PEDIATRIC DISASTER TRIAGE UTILIZING THE JUMPSTART METHOD MARCH
![PEDIATRIC DISASTER TRIAGE UTILIZING THE JUMPSTART © METHOD MARCH 2016 (4 TH EDITION) PEDIATRIC DISASTER TRIAGE UTILIZING THE JUMPSTART © METHOD MARCH 2016 (4 TH EDITION)](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-1.jpg)
![Disclaimer This slide set and all related training information provided in this session is Disclaimer This slide set and all related training information provided in this session is](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-2.jpg)
![Acknowledgements • This 4 th edition education program was developed under the direction and Acknowledgements • This 4 th edition education program was developed under the direction and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-3.jpg)
![Objectives • Identify unique characteristics that make children more vulnerable in a disaster • Objectives • Identify unique characteristics that make children more vulnerable in a disaster •](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-4.jpg)
![Introduction Introduction](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-5.jpg)
![Background Illinois Emergency Medical Services for Children (EMSC) 1984: National EMSC Program established through Background Illinois Emergency Medical Services for Children (EMSC) 1984: National EMSC Program established through](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-6.jpg)
![Illinois EMSC Pediatric Disaster Preparedness • 2002: • Illinois Pediatric Bioterrorism Workgroup convened • Illinois EMSC Pediatric Disaster Preparedness • 2002: • Illinois Pediatric Bioterrorism Workgroup convened •](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-7.jpg)
![Illinois Communities • Illinois is the 5 th most populous state with a population Illinois Communities • Illinois is the 5 th most populous state with a population](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-8.jpg)
![Children and Disasters Children and Disasters](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-9.jpg)
![Disaster “A medical disaster occurs when the destructive effects of natural or man made Disaster “A medical disaster occurs when the destructive effects of natural or man made](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-10.jpg)
![Natural Disasters • Earthquake • Flood • Snow/ice storm • Tornado • Others Natural Disasters • Earthquake • Flood • Snow/ice storm • Tornado • Others](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-11.jpg)
![Human Caused Disasters • Terrorist Events • Arson • Bombings • Shootings • Use Human Caused Disasters • Terrorist Events • Arson • Bombings • Shootings • Use](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-12.jpg)
![Terrorist Events and the Pediatric Population Myth Kids are secondary victims of terrorism and Terrorist Events and the Pediatric Population Myth Kids are secondary victims of terrorism and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-13.jpg)
![Harsh Realities: Children as Victims of Disasters • 1984: Bhopal, India – Industrial gas Harsh Realities: Children as Victims of Disasters • 1984: Bhopal, India – Industrial gas](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-14.jpg)
![Why Children are More Vulnerable During Disasters Lack of appropriate sized equipment and supplies Why Children are More Vulnerable During Disasters Lack of appropriate sized equipment and supplies](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-15.jpg)
![Respiratory Airway is smaller and more narrow Higher risk for respiratory issues Depend on Respiratory Airway is smaller and more narrow Higher risk for respiratory issues Depend on](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-16.jpg)
![Exposure Faster respiratory rates More susceptible to: infections effects of agents prolonged exposures hypothermia Exposure Faster respiratory rates More susceptible to: infections effects of agents prolonged exposures hypothermia](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-17.jpg)
![Trauma Rib cage is higher Higher risk for injury, irreversible shock and death from Trauma Rib cage is higher Higher risk for injury, irreversible shock and death from](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-18.jpg)
![Developmental May lack cognitive ability to sense a dangerous situation Increased exposure and risk Developmental May lack cognitive ability to sense a dangerous situation Increased exposure and risk](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-19.jpg)
![Developmental May be nonverbal or not know personal information Age & developmental level influences Developmental May be nonverbal or not know personal information Age & developmental level influences](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-20.jpg)
![Children with Special Health Care Needs (CSHCN)/Children with Functional Access Needs (CFAN) • Can Children with Special Health Care Needs (CSHCN)/Children with Functional Access Needs (CFAN) • Can](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-21.jpg)
![Triage Triage](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-22.jpg)
![Triage • • • Sorting and prioritizing patients Looks at the medical needs and Triage • • • Sorting and prioritizing patients Looks at the medical needs and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-23.jpg)
![Triage • Primary Triage • • Typically performed at the scene of the incident Triage • Primary Triage • • Typically performed at the scene of the incident](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-24.jpg)
![Mass Casualty Incident Any incident in which there are more patients than rescuers (Source: Mass Casualty Incident Any incident in which there are more patients than rescuers (Source:](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-25.jpg)
![~80% of casualties self or buddy transport to the closest hospital ~80% of casualties self or buddy transport to the closest hospital](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-26.jpg)
![MCI Triage • All victims must have equal importance at the time of primary MCI Triage • All victims must have equal importance at the time of primary](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-27.jpg)
![MCI Triage Categories • IMMEDIATE = Emergent • DELAYED = Urgent • MINOR = MCI Triage Categories • IMMEDIATE = Emergent • DELAYED = Urgent • MINOR =](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-28.jpg)
![IMMEDIATE Severely ill/injured but treatable and able to be saved with relatively quick treatment IMMEDIATE Severely ill/injured but treatable and able to be saved with relatively quick treatment](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-29.jpg)
