Incident Command Triage Objectives Describe Incident Command System

Incident Command Triage

Objectives Describe Incident Command System Describe primary responsibilities of five functional areas of the incident command system Describe and demonstrate how to use ID-ME system Describe and demonstrate how to use the START system of triage

�National Incident Management System: Created by a 2003 federal mandate to create : � “a consistent nationwide approach for federal, state, tribal, and local governments to work effectively and efficiently together to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity” Incident: Anything out of the ordinary from day-to-day activities that necessitates a response Incident Command System (ICS): A formal, organized method for managing an incident, regardless of its cause, size, scope, or complexity.

Five Functional Areas of the ICS Incident Command Operations Section Planning Section Logistics Section Finance/Administration Section

Incident Command Managed by the Incident Commander Provides overall leadership Typically the most senior person among the initial responders. Primary tasks of Incident Commander Assume command of incident Establishes Command Post Provides overall management Determine incident objectives and strategies Determine and develop organizational structure

Operations Headed by Operations Chief Responsibilities include: Participating in the planning process Reducing immediate hazards Saving lives and property Establishing situational control Restoring the scene to normalcy

Planning, Logistics, Finance Make sure you’re prepared for an incident Determine resource needs Obtain resources and supplies Documentation and track costs

Triage is the process of prioritizing patients for treatment and transportation based on their clinical signs and symptoms Triage is performed during a Multiple Casualty Incident (MCI) “Do the most good for the most people. ”

ID-ME

Immediate- RED Vital signs and injuries so severe that the patient will die unless they receive medical treatment within two hours A head injury with AMS Severe Respiratory distress Tension pneumothorax Extensive 2 nd or 3 rd degree burns Uncontrolled bleeding Decompensated shock Extensive thoracic, abdominal, or pelvic injuries Amputation above elbow or knee

Delayed- YELLOW Needs medical attention but will not rapidly deteriorate if treatment is delayed up to 4 hours Moderate shortness of breath Compensated shock Moderate to severe bleeding that is controlled Penetrating injury without compromised airway Open fractures Uncomplicated cervical spine injury Severe abdominal pain with stable vital signs Unable to walk

Minimal- GREEN Could potentially go untreated for days Mild respiratory distress Closed fractures or dislocation with accompanying shock Minor to moderate bleeding Burns involving less than 20% of the body and not involving the head, face, or joints Isolated penetrating injury Frostbite Strains and sprains Minor head injury

Expectant- BLACK Already dead or expected to die Cardiac Arrest Severe head or brain injury 2 nd or 3 rd degree burn involving more than 70% of the body (recall rule of nines) Irreversible Shock Gunshot wound to the head

START Triage Simple Triage And Rapid Transport

1. Walking 1. 2. Ask those who can walk to move to a specific location and reassess later (minimal/green) Respirations 1. 2. 3. No respirations? (Expectant/Black) Greater than 30/min (Immediate/Red) Less than 30/min #3 Pulse 1. 2. 4. Cap Refill Greater than 2 seconds (Immediate/Red) Warm skin, cap refill less than two seconds #4 Mental Status 1. Unresponsive? Can they follow simple commands? 1. 2. If no (Immediate/Red) If yes (Delayed/Yellow)

30 -2 Can Do Walking… Heart Rate: 30 bpm Cap Refill: 2 Seconds Mental Status: “Can do”

Examples MCI quiz!

Case Study