both military and civilian sources. They employ different methods of classifying and tagging victims using symbols, colors, and other devices. Healthcare workers, first responders and EMS personnel among you might want to take the time to familiarize yourself with the system used by your agency. Ideally, everyone – both field personnel and hospital personnel – would use the same system. This would minimize confusion and maximize communication. ____________ NACCHO

“M.A.S.S.” Triage A – Assess S – Sort S – Send M – Move
Redo the graphics…. Again, “MASS” is an easy-to-remember acronym that stands for “move, assess, sort and send”. The system has been tested and validated for handling large numbers of casualties in mass casualty incidents (MCIs). It utilizes U.S. military triage categories. One may also think of this system as it refers to “MASS” casualty incidents. Conducted in the “T” step of DISASTER MASS – Designed to quickly sort large numbers of victims that are in the same proximity. NACCHO

“M.A.S.S.” Triage Developed by the military
Tested & used by the military Adapted for civilian disasters It works! Fast Accurate (70%) Can handle large numbers of victims NACCHO

...ASSESS individual victims
“M.A.S.S.” Triage GROUP victims first... then.... ...ASSESS individual victims NACCHO

Basis of “M.A.S.S.” Triage Ability to MOVE best predicts survival
Head Injury patients Glasgow Coma Scale (GCS) MASS Triage is based on research which shows that the motor component of the Glasgow Coma Scale is the best predictor of mortality for trauma patients. In other words, a patient’s ability to move strongly correlates with outcome. Let’s see how this works…. NACCHO

“M.A.S.S.” Triage “MOVE”: STEP 1 Goal: Action:
Group - Victims who can WALK Action: “Everyone who can hear me and who can walk, please move to the area with the green flag.” The first step in the MOVE portion of MASS triage is to identify the minimally injured patients who require the least critical care. These patients are awake and ambulatory (and would have a normal score of 6 on the motor portion of the GCS). They are identified by asking “everyone who can hear me and who can walk, please move to the area with the green flag”. These victims then become the green, MINIMAL group. MINIMAL NACCHO

Why Bother With Them FIRST?
MINIMAL group: major vital functions intact Assess last, after more critical groups However, actively managing this group may: Facilitate scene management Conserve scene resources Reduce self-transports & overburdening of nearest hospital ERs Caveats: No individual assessment, yet Worsening conditions Brief screening of this group will reveal the following: Airway, breathing, and circulation are intact. Mental status is also intact, at least to the extent that they can follow commands. These patients are NOT likely to have low blood pressure or breathing trouble. As such, this group should undergo formal assessment LAST, after that of the more critically injured victims. Why invest time to identify this group early? Active management of this group will conserve scene resources for those victims with the most dire need. And it may reduce self-transports and unnecessary overburdening of hospital emergency departments by minimally injured persons. Hence, limited hospital resources can be saved for the more critically ill, as well. Limitations: not based upon individual assessment yet. Some conditions may worsen over time, necessitating triage to a more urgent category. Ideally, trained personnel should monitor and frequently reassess these patients, re-triaging as needed. This gets them out of the way so that you may find the higher priority patients This also puts them in one area so they may be contained and assessed there when enough personnel become available ideally, assign someone to keep them in that area or else they will wander off. These patients must be assessed and reassessed as soon as possible as patients may deteriorate and change from their initial triage categories NACCHO

“M.A.S.S.” Triage “MOVE”: STEP 2 Goal: Action:
Group – Victims who can’t walk, but who can MOVE Action: Ask the remaining victims “Everyone who can hear me and needs help, please raise an arm or leg so we can come help you.” The next group to be identified during the “MOVE” Step of MASS Triage is the DELAYED group. These victims cannot walk, but are awake and able to follow commands to MOVE an arm or a leg. They are identified by asking the remaining victims, “everyone who can hear me please raise an arm or a leg so that we can come help you”. This becomes the yellow, DELAYED group. DELAYED NACCHO