![DELAYED Injured/ill and unable to walk on their own; Potentially serious injuries/illnesses but stable DELAYED Injured/ill and unable to walk on their own; Potentially serious injuries/illnesses but stable](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-30.jpg)
![MINOR Minor injuries/illnesses that can wait for a longer period of time for treatment MINOR Minor injuries/illnesses that can wait for a longer period of time for treatment](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-31.jpg)
![EXPECTANT/DECEASED Dead or obviously dying; May have signs of life but injuries are incompatible EXPECTANT/DECEASED Dead or obviously dying; May have signs of life but injuries are incompatible](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-32.jpg)
![Triaging Expectant/Deceased Patients • Can be psychologically difficult to tag a child as Expectant/Deceased Triaging Expectant/Deceased Patients • Can be psychologically difficult to tag a child as Expectant/Deceased](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-33.jpg)
![MCI Triage Considerations Scene Safety • Ensure the scene is safe before entering • MCI Triage Considerations Scene Safety • Ensure the scene is safe before entering •](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-34.jpg)
![MCI TRIAGE TOOLS MCI TRIAGE TOOLS](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-35.jpg)
![MCI Triage Tools • START Algorithm • Jump. START© Algorithm • SMART Triage Pacs™ MCI Triage Tools • START Algorithm • Jump. START© Algorithm • SMART Triage Pacs™](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-36.jpg)
![START TRIAGE START TRIAGE](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-37.jpg)
![START • Simple Triage And Rapid Treatment • Joint development by the Fire & START • Simple Triage And Rapid Treatment • Joint development by the Fire &](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-38.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-39.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-40.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-41.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-42.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-43.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-44.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-45.jpg)
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-46.jpg)
![Jump. START© Triage Jump. START© Triage](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-47.jpg)
![Jump. START© Triage • Developed in 1995 to parallel the START Triage system and Jump. START© Triage • Developed in 1995 to parallel the START Triage system and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-48.jpg)
![Jump. START© Triage • In children, typically respiratory failure precedes circulatory failure • Apnea Jump. START© Triage • In children, typically respiratory failure precedes circulatory failure • Apnea](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-49.jpg)
![Jump. START© Triage and Age What age defines the pediatric patient? Jump. START© Triage and Age What age defines the pediatric patient?](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-50.jpg)
![Jump. START© Triage and Age It can be difficult to discern the age of Jump. START© Triage and Age It can be difficult to discern the age of](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-51.jpg)
![Differences Between START and Jump. START© START Jump. START© Airway If positioning the airway Differences Between START and Jump. START© START Jump. START© Airway If positioning the airway](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-52.jpg)
![](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-53.jpg)
![Step 1 Patients who are able to walk are assumed to have stable, well Step 1 Patients who are able to walk are assumed to have stable, well](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-54.jpg)
![Step 2 Evaluate all non-ambulatory victims that are carried to the MINOR area Step 2 Evaluate all non-ambulatory victims that are carried to the MINOR area](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-55.jpg)
![Non-ambulatory Children Non-ambulatory children include: • Infants who normally can’t walk yet • Children Non-ambulatory Children Non-ambulatory children include: • Infants who normally can’t walk yet • Children](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-56.jpg)
![Non-ambulatory Children All children carried to the MINOR area by other ambulatory victims must Non-ambulatory Children All children carried to the MINOR area by other ambulatory victims must](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-57.jpg)
![Step 3 Next begin triaging the remaining victims in the order that they are Step 3 Next begin triaging the remaining victims in the order that they are](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-58.jpg)
![Step 3 (Continued) If the child is still apneic after positioning their upper airway Step 3 (Continued) If the child is still apneic after positioning their upper airway](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-59.jpg)
![Step 3 (Continued) If the child is still apneic after positioning their upper airway Step 3 (Continued) If the child is still apneic after positioning their upper airway](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-60.jpg)
![FOR THOSE CHILDREN WHO REMAIN APNEIC AFTER 5 RESCUE BREATHS, DO NOT CONTINUE TO FOR THOSE CHILDREN WHO REMAIN APNEIC AFTER 5 RESCUE BREATHS, DO NOT CONTINUE TO](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-61.jpg)
![Step 4 Assess the respiratory rate of each spontaneously breathing child. • If <15 Step 4 Assess the respiratory rate of each spontaneously breathing child. • If <15](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-62.jpg)
![Step 5 Assess the child’s perfusion. • If no palpable pulse, tag the child Step 5 Assess the child’s perfusion. • If no palpable pulse, tag the child](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-63.jpg)
![Step 6 Assess the child’s mental status. • If child is inappropriately responsive to Step 6 Assess the child’s mental status. • If child is inappropriately responsive to](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-64.jpg)
![SMART TRIAGE TAG SYSTEM SMART TRIAGE TAG SYSTEM](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-65.jpg)
![State Mass Casualty Triage System • 2004 - State committee identified need for consistency State Mass Casualty Triage System • 2004 - State committee identified need for consistency](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-66.jpg)
