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#181329 - 09/04/09 12:42 AM Triage for Civilians
Compugeek Offline
Enthusiast

Registered: 08/09/09
Posts: 392
Loc: San Diego, CA
Okay, I started this in Dweste's Urban FAK thread, but rather than continue the hijack, I'm starting a new one.

My initial post:
Originally Posted By: Compugeek
Is there a "Triage for Dummies Civilians"?


Comms reply:
Originally Posted By: Comms
Yes. First, call 911. Then, if their dead you move on to the next victim. If they look like their going to die from their injuries, you move on to the next. If they look like you can provide aid with what you got, you help them. If there is multiple people and you can do it, write down what you do to the victim and put it where a 1st Responder can see when they get there.

Yes this is cavalier, but its honest. You can't save everyone all the time, and you shouldn't treat outside your ability.


MDinana's post:
Originally Posted By: MDinana
Sure is. Holler at the top of your lungs, like you're in charge, "Everyone that can walk, meet up over here!" Then point to some highly visible landmark.

Bam, you've just gotten your walking wounded out of the way. Everyone else is dead or actually hurt.

The START algorithm is based on "30-2-Can Do." If they're breathing over 30 breaths/min, have a capillary refill >2seconds, or can't follow commands, they're either red (high acuity) or dead. If they pass all 3, but weren't one of the folks that walked to the side of the road, they're intermediate. It's that easy.

The big thing about triage though, is that you keep doing it. Everyone seems to forget (or at least not mention when we discuss it here) that it's an ongoing process. You constantly re-triage based on ongoing medical/traumatic complaints, body's decompensating, resources changing, etc.

In a real world professionally-run event, there's usually one paramedic/EMT running each triage "center" and someone over them, someone coordinating ambulances/helos, someone being gopher, people under the triage "boss" doing the actual hands-on patient care... it's actually rather complex.


Anyone else? (And if I'm doing this wrong, let me know.)
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#181350 - 09/04/09 04:43 AM Re: Triage for Civilians [Re: Compugeek]
dweste Offline
Pooh-Bah

Registered: 02/16/08
Posts: 2463
Loc: Central California
Good thread.

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#181357 - 09/04/09 10:55 AM Re: Triage for Civilians [Re: dweste]
scafool Offline
Pooh-Bah

Registered: 12/18/08
Posts: 1534
Loc: Muskoka
I was taught some triage as part of an industrial first aid course for working in refineries. They called it multiple casualty scene response or something like that.


In USA triage is also taught through FEMA to Community Emergency Response Teams (CERT) and you can find more information here.
http://www.citizencorps.gov/cert/about.shtm
They include contact information and training material.

The Triage teaching unit is in the instructors manual under emergency medical (part 1).

For somebody living in USA CERT would be a good way of getting a pretty good bit of training really cheaply.

Just as an after-note:
There are a lot of different forms of triage and they almost all have different priorities.
One of them might base the priorities on who is likely to survive, ie severity of injury.
Another triage system might base priority on how important it is to transport them to treatment instead of treating them right where they are.
A third might be based on what you can effectively treat with what you have right there, and who is more likely to die before help arrives without any treatment.

Triage as applied in a hospital ER and triage as applied by EMT are horses of different colours. They have different priorities and different resources.

START is likely the first triage training program to be directed at civilian EMT and First Responders. It was developed for responders to earthquakes in California.

The one thing about field triage is that it is an assessment system. You need to assess how serious all of the injuries are.
You can't stop and freeze on any one survivor because the next one might be even more critical.

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May set off to explore without any sense of direction or how to return.

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#181383 - 09/04/09 03:03 PM Re: Triage for Civilians [Re: scafool]
comms Offline
Veteran

Registered: 07/23/08
Posts: 1502
Loc: Mesa, AZ
Yeah, I think CERT is good program, and first learned of it in this forum. Unfortunately in my city and this is probably endemic due to the economy, it got dropped as a service as the city tightened its belt.
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#181418 - 09/04/09 10:10 PM Re: Triage for Civilians [Re: comms]
Compugeek Offline
Enthusiast

Registered: 08/09/09
Posts: 392
Loc: San Diego, CA
There's an active CERT program here in San Diego. I'm looking into it.
_________________________
Okey-dokey. What's plan B?

