We are almost all gear-heads, 'lest we not be here. But, please look at this article. It is a tribute, in typical understated British fashion, to what training vs. gear is worth.

As Creasy said, "There is no such thing as good; there is just trained, or untrained."

Link? Or do we have to pick up the actual dead-tree magazine?

Here's the link.
http://content.nejm.org/cgi/content/full/353/6/541

Thank you. Prior post failed ???

Where would we be without our freinds - -

Wow. The account pulls you right in.

-- Craig

First, I'm not jumping on Dr. Holden, God only knows how I would react to a situation like that. His quick action no doubt helped many of the bus bombing victims. That said, here's an observation: He stated that he had no pen or paper and to wait for trauma lables to arrive. Now, he had just come out of an office building. Send some one in for notebooks, pens and a stapler. Why a stapler? To attach the trauma notes you write to the victim's clothing (regular tape is usless in this situation).

Again, I'm not trying to be critical - His technical training kicked in and served him well. But the "what do you do if x happens and you don't have y" training (even if it's just thinking it through) is important too. Which is precisely what forums like this provide.

Jim

"Failing to Prepare is preparing to fail." ~ Benjamin Franklin
"50% of the game is half mental" ~ Yogi Berra

I don't know if you have any experience working in triage - I have none, but I googled on "triage labels" and found this on the Scottish National Health Service website:
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The standard format Casualty Triage Label may be folded and fixed to the patient to give a clear indication of the Triage category. Triage categories, shown on the label by both category number and colour coding, are:

* 1 Red: requires immediate evacuation and treatment to save life.

* 2 Yellow: requires urgent evacuation and treatment but whose life is not in jeopardy.

* 3 Green: evacuation and treatment may be delayed. This category includes the lightly injured, walking wounded and others whose condition would not be affected by delay.

* White: dead - clearly labelling the dead saves time and makes further involvement by Health Service staff unnecessary. The triage label has space for a note by the doctor pronouncing death, the time and for police information.
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Stapling white sheets of paper to the casualties' clothing would not have allowed the rescuers to take advantage of the colour coding scheme. Worse, it might have had the unwanted side effect of misleading other rescuers arriving on scene into thinking that living casualties were dead - because that is what a white label signifies.

I saw no indication in the article that the lack of pen and paper in any way impaired the responders' ability to treat the casualties. I got the impression that the triage labels were used when they became available simply to make it easier for ambulance attendants arriving to decide which casualties required priority; without them, the doctors would likely have found some other way to achieve the same result.

Whether this figured into the writer's decision-making I have no way of knowing. But to treat 15 seriously injured casualties and have them all evacuated to hospital in the middle of rush-hour (with the transportation system all but shut down) in 2 hours and 20 minutes (from the time of the explosion to the last casualty being loaded for transport) signifies to me a very high degree of professionalism and competence.

Not a criticism - you're quite right that we should always take the opportunity to ask if something could have been done better. But I think you may have been reading something into the doctor's comment that he didn't even have a pen that wasn't warranted.