![SMART Triage Pacs™ • MCI triage tags • Part of a larger Command System SMART Triage Pacs™ • MCI triage tags • Part of a larger Command System](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-67.jpg)
![SMART Triage Pacs™ • Triage tags • Equipment used to perform START and Jump. SMART Triage Pacs™ • Triage tags • Equipment used to perform START and Jump.](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-68.jpg)
![SMART Triage Pacs™( Continued) SMART Triage Pacs™( Continued)](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-69.jpg)
![SMART Triage Pacs™( Continued) SMART Triage Pacs™( Continued)](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-70.jpg)
![START Triage vs. the SMART Triage Pacs™ The START algorithm looks like this… The START Triage vs. the SMART Triage Pacs™ The START algorithm looks like this… The](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-71.jpg)
![Scenarios Scenarios](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-72.jpg)
![Scenario 1: Bus Crash It’s 7 pm on a summer night when a bus Scenario 1: Bus Crash It’s 7 pm on a summer night when a bus](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-73.jpg)
![Scenario 1 (continued) 10 y/o female, open femur fracture, breathing 10/min, good distal pulse, Scenario 1 (continued) 10 y/o female, open femur fracture, breathing 10/min, good distal pulse,](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-74.jpg)
![9 y/o M RR 0 Faint distal pulse Unresponsive Lying outside the bus in 9 y/o M RR 0 Faint distal pulse Unresponsive Lying outside the bus in](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-75.jpg)
![Scenario 2: F 5 Tornado An F 5 tornado has struck within your city/town. Scenario 2: F 5 Tornado An F 5 tornado has struck within your city/town.](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-76.jpg)
![Scenario 2 (continued) School Age Girl • Open arm fracture • RR 26, and Scenario 2 (continued) School Age Girl • Open arm fracture • RR 26, and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-77.jpg)
![8 y/o M RR 10 Weak, thready pulse Unresponsive Outside, face down 3 y/o 8 y/o M RR 10 Weak, thready pulse Unresponsive Outside, face down 3 y/o](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-78.jpg)
![Scenario 3: High-Rise Fire • Fire reported on 15 th floor • Smoke to Scenario 3: High-Rise Fire • Fire reported on 15 th floor • Smoke to](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-79.jpg)
![4 y/o F RR 38 Radial pulse present Knows name and recalls incident Facial 4 y/o F RR 38 Radial pulse present Knows name and recalls incident Facial](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-80.jpg)
![Scenario 3 (continued) 5 kids are carried out, all being given CPR. As lead Scenario 3 (continued) 5 kids are carried out, all being given CPR. As lead](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-81.jpg)
![Recovery Recovery](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-82.jpg)
![Taking Care of Yourself After a critical event, rescue workers often struggle to get Taking Care of Yourself After a critical event, rescue workers often struggle to get](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-83.jpg)
![Conclusion • START/Jump. START are the MCI triage systems used in Illinois • SMART Conclusion • START/Jump. START are the MCI triage systems used in Illinois • SMART](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-84.jpg)
![ANY QUESTIONS? ANY QUESTIONS?](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-85.jpg)
![APPLYING START AND © JUMPSTART APPLYING START AND © JUMPSTART](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-86.jpg)
![THANK YOU! www. stritch. luc. edu/emsc THANK YOU! www. stritch. luc. edu/emsc](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-87.jpg)
- Slides: 87
![PEDIATRIC DISASTER TRIAGE UTILIZING THE JUMPSTART METHOD MARCH 2016 4 TH EDITION PEDIATRIC DISASTER TRIAGE UTILIZING THE JUMPSTART © METHOD MARCH 2016 (4 TH EDITION)](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-1.jpg)
PEDIATRIC DISASTER TRIAGE UTILIZING THE JUMPSTART © METHOD MARCH 2016 (4 TH EDITION)
![Disclaimer This slide set and all related training information provided in this session is Disclaimer This slide set and all related training information provided in this session is](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-2.jpg)
Disclaimer This slide set and all related training information provided in this session is in accordance with current practice at the time that this program was developed.
![Acknowledgements This 4 th edition education program was developed under the direction and Acknowledgements • This 4 th edition education program was developed under the direction and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-3.jpg)
Acknowledgements • This 4 th edition education program was developed under the direction and guidance of the Illinois Pediatric Preparedness Workgroup. The original program was adapted in 2006 from a module developed by Children’s Memorial Hospital (now Ann & Robert H. Lurie Children’s Hospital of Chicago). • This program was developed from an Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) grant. All training materials are considered under public domain and can be utilized by others in the conduction of similar educational programs, provided there is acknowledgement of the source of these materials.
![Objectives Identify unique characteristics that make children more vulnerable in a disaster Objectives • Identify unique characteristics that make children more vulnerable in a disaster •](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-4.jpg)
Objectives • Identify unique characteristics that make children more vulnerable in a disaster • Discuss mass casualty triage and the pediatric patient • Review START and Jump. START© Triage Tools and the SMART Triage Pacs™ • Demonstrate the use of the START and Jump. START© Triage Tool
![Introduction Introduction](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-5.jpg)
Introduction
![Background Illinois Emergency Medical Services for Children EMSC 1984 National EMSC Program established through Background Illinois Emergency Medical Services for Children (EMSC) 1984: National EMSC Program established through](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-6.jpg)
Background Illinois Emergency Medical Services for Children (EMSC) 1984: National EMSC Program established through federal legislation • Jointly sponsored by • Maternal & Child Health Bureau • National Highway Traffic Safety Administration • States are charged with enhancing the pediatric component of their Emergency Medical Services (EMS) systems. 1994: Illinois EMSC was established.