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#181454 - 09/05/09 03:29 AM Re: Triage for Civilians [Re: Compugeek]
Todd W Offline
Product Tester
Pooh-Bah

Registered: 11/14/04
Posts: 1928
Loc: Mountains of CA
I thought CERT was just some acronym I didn't know... didn't realize it was an actual coarse blush
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Self Sufficient Home - Our journey to self sufficiency.

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#181465 - 09/05/09 01:47 PM Re: Triage for Civilians [Re: Todd W]
Compugeek Offline
Enthusiast

Registered: 08/09/09
Posts: 392
Loc: San Diego, CA
"Community Emergency Response Team"

About CERT

This looks interesting, for many reasons.
_________________________
Okey-dokey. What's plan B?

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#181478 - 09/05/09 08:11 PM Re: Triage for Civilians [Re: Todd W]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Originally Posted By: Todd W
I thought CERT was just some acronym I didn't know... didn't realize it was an actual coarse blush

Although we do have CERT in my area, my particular city runs a CEPA program--Community Emergency Preparedness Academy. The actual curriculum is very similar between the two, but there is no official team to join as with CERT. You're just trained to be ready to help yourself and your neighbors.

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#182033 - 09/12/09 03:22 PM Re: Triage for Civilians [Re: Arney]
Lono Offline
Old Hand

Registered: 10/19/06
Posts: 1013
Loc: Pacific NW, USA
quote=Todd W]
Although we do have CERT in my area, my particular city runs a CEPA program--Community Emergency Preparedness Academy. The actual curriculum is very similar between the two, but there is no official team to join as with CERT. You're just trained to be ready to help yourself and your neighbors. [/quote]

I live in a city that does CEPA - it has the advantage of not requiring much leadership to maintain, just open classes on a schedule; and keeping the trained CERTS out of the way of the local first responders, who sometimes find them to be a pain in the ass. I've seen self-responders show up at fires and local disasters and self-deploy, and I agree some of them can be a pain, but if you have a trained CERT team 1. they know not to try to self-respond, or they'll quickly get dropped and 2. they can be available for more stuff, whether its staffing a first aid station at a community event or directing traffic. Plus as you reach a critical mass of trained CERTS, some interesting possibilities emerge where you can actually integrate them into the community response plan. Also the lack of organization and leadership has a couple pitfalls: I took the CEPA introduction course from my city, and asked how we could connect with others in the area who have taken CEPA. The answer was we can't, they don't provide a list of other CEPA trainees, so you won't actually know who has trained in your neighborhood until an event occurs. Also, lacking organization means you lack follow up training oppportunities, the chance to practice what you learn in class and internalize it better. And last, if I hadn't joined a CERT team in an nearby city instead of my own, I wouldn't have found an even better opportunity with the Red Cross, basically putting CERTish skills to use on a much more regular basis.

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#182132 - 09/14/09 04:05 AM Re: Triage for Civilians [Re: comms]
philip Offline
Addict

Registered: 09/19/05
Posts: 639
Loc: San Francisco Bay Area
Originally Posted By: comms
Yeah, I think CERT is good program, and first learned of it in this forum. Unfortunately in my city and this is probably endemic due to the economy, it got dropped as a service as the city tightened its belt.


You can get training from other resources. My city has it's CERT training manual online at
http://www.sanmateocert.org/disaster/pdf/cert_handbook.pdf
which triggers the download of a 2.1MB file. It has a chapter on triage and a great deal of information on first aid and preparedness. But there's nothing like hands on training. See if any of these links provide a course near you:
http://www.cieux.com/adventureKits.html#train

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