Disaster Triage DecisionsDisaster Triage Decisions

Remember the point of primary triageRemember the point of primary triage To sort