![Illinois EMSC Pediatric Disaster Preparedness 2002 Illinois Pediatric Bioterrorism Workgroup convened Illinois EMSC Pediatric Disaster Preparedness • 2002: • Illinois Pediatric Bioterrorism Workgroup convened •](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-7.jpg)
Illinois EMSC Pediatric Disaster Preparedness • 2002: • Illinois Pediatric Bioterrorism Workgroup convened • Name changed in 2011 to Pediatric Preparedness Workgroup to ensure a more all-hazards approach. • Reports to EMSC Advisory Board and Illinois Terrorism Task Force • Assists in assuring that the special needs of children are addressed during a disaster or terrorist event by: • Enhancing awareness of pediatric needs • Identifying/sharing best practices • Developing resource documents, tools, and guidelines • Integrating disaster preparedness into existing state initiatives
![Illinois Communities Illinois is the 5 th most populous state with a population Illinois Communities • Illinois is the 5 th most populous state with a population](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-8.jpg)
Illinois Communities • Illinois is the 5 th most populous state with a population of 12. 9 million • Almost 3 million children <18 years of age • Approximately 800, 000 are age five and younger.
![Children and Disasters Children and Disasters](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-9.jpg)
Children and Disasters
![Disaster A medical disaster occurs when the destructive effects of natural or man made Disaster “A medical disaster occurs when the destructive effects of natural or man made](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-10.jpg)
Disaster “A medical disaster occurs when the destructive effects of natural or man made forces overwhelm the ability of a given area or community to meet the demand for health care. ” (Source: ACEP Disaster Medical Services Policy Statement, 2006)
![Natural Disasters Earthquake Flood Snowice storm Tornado Others Natural Disasters • Earthquake • Flood • Snow/ice storm • Tornado • Others](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-11.jpg)
Natural Disasters • Earthquake • Flood • Snow/ice storm • Tornado • Others
![Human Caused Disasters Terrorist Events Arson Bombings Shootings Use Human Caused Disasters • Terrorist Events • Arson • Bombings • Shootings • Use](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-12.jpg)
Human Caused Disasters • Terrorist Events • Arson • Bombings • Shootings • Use of chemical, biological or nuclear agents • Hazmat incidents
![Terrorist Events and the Pediatric Population Myth Kids are secondary victims of terrorism and Terrorist Events and the Pediatric Population Myth Kids are secondary victims of terrorism and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-13.jpg)
Terrorist Events and the Pediatric Population Myth Kids are secondary victims of terrorism and inadvertently targeted Fact Children may be intentionally targeted
![Harsh Realities Children as Victims of Disasters 1984 Bhopal India Industrial gas Harsh Realities: Children as Victims of Disasters • 1984: Bhopal, India – Industrial gas](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-14.jpg)
Harsh Realities: Children as Victims of Disasters • 1984: Bhopal, India – Industrial gas release (methyl isocyanate) – Estimated 20% of victims were children • 1999: Columbine High School Shootings – 12 students killed, 24 injured • 2004: Beslan, Russia – Three day hostage event at school – 334 hostages killed including 186 (56%) children • 2011: Oslo and Utoya Norway Attacks – At least 60 children killed after a gunman opened fire at a youth summer camp • 2012: Sandy Hook Elementary School Shooting – 26 people killed (20 children and 6 adults)
![Why Children are More Vulnerable During Disasters Lack of appropriate sized equipment and supplies Why Children are More Vulnerable During Disasters Lack of appropriate sized equipment and supplies](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-15.jpg)
Why Children are More Vulnerable During Disasters Lack of appropriate sized equipment and supplies Challenges related to medical interventions and safety Gaps in pediatric preparedness in hospitals, agencies, communities, and on the state and federal levels Anatomical, physiological and developmental differences Critical emergency care interventions performed infrequently Increased vulnerability during disasters May be intentionally targeted during the disaster
![Respiratory Airway is smaller and more narrow Higher risk for respiratory issues Depend on Respiratory Airway is smaller and more narrow Higher risk for respiratory issues Depend on](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-16.jpg)
Respiratory Airway is smaller and more narrow Higher risk for respiratory issues Depend on diaphragm to breath Equipment needs vary based on size
![Exposure Faster respiratory rates More susceptible to infections effects of agents prolonged exposures hypothermia Exposure Faster respiratory rates More susceptible to: infections effects of agents prolonged exposures hypothermia](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-17.jpg)
Exposure Faster respiratory rates More susceptible to: infections effects of agents prolonged exposures hypothermia Thinner skin/ greater body surface area Shorter stature Faster metabolism Immature immune system
![Trauma Rib cage is higher Higher risk for injury irreversible shock and death from Trauma Rib cage is higher Higher risk for injury, irreversible shock and death from](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-18.jpg)
Trauma Rib cage is higher Higher risk for injury, irreversible shock and death from traumatic events Larger head/higher center of gravity Smaller circulating blood volume
![Developmental May lack cognitive ability to sense a dangerous situation Increased exposure and risk Developmental May lack cognitive ability to sense a dangerous situation Increased exposure and risk](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-19.jpg)
Developmental May lack cognitive ability to sense a dangerous situation Increased exposure and risk of injuries May lack motor skills to flee from danger
![Developmental May be nonverbal or not know personal information Age developmental level influences Developmental May be nonverbal or not know personal information Age & developmental level influences](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-20.jpg)
Developmental May be nonverbal or not know personal information Age & developmental level influences response to stressful events May be uncooperative Unable to help with reunification Long term psychological effects are possible
![Children with Special Health Care Needs CSHCNChildren with Functional Access Needs CFAN Can Children with Special Health Care Needs (CSHCN)/Children with Functional Access Needs (CFAN) • Can](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-21.jpg)
Children with Special Health Care Needs (CSHCN)/Children with Functional Access Needs (CFAN) • Can include those kids who are/have: • Technology dependent • • • 23% of U. S. households have at least 1 child that meet criteria • 15. 1% (>11. 2 million) children in U. S. meet criteria • Illinois: 14. 3% (452, 574) (ventilators, G-tubes, shunts, insulin pumps) Developmentally delayed or disabled Chronic diseases Immunocompromised Psychiatric/behavioral illnesses • Many emergency personnel and disaster responders are not used to dealing with this population