“M.A.S.S.” Triage “ASSESS”: Goal: Action:
Group – Identify who is left, victims unable to walk & unable to follow simple commands to move Action: Go immediately to these patients for life-saving interventions (if medically trained) Now that all the patients who can MOVE have been identified, MASS triage next focuses on ASSESSMENT of those victims who are left. Since they cannot either ambulate or follow simple commands to move (lower score on the motor scale of the GCS), it is assumed that they are more critically injured. Rescuers must proceed immediately to these patients to deliver critical life-saving interventions. This group of victims is now the red, IMMEDIATE group. Go to these patients first and deliver immediate life-saving interventions (bleeding control, airway opening, perhaps a MARK 1 kit), but that’s it for this moment. Whatever category the patient is in, tag him as such and move quickly to the next IMMEDIATE (failure to tag patient will result in another rescuer having to spend time triaging the same patient). Don’t forget that some of these patients may belong in other triage groups despite their initial grouping as immediate. For example, some may be dead or expectant. Expectant patients are those with likely fatal injuries. Dead patients should be tagged as such to prevent consumption of resources or wasting time by having other personnel attempting to triage the patient again. NACCHO

“M.A.S.S.” Triage “ASSESS” IMMEDIATE patients: Goal:
Accurate count of IMMEDIATE patients Action: Rapidly Assess ABCs If not or already DEAD Correct immediate life threats… EXPECTANT The next step in the sequence is the individual ASSESSMENT of IMMEDIATE patients. The goal is to obtain an accurate count of these most severely injured patients who still have a chance of survival if proper treatment can be delivered quickly. (Similarly, victims who are either EXPECTANT or DEAD will also be identified during this stage.) (The I.C. or Transport Officer should contact hospitals to advise them of the number of patients on-scene and to ask how many IMMEDIATE patients each hospital can accept………he must then ensure that the patients are distributed to the different hospitals in a logical manner and order) ABCs are assessed VERY rapidly. Is a likely fatal injury – such as a massive open brain injury -- present? If yes, the patient is assigned to the EXPECTANT group and the rescuer proceeds to the next patient. If the patient does NOT meet criteria for triage to expectant or dead categories, a LIMITED number of immediate life threats can be managed, but only in a most basic way at this time. These are listed on the next slide…. NACCHO

“M.A.S.S.” Triage “ASSESS” IMMEDIATE patients: Open Airway
Stop Bleeding Give Chemical antidote Need to qualify FIRST, Is the victim’s airway open? If not, open it manually with a jaw thrust or similar maneuver. NEXT, with the airway opened: Is the patient breathing? If not, he or she is assigned to the EXPECTANT group, and the rescuer proceeds to the next patient. NEXT, if the patient IS breathing: Is uncontrolled bleeding present? If so, apply direct pressure or a tourniquet. We will come back to this in a moment. (In contrast to what we were taught with boy scouts, basic first aid, basic life support or even advanced life support, one should not hesitate in THESE CRITICAL CIRCUMSTANCES to use a tourniquet, if necessary. The goal in this setting is to save a life, and it may be necessary to sacrifice a limb. Try to record on the patient the time the tourniquet was applied.) It may be necessary to assign someone else to do this, so that the rescuer can keep moving… FINALLY, In the setting of a nerve agent exposure, antidote kits, if available, may also be administered at this time. From a practical standpoint, this may be ALL the rescuer can do during this phase. Some authors include needle decompression of a tension pneumothorax with this list – assumes one has a large-bore angiocatheter handy! “D” for “decompression” or “dart” the chest! NACCHO

“M.A.S.S.” Triage “ASSESS” IMMEDIATE patients: Stop Bleeding
Open Airway Stop Bleeding Give Chemical antidote Pressure Points Whatever it takes! Be creative! Delete In contrast to what we were taught with boy scouts, basic first aid, basic life support or even advanced life support, one should not hesitate in THESE CRITICAL CIRCUMSTANCES to use a tourniquet, if necessary. If an actual tourniquet is unavailable, alternative devices that can fill this need include: gauze bandages, belts, brassieres, disposable gloves or anything else that might be at hand. The goal in this setting is to save a life, and it may be necessary to sacrifice a limb. Try to record on the patient the time the tourniquet was applied. It may be necessary to assign someone else to do this, so that the rescuer can keep moving… FINALLY, In the setting of a nerve agent exposure, antidote kits, if available, may also be administered at this time. From a practical standpoint, this may be ALL the rescuer can do during this phase. Some authors include needle decompression of a tension pneumothorax with this list – assumes one has a large-bore angiocatheter handy! “D” for “decompression” or “dart” the chest! Tourniquets NACCHO