![Triage Triage](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-22.jpg)
Triage
![Triage Sorting and prioritizing patients Looks at the medical needs and Triage • • • Sorting and prioritizing patients Looks at the medical needs and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-23.jpg)
Triage • • • Sorting and prioritizing patients Looks at the medical needs and urgency of each individual patient Conventional Triage • • Do the best for each individual Disaster/MCI Triage Do the greatest good for the greatest number • Based on physiology • Provides an objective framework for stressful and emotional decisions • Helps in resource allocation •
![Triage Primary Triage Typically performed at the scene of the incident Triage • Primary Triage • • Typically performed at the scene of the incident](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-24.jpg)
Triage • Primary Triage • • Typically performed at the scene of the incident Helps prioritize patients for evacuation/transport Can occur at a hospital Secondary Triage • • • Performed to re-evaluate the patient after primary triage has been completed Typically done once the patient arrives at the hospital. Can also take place at an alternate care site or at the scene of the incident if prolonged scene time or in casualty collection areas
![Mass Casualty Incident Any incident in which there are more patients than rescuers Source Mass Casualty Incident Any incident in which there are more patients than rescuers (Source:](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-25.jpg)
Mass Casualty Incident Any incident in which there are more patients than rescuers (Source: newyearseve. com)
![80 of casualties self or buddy transport to the closest hospital ~80% of casualties self or buddy transport to the closest hospital](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-26.jpg)
~80% of casualties self or buddy transport to the closest hospital
![MCI Triage All victims must have equal importance at the time of primary MCI Triage • All victims must have equal importance at the time of primary](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-27.jpg)
MCI Triage • All victims must have equal importance at the time of primary triage • Sort patients based on the need for immediate care • Be able to recognize futility • No patient group can receive special consideration other than that dictated by their physiologic state This includes children! (Source: Dr. Lou Romig-slide presentation: Jump. START Pediatric Multi-casualty Triage System)
![MCI Triage Categories IMMEDIATE Emergent DELAYED Urgent MINOR MCI Triage Categories • IMMEDIATE = Emergent • DELAYED = Urgent • MINOR =](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-28.jpg)
MCI Triage Categories • IMMEDIATE = Emergent • DELAYED = Urgent • MINOR = Non-urgent/walking wounded • EXPECTANT/DECEASED = Dead/little to no hope of survival
![IMMEDIATE Severely illinjured but treatable and able to be saved with relatively quick treatment IMMEDIATE Severely ill/injured but treatable and able to be saved with relatively quick treatment](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-29.jpg)
IMMEDIATE Severely ill/injured but treatable and able to be saved with relatively quick treatment and transport • Examples: • Severe bleeding • Shock • Open chest or abdominal wounds • Severe respiratory distress • Emotionally out of control (Source: Optimistworld. com/anaphylaxis)
![DELAYED Injuredill and unable to walk on their own Potentially serious injuriesillnesses but stable DELAYED Injured/ill and unable to walk on their own; Potentially serious injuries/illnesses but stable](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-30.jpg)
DELAYED Injured/ill and unable to walk on their own; Potentially serious injuries/illnesses but stable enough to wait a short while for medical treatment • Examples • Burns with no respiratory distress • Spinal injuries • Moderate blood loss • Conscious with head injury (Source: Chemaxx. com)
![MINOR Minor injuriesillnesses that can wait for a longer period of time for treatment MINOR Minor injuries/illnesses that can wait for a longer period of time for treatment](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-31.jpg)
MINOR Minor injuries/illnesses that can wait for a longer period of time for treatment • Examples • Minor fractures • Minor bleeding • Minor lacerations
![EXPECTANTDECEASED Dead or obviously dying May have signs of life but injuries are incompatible EXPECTANT/DECEASED Dead or obviously dying; May have signs of life but injuries are incompatible](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-32.jpg)
EXPECTANT/DECEASED Dead or obviously dying; May have signs of life but injuries are incompatible with survival • Examples • Cardiac arrest • Respiratory arrest with a pulse • Massive head injury
![Triaging ExpectantDeceased Patients Can be psychologically difficult to tag a child as ExpectantDeceased Triaging Expectant/Deceased Patients • Can be psychologically difficult to tag a child as Expectant/Deceased](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-33.jpg)
Triaging Expectant/Deceased Patients • Can be psychologically difficult to tag a child as Expectant/Deceased • Can be hard to resist the tendency to assign pediatric patients a higher triage category just because they are children • Using a MCI triage tool especially with children can help to eliminate the role of emotions in the triage process • Objective triage criteria during an MCI can provide emotional support for triage personnel forced to make life or death decisions for children
![MCI Triage Considerations Scene Safety Ensure the scene is safe before entering MCI Triage Considerations Scene Safety • Ensure the scene is safe before entering •](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-34.jpg)
MCI Triage Considerations Scene Safety • Ensure the scene is safe before entering • Assess for need for decontamination Designate Treatment Areas • Establish areas for each triage color category • Triaged patients should be moved to designated areas Incident command (IC) • Process what you see and hear in 30 seconds and paint as accurate a picture as you can in your report to IC
![MCI TRIAGE TOOLS MCI TRIAGE TOOLS](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-35.jpg)
MCI TRIAGE TOOLS
![MCI Triage Tools START Algorithm Jump START Algorithm SMART Triage Pacs MCI Triage Tools • START Algorithm • Jump. START© Algorithm • SMART Triage Pacs™](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-36.jpg)
MCI Triage Tools • START Algorithm • Jump. START© Algorithm • SMART Triage Pacs™
![START TRIAGE START TRIAGE](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-37.jpg)
START TRIAGE
![START Simple Triage And Rapid Treatment Joint development by the Fire START • Simple Triage And Rapid Treatment • Joint development by the Fire &](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-38.jpg)
START • Simple Triage And Rapid Treatment • Joint development by the Fire & Marine Department and Hoag Hospital in New Port Beach, California • Gold standard for field adult MCI triage in U. S. and numerous other countries • Utilizes the standard four color triage categories • Used for primary triage • More information at www. start-triage. com
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-39.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-40.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-41.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-42.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-43.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-44.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-45.jpg)
START Triage Algorithm
![START Triage Algorithm START Triage Algorithm](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-46.jpg)
START Triage Algorithm
![Jump START Triage Jump. START© Triage](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-47.jpg)
Jump. START© Triage
![Jump START Triage Developed in 1995 to parallel the START Triage system and Jump. START© Triage • Developed in 1995 to parallel the START Triage system and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-48.jpg)
Jump. START© Triage • Developed in 1995 to parallel the START Triage system and revised in 2002 • Designed for use in MCI events • Provides an objective framework to decrease the emotional burden on medical personnel who have to make rapid life or death decisions about children • Reflects unique aspects of pediatric physiology • Originally used with children under 8 years old but now used on any victim that appears to be child • Can be completed within 30 seconds (Source: Dr. Lou Romig-slide presentation: Jump. START Pediatric Multi-casualty Triage System)
![Jump START Triage In children typically respiratory failure precedes circulatory failure Apnea Jump. START© Triage • In children, typically respiratory failure precedes circulatory failure • Apnea](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-49.jpg)
Jump. START© Triage • In children, typically respiratory failure precedes circulatory failure • Apnea may occur relatively rapidly, rather than after a prolonged period of hypoxia • There may be a brief period when the child is apneic but not pulseless since the heart has not yet experienced prolonged hypoxia. It is felt that providing a brief trial of ventilations may help “jumpstart” their respirations
![Jump START Triage and Age What age defines the pediatric patient Jump. START© Triage and Age What age defines the pediatric patient?](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-50.jpg)
Jump. START© Triage and Age What age defines the pediatric patient?
![Jump START Triage and Age It can be difficult to discern the age of Jump. START© Triage and Age It can be difficult to discern the age of](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-51.jpg)
Jump. START© Triage and Age It can be difficult to discern the age of a child especially preteen and early teen years, and which triage tool to use. If a victim appears to be a CHILD, use Jump. START© If a victim appears to be a YOUNG ADULT, use START (Source: Dr. Lou Romig-slide presentation: Jump. START Pediatric Multi-casualty Triage System)
![Differences Between START and Jump START START Jump START Airway If positioning the airway Differences Between START and Jump. START© START Jump. START© Airway If positioning the airway](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-52.jpg)
Differences Between START and Jump. START© START Jump. START© Airway If positioning the airway does not restart breathing, patient tagged as Expectant/Deceased If positioning the airway does not restart breathing, a ventilation trial is given if pulse is palpable Perfusion/Circulation Capillary refill or peripheral pulses can be used to assess perfusion Only peripheral pulses are used to assess perfusion Mental Status Ability to follow commands is used to assess mental status AVPU is used to assess mental status
![](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-53.jpg)
![Step 1 Patients who are able to walk are assumed to have stable well Step 1 Patients who are able to walk are assumed to have stable, well](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-54.jpg)
Step 1 Patients who are able to walk are assumed to have stable, well compensated physiology, regardless of the nature of their injuries or illnesses. These are triaged as MINOR
![Step 2 Evaluate all nonambulatory victims that are carried to the MINOR area Step 2 Evaluate all non-ambulatory victims that are carried to the MINOR area](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-55.jpg)
Step 2 Evaluate all non-ambulatory victims that are carried to the MINOR area
![Nonambulatory Children Nonambulatory children include Infants who normally cant walk yet Children Non-ambulatory Children Non-ambulatory children include: • Infants who normally can’t walk yet • Children](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-56.jpg)
Non-ambulatory Children Non-ambulatory children include: • Infants who normally can’t walk yet • Children with developmental delays • Children with acute injuries which prevented them from walking before the incident occurred • Children with chronic disabilities CHILDREN MEETING THIS CRITERIA©SHOULD BE EVALUATED USING THE Jump. START ALGORITHM BEGINNING WITH STEP 2
![Nonambulatory Children All children carried to the MINOR area by other ambulatory victims must Non-ambulatory Children All children carried to the MINOR area by other ambulatory victims must](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-57.jpg)
Non-ambulatory Children All children carried to the MINOR area by other ambulatory victims must be the first assessed by medical personnel in that area. • If a child meets any red criteria, tag as IMMEDIATE • If a child has significant external signs of injury, tag as • If a child has no significant external signs of injury, tag as MINOR • If a child meets the criteria for the expectant/deceased category, tag as EXPECTANT/DECEASED DELAYED
![Step 3 Next begin triaging the remaining victims in the order that they are Step 3 Next begin triaging the remaining victims in the order that they are](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-58.jpg)
Step 3 Next begin triaging the remaining victims in the order that they are encountered. Assess the breathing status of each child. • If the child is breathing spontaneously, go on to step 4 • If child is apneic, position the upper airway. If they start to breath on their own, tag them as IMMEDIATE
![Step 3 Continued If the child is still apneic after positioning their upper airway Step 3 (Continued) If the child is still apneic after positioning their upper airway](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-59.jpg)
Step 3 (Continued) If the child is still apneic after positioning their upper airway in Step 2 and they have no palpable pulses, tag as EXPECTANT/ DECEASED
![Step 3 Continued If the child is still apneic after positioning their upper airway Step 3 (Continued) If the child is still apneic after positioning their upper airway](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-60.jpg)
Step 3 (Continued) If the child is still apneic after positioning their upper airway but has a palpable pulse, give 5 rescue breaths. • If they start breathing spontaneously, tag as IMMEDIATE • If they remain apneic, tag as EXPECTANT/DECEASED
![FOR THOSE CHILDREN WHO REMAIN APNEIC AFTER 5 RESCUE BREATHS DO NOT CONTINUE TO FOR THOSE CHILDREN WHO REMAIN APNEIC AFTER 5 RESCUE BREATHS, DO NOT CONTINUE TO](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-61.jpg)
FOR THOSE CHILDREN WHO REMAIN APNEIC AFTER 5 RESCUE BREATHS, DO NOT CONTINUE TO VENTILATE THE PATIENT RESUME TRIAGE DUTIES.