Move on! “M.A.S.S.” Triage Question: Is transport available?
“ASSESS” IMMEDIATE patients: Question: Is transport available? Move on! Delete While this assessment is underway, consider the availability of TRANSPORT means for these most severely injured victims. The incident commander or triage officer will contact receiving hospitals to advise them of the number of IMMEDIATE patients and to determine how many each facility can accept. Above all, keep moving. This assessment and intervention stage must be performed quickly, in order to identify as many salvageable patients as possible. Minimize the amount of time spent with each patient until all IMMEDIATES have been individually assessed. NACCHO

Victim Group Summary Goal Action ID-me Group Minimal Delayed Immediate
Group ambulatory patients “Everyone who can hear me and needs medical attention, move to the area with the green flag” Minimal Group awake, can follow commands “Everyone who can hear me, raise an arm or leg so we can come help you” Delayed Identify who is left Go immediately to these patients for life-saving interventions Immediate NACCHO

ONLY NOW Do We Assess Individuals
Having grouped victims according to their ability to move... ...The next phase entails more detailed individual assessment. Change assess to sort NACCHO

“M.A.S.S.” Triage “SORT”: Goal: Actions:
Sort patients based upon INDIVIDUAL assessment Actions: Assign to “ID-me” Categories: IMMEDIATE, DELAYED, MINIMAL, Continue treatment Change assessment to sorting The next step, after moving groups of patients, is to SORT victims based on individual assessment. To a certain extent, this sorting process has already occurred during the MOVE and ASSESSMENT stages, using the “ID-me” mnemonic to classify patients into the RED (immediate), YELLOW (delayed), GREEN (minimal) and BLACK (expectant) groups. (In some systems, EXPECTANT patients are assigned a BLUE tag, with BLACK being reserved for DEAD patients.) We will return to a detailed explanation of this category in a moment. Treatment also continues during this phase, as preparations are made for evacuation and transport, the final step. EXPECTANT NACCHO

“M.A.S.S.” Triage “SORT”: Start with those who could MOVE
Unless sufficient personnel for all groups Ideal: trained medical personnel May not be available Tag immediately upon triage Including dead victims Now that the most immediately-needed life-saving interventions have been performed on the IMMEDIATE patients, all the rest of the patients are individually assessed and then sorted further in to the most appropriate triage category. (starting with the DELAYED group……..unless there are enough rescuers to start all groups simultaneously) The individual assessments would be best performed by trained medical personnel. However this of course may not be possible. TAG patients as they are triaged…….otherwise they will be triaged by multiple personnel, wasting time. Dead patients should also be tagged as such to prevent wasting resources to re-triage the patient. We will return to this in a moment…. NACCHO

There Are Many Different Patient Assessment Tools
A number of patient assessment tools may be used at this stage. CERT L.A. 2003 NACCHO

START Triage “R” “P” “M”
Many of us are likely familiar with one such triage system, “START”, which stands for “Simple Triage and Rapid Treatment”. Originally developed by the Newport Beach, CA Fire and Marine Department, START is the current Department of Transportation standard triage system. Recall the 3 steps of START Triage, “R”, “P”, “M”, which stand for Respiration, Perfusion and Mental Status. This slide illustrates the algorithm. As you can see, it is somewhat complicated and includes parameters that might be impractical under dire MCI conditions. For example, the assessment of capillary refill (“blanch test”) might be nearly impossible or unreliable when the patient is cold or covered with debris (?contaminated) or blood, or in the dark. A somewhat simplified version of this algorithm has been developed.... “M” NACCHO