![Step 4 Assess the respiratory rate of each spontaneously breathing child If 15 Step 4 Assess the respiratory rate of each spontaneously breathing child. • If <15](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-62.jpg)
Step 4 Assess the respiratory rate of each spontaneously breathing child. • If <15 or > 45, tag as IMMEDIATE • If 15 -45, go to Step 5
![Step 5 Assess the childs perfusion If no palpable pulse tag the child Step 5 Assess the child’s perfusion. • If no palpable pulse, tag the child](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-63.jpg)
Step 5 Assess the child’s perfusion. • If no palpable pulse, tag the child as IMMEDIATE • If the child’s pulse is palpable, move on to Step 6
![Step 6 Assess the childs mental status If child is inappropriately responsive to Step 6 Assess the child’s mental status. • If child is inappropriately responsive to](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-64.jpg)
Step 6 Assess the child’s mental status. • If child is inappropriately responsive to pain, posturing, or unresponsive, tag as IMMEDIATE • If child is alert, responds to voice or appropriately responds to pain, tag as DELAYED
![SMART TRIAGE TAG SYSTEM SMART TRIAGE TAG SYSTEM](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-65.jpg)
SMART TRIAGE TAG SYSTEM
![State Mass Casualty Triage System 2004 State committee identified need for consistency State Mass Casualty Triage System • 2004 - State committee identified need for consistency](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-66.jpg)
State Mass Casualty Triage System • 2004 - State committee identified need for consistency in MCI triaging throughout Illinois � Various MCI triage systems reviewed � Endorsement of SMART Incident Command System™ for use in Illinois • 2007 -Statewide distribution of SMART Triage Pacs™ • Illinois Custom-Designed SMART Pacs™ � Contains a START and Jump. START© algorithm card � Does not have the SMART Pediatric Tape (tape not approved for use in Illinois)
![SMART Triage Pacs MCI triage tags Part of a larger Command System SMART Triage Pacs™ • MCI triage tags • Part of a larger Command System](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-67.jpg)
SMART Triage Pacs™ • MCI triage tags • Part of a larger Command System product that includes ability to assist with tracking patients from the scene. • Full system not necessary to use triage tag portion • SMART Triage tags are recommended to use in Illinois (Source: emsstaff. buncombecounty. org)
![SMART Triage Pacs Triage tags Equipment used to perform START and Jump SMART Triage Pacs™ • Triage tags • Equipment used to perform START and Jump.](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-68.jpg)
SMART Triage Pacs™ • Triage tags • Equipment used to perform START and Jump. START© triage • Have standard barcodes for tracking patients • Card folds to the assigned color and only shows one color at a time • Allows patients to be re-triaged to another color classification without having to replace the tag and reassessment can be documented on the same tag • Separate tags for Expectant/Deceased category (Source: emsstaff. buncombecounty. org)
![SMART Triage Pacs Continued SMART Triage Pacs™( Continued)](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-69.jpg)
SMART Triage Pacs™( Continued)
![SMART Triage Pacs Continued SMART Triage Pacs™( Continued)](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-70.jpg)
SMART Triage Pacs™( Continued)
![START Triage vs the SMART Triage Pacs The START algorithm looks like this The START Triage vs. the SMART Triage Pacs™ The START algorithm looks like this… The](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-71.jpg)
START Triage vs. the SMART Triage Pacs™ The START algorithm looks like this… The SMART Triage Pacs™ algorithm looks like this. . . Although these algorithms look different… THEY ARE THE SAME
![Scenarios Scenarios](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-72.jpg)
Scenarios
![Scenario 1 Bus Crash Its 7 pm on a summer night when a bus Scenario 1: Bus Crash It’s 7 pm on a summer night when a bus](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-73.jpg)
Scenario 1: Bus Crash It’s 7 pm on a summer night when a bus returning from a day camp collides with a train on a remote road. You are the first responder and you find 20 + kids. Some are still in the bus and train while some are lying about the road.
![Scenario 1 continued 10 yo female open femur fracture breathing 10min good distal pulse Scenario 1 (continued) 10 y/o female, open femur fracture, breathing 10/min, good distal pulse,](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-74.jpg)
Scenario 1 (continued) 10 y/o female, open femur fracture, breathing 10/min, good distal pulse, groans to verbal stimuli
![9 yo M RR 0 Faint distal pulse Unresponsive Lying outside the bus in 9 y/o M RR 0 Faint distal pulse Unresponsive Lying outside the bus in](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-75.jpg)
9 y/o M RR 0 Faint distal pulse Unresponsive Lying outside the bus in a pile of debris 50 y/o F RR 20 Cap refill < 2 Obeys simple sec commands Dizzy & unable to walk 10 y/o F RR 22 Good distal pulse Asks for help Walking 9 y/o F RR 12 Distal pulse absent Groans to painful stimuli Lying in the ditch 15 ft away 10 y/o M RR 26 Distal pulse present Obeys commands Unable to move his legs 25 y/o F RR 12 Cap refill 4 sec Eye movement to stimulation 6 months pregnant
![Scenario 2 F 5 Tornado An F 5 tornado has struck within your citytown Scenario 2: F 5 Tornado An F 5 tornado has struck within your city/town.](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-76.jpg)
Scenario 2: F 5 Tornado An F 5 tornado has struck within your city/town. It occurred at 3 pm while school was letting out. The tornado touched down near 3 schools and a shopping mall.
![Scenario 2 continued School Age Girl Open arm fracture RR 26 and Scenario 2 (continued) School Age Girl • Open arm fracture • RR 26, and](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-77.jpg)
Scenario 2 (continued) School Age Girl • Open arm fracture • RR 26, and pulse • Alert and talking
![8 yo M RR 10 Weak thready pulse Unresponsive Outside face down 3 yo 8 y/o M RR 10 Weak, thready pulse Unresponsive Outside, face down 3 y/o](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-78.jpg)
8 y/o M RR 10 Weak, thready pulse Unresponsive Outside, face down 3 y/o M RR 18 Pulse present but irregular Responds Deformity to appropriately to lower pain extremity 9 m/o F RR 44 Pulse present Responds to voice Superficial lacs to head/face 10 y/o M Screaming Pulse present Not focusing Running in hall 50 y/o F RR 32 Weak pulse Not following commands Trapped under bookcase 7 y/o M RR 0 Very weak Pulse Unresponsive Trapped under rubble
![Scenario 3 HighRise Fire Fire reported on 15 th floor Smoke to Scenario 3: High-Rise Fire • Fire reported on 15 th floor • Smoke to](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-79.jpg)
Scenario 3: High-Rise Fire • Fire reported on 15 th floor • Smoke to the 16 th and 17 th floors. • The building’s day care center is located on the 17 th floor with 30 kids and 6 employees. (Source: Used with permission from Paula Willoughby De. Jesus, DO, MHPE)
![4 yo F RR 38 Radial pulse present Knows name and recalls incident Facial 4 y/o F RR 38 Radial pulse present Knows name and recalls incident Facial](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-80.jpg)
4 y/o F RR 38 Radial pulse present Knows name and recalls incident Facial burns, coughing 53 y/o F RR 48 Cap refill > 2 sec Moaning Burns to abdomen; wheezing 3 y/o F Unresponsive Found under desk 4 y/o M RR 45 Pulse present Crying No obvious injuries 2 y/o M RR 20 Palpable pulse Hoarse cry Soot to face RR 0 Weak pulse 3 y/o M RR 28 Strong palpable Crying pulse 2 nd/3 rd degree burns to extremities
![Scenario 3 continued 5 kids are carried out all being given CPR As lead Scenario 3 (continued) 5 kids are carried out, all being given CPR. As lead](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-81.jpg)
Scenario 3 (continued) 5 kids are carried out, all being given CPR. As lead triage officer, what do you do? , (Source: Used with permission from Paula Willoughby De. Jesus DO, MHPE)
![Recovery Recovery](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-82.jpg)
Recovery
![Taking Care of Yourself After a critical event rescue workers often struggle to get Taking Care of Yourself After a critical event, rescue workers often struggle to get](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-83.jpg)
Taking Care of Yourself After a critical event, rescue workers often struggle to get back to their daily lives and deal with their experiences • Can have difficulty coping and feeling back to normal • Look for mental health resources/professionals that may be available through your employer/organization or in your community • No one should feel alone in this process or that one has to get through this completely on their own
![Conclusion STARTJump START are the MCI triage systems used in Illinois SMART Conclusion • START/Jump. START are the MCI triage systems used in Illinois • SMART](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-84.jpg)
Conclusion • START/Jump. START are the MCI triage systems used in Illinois • SMART Triage Tags are recommended for use in Illinois • Jump. START incorporates unique aspects of pediatric physiology • Provide an objective framework to assist responders with making difficult life or death decisions during a disaster • Helps provide emotional support when responders know they followed the protocols
![ANY QUESTIONS ANY QUESTIONS?](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-85.jpg)
ANY QUESTIONS?
![APPLYING START AND JUMPSTART APPLYING START AND © JUMPSTART](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-86.jpg)
APPLYING START AND © JUMPSTART
![THANK YOU www stritch luc eduemsc THANK YOU! www. stritch. luc. edu/emsc](https://slidetodoc.com/presentation_image_h/b858902950691b66e527c683868462ed/image-87.jpg)
THANK YOU! www. stritch. luc. edu/emsc
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