“ID-me” Categories I - IMMEDIATE D - DELAYED M - MINIMAL E - EXPECTANT
LETHAL INJURY E - EXPECTANT I – Needs IMMEDIATE care, but still potentially salvageable D – Needs definitive care, but not likely to die in next few minutes if care is DELAYED M – MINIMALLY injured “walking wounded” (& uninjured) E – EXPECTANT: “expected” to die soon because of the severity of injuries. Some systems use a BLUE tag for this category, to distinguish it from the BLACK used for those confirmed dead. D- Some agencies use a separate category/tag for victims that are already confirmed to be DEAD. NACCHO

“M.A.S.S.” Triage “SORT” – IMMEDIATE: Life- or Limb-threatening injury
Airway, Breathing or Circulation Problem Unconscious Examples: Unresponsive, altered level of consciousness, severe breathing difficulty, uncontrollable bleeding, amputations above elbow or knee, blue skin color, rapid or weak pulse, open abdominal wounds, etc. If IMMEDIATE patients are found to be among the other triage groups, then immediately render life-saving interventions, TAG them, and move them to the IMMEDIATE area or the TRANSPORT area and advise the I.C./Triage Officer of the additional IMMEDIATE pt. Examples of this category are shown on this slide. NACCHO

“M.A.S.S.” Triage “SORT” – DELAYED:
Need definitive medical care, but should not worsen rapidly, if initial care is delayed Examples: Deep cuts or open fractures with controlled bleeding and strong pulses, finger amputations, abdominal injuries with stable vital signs, closed head injuries without altered LOC, etc. Human nature will likely compel rescue personnel to “over-triage” victims from the DELAYED category to the IMMEDIATE (RED) group. Such over-triage may complicate resource allocation, however. These patients should generally be OK to wait on transport until all the IMMEDIATEs have left the scene Ideally they will be physically grouped together into a DELAYED area, marked with YELLOW signs/flags/tarps/etc… Ideally a team of rescuers will be monitoring and treating them until they are transported If their condition changes, their triage category can be changed at any time and they can be moved to the other category’s physical collection area Examples of conditions triaged to the delayed group are listed here. NACCHO

“M.A.S.S.” Triage “SORT” – MINIMAL: “Walking wounded”
Group, sort & facilitate transport from scene Volunteer help? Risk vs. Benefit Examples: Scrapes, bruises, minor cuts, no apparent injuries The next group to be individually sorted is the MINIMAL group. Ideally they will be physically grouped together into a MINIMAL area, marked with GREEN signs/flags/tarps/etc… Ideally a team of rescuers will monitor and treat them until they are transported, watching for deterioration due to “hidden” injuries missed during the initial triage. If their condition changes, their triage category can be changed at any time and they can be moved to the other category’s physical collection area If medical providers and equipment can be brought to the scene, then it may be possible to treat and release them AT THE SCENE (thus keeping the hospitals from being overwhelmed). Or they may be enlisted as volunteers to provide comfort to the dying, to hold pressure on exsanguinating wounds, and so on. On the other hand, their presence at the scene may contribute to confusion and disorganization. Similarly, one must consider the drain on resources they might create. NACCHO

“M.A.S.S.” Triage “SORT” – : EXPECTANT
Most severely injured with little chance of survival They are “expected” to die soon In a perfect world, they would receive the most care, even though chance of survival is low In an MCI.... EXPECTANT Consolidate to one slide Who is left???? By this point, ideally, only EXPECTANT and DEAD victims will remain. Ideally, the expectant victims will be physically grouped together into an EXPECTANT area, marked with BLACK (sometimes BLUE) signs/flags/tarps/etc… Which patients are classified as EXPECTANT? They are the most critically injured, the most critically ill victims who still show some signs of life. They are the patients who, in an ideal world of a well-equipped and well-staffed ED, would receive the most intensive care and who might even survive. In an MCI setting, however, there are insufficient resources to render such intensive care for them; consequently, they are “expected” to die. As with the other groups, a team of rescuers should monitor and treat them until they are transported, if possible. If their condition changes, their triage category can be changed at any time and they can be moved to the other category’s physical collection area. As more resources become available and the IMMEDIATEs have been dealt with, more resources can be devoted to this group. Until then, one must recall that death might be hours or days away. Hence, any measure of comfort care possible should be provided. These patients should not be abandoned. NACCHO

“M.A.S.S.” Triage “SORT” – : EXPECTANT
Care resources NOT utilized initially Comfort care as available Death could be hours or days away! Reassessment & transport Transport those still alive after all IMMEDIATE victims evacuated Resuscitate & treat as resources allow EXPECTANT Who is left???? By this point, ideally, only EXPECTANT and DEAD victims will remain. Ideally, the expectant victims will be physically grouped together into an EXPECTANT area, marked with BLACK (sometimes BLUE) signs/flags/tarps/etc… Which patients are classified as EXPECTANT? They are the most critically injured, the most critically ill victims who still show some signs of life. They are the patients who, in an ideal world of a well-equipped and well-staffed ED, would receive the most intensive care and who might even survive. In an MCI setting, however, there are insufficient resources to render such intensive care for them; consequently, they are “expected” to die. As with the other groups, a team of rescuers should monitor and treat them until they are transported, if possible. If their condition changes, their triage category can be changed at any time and they can be moved to the other category’s physical collection area. As more resources become available and the IMMEDIATEs have been dealt with, more resources can be devoted to this group. Until then, one must recall that death might be hours or days away. Hence, any measure of comfort care possible should be provided. These patients should not be abandoned. NACCHO

“M.A.S.S.” Triage “SORT” – : EXPECTANT Examples: Near 100 % burns
Fatal radiation doses Absent pulse or breathing Especially if multiple injuries Severe open brain injury Death “imminent” “Judgment call” NACCHO

Triage Caveats OVER-TRIAGE:
Tendency to classify all victims as IMMEDIATE Defeats the purpose! Ruptured eardrums, chronic hearing loss, language barrier, developmental handicaps, etc. Cannot respond to “MASS” commands Combine over and under triage slides NACCHO

Other Triage Caveats UNDER-TRIAGE:
Initial grouping ≠ individual assessment Worsening patient conditions: Internal or external bleeding, shock Closed head injury Blast injury to lung, gut, brain Airway swelling Delayed chemical exposure symptom onset Etc. NACCHO

“M.A.S.S.” Triage “SORT” process is dynamic: Resources change
Patient conditions change Frequent reassessment All categories may become IMMEDIATE “Most serious” injury present demands “immediate” attention! EXPECTANT It is critical to remember that the “SORT” process of “MASS” triage – or of ANY triage system – is DYNAMIC. This is true for ALL categories. Triage requires frequent reassessment. Once the IMMEDIATE (RED) group has been evacuated, the EXPECTANT (BLACK) group moves “up” to become the new IMMEDIATE (RED) group. In other words, the most “serious” injury present demands the immediate attention of on-scene personnel. Similarly, the LAST patient on the scene also moves “up” to become the most IMMEDIATE patient for attention and treatment, regardless of injury severity. NACCHO

Triage Tags Tag immediately after sorting
Tie triage tag directly to patient May need to improvise tags (tape, exam gloves, cloth) May need to write on patient (lipstick, marker) Kelly will send pics of triage tags to Ronna TAG each patient as he/she is categorized. Otherwise another rescuer will waste time re-tagging the same patient. The tag should be tied securely directly to the patient (not to clothing or shoes, which will be removed and perhaps lost). If formal triage kits are not available, improvise with tape or even by writing on the patient with a pen, lipstick, whatever is available. NACCHO

Wrapping up the SORT... When all patients have been triaged and tagged: Count all IMMEDIATES Advise incident commander or transport officer of number Take all IMMEDIATES to collection point for urgent transport When all patients have been sorted and tagged, count all the IMMEDIATES and give the info to the Inc Command or Transport officer. All the IMMEDIATES must be moved to a collection point for urgent transport. The Transport Officer will have to control the flow of transport units into the scene and will have to ensure there are enough units en route he will also need to ensure that the most urgent patients are transported first It is essential that a clear route of egress be preserved for the transport units to leave the scene………it is not uncommon for incoming units to block EMS units in landing zones for helicopter transports may be needed and patients may need to be further prioritized for ground versus air transport NACCHO

“M.A.S.S.” Triage “SEND”: Objective:
Transport or release ALL living patients ASAP Traditional sequence: IMMEDIATE DELAYED MINIMAL The final step of MASS triage is to “SEND” - to evacuate, to transport or to release all living patients as soon as possible. Traditional sequence, not surprisingly, is Immediate > Delayed > Minimal > Expectant. EXPECTANT NACCHO

“M.A.S.S.” Triage “SEND”: Be mission-focused: Be resourceful:
Send MINIMALS or DELAYEDS with each IMMEDIATE, if space allows Be resourceful: Secondary treatment facilities for MINIMALS Be creative: Buses, taxis, trains, boats, etc. Hence, if vehicle space and resources allow, patients in the MINIMAL (GREEN) group can be sent with patients in the IMMEDIATE (RED) group. Once again, in the direst circumstances, the “GREEN” patients can assist in providing basic first aid or other tasks during the transport of the critically ill or injured. However, ambulance transport of IMMEDIATE victims should not be delayed while waiting to locate a MINIMAL patient to ride along. Moreover, as mentioned in previous sections, it is best not to tax resources by flooding hospitals that are receiving the most critical victims with a flood of “walking wounded”. Scene management and incident command will be facilitated by moving as many of these “MINIMAL” patients to secondary facilities, such as a makeshift clinic set up in a school gymnasium or other location. This process can be expedited by the use of non-conventional vehicles, such as buses, taxis, trains and boats. NACCHO

What About The DEAD? Should NOT be moved or sent 1 EXCEPTION?
Medical examiner / coroner: Identification of remains Disposition of remains Crime scene investigation: Evidence must be preserved Apprehend perpetrators and prevent future attacks What about the dead slide? What about the dead? First and foremost, the dead should NOT be moved or sent during the initial response. The highest level medical director should personally re-assess all black-tagged patients and affirm their designation as DEAD. If final determination has been made that patient is dead and no resuscitation is to be attempted, DO NOT DISTURB THE REMAINS OR THEIR IMMEDIATE SURROUNDINGS***. Why? evidence may be lost that could have lead to; proper identification of the remains cause of death time of death crucial information about the incident determination of whether this was an accident or an act of terrorism The person or persons responsible for the attack/crime PREVENTION of future attacks ***Exception- small soft-tissue fragments may rapidly degrade if exposed to high temperatures (thus DNA may be denatured). If these are the only remains found, it may be advisable to obtain permission from law enforcement personnel to quickly move the tissue out of sunlight and into a cool area to preserve the DNA. Law enforcement authorities will typically determine the deceased victim’s disposition (whether the body will be released to the family or if an autopsy/investigation is to be performed by the medical examiner/coroner/etc…). This may vary according to state law. Also: better not to strain on-scene resources caring for fatalities. Even for non-terrorism events, it is best to defer this care until additional specialized personnel and resources arrive, such as federal DMORT teams, to be discussed in a later presentation. NACCHO

The Need To Drill Regardless of which triage system your agency favors... ...Practice, practice, practice! “TRIAGE TAG TUESDAY” Preparation will promote more efficient triage in an actual MCI Sex it up NACCHO

When All Is Said and Done...
MCI Triage is NOT “business as usual” Difficult decisions must be made Fatalities and suffering are likely “Gut check” for healthcare providers “Non-medical” people can participate NACCHO

Summary: Now you can Define “Triage” Identify goals of MCI triage
Implement “MASS” Triage Classify MCI victims by “ID-me” categories Delete last bullet point NACCHO

Thank You! Questions? NACCHO

So, How Did You Do? As a segue from the exercise to the PPT, this slide could be projected on the screen as the students find their seats after the simulated.

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So, How Did You Do? As a segue from the exercise to the PPT, this slide could be projected on the screen as the students find their seats after the simulated.

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Presentation on theme: "So, How Did You Do? As a segue from the exercise to the PPT, this slide could be projected on the screen as the students find their seats after the simulated."— Presentation transcript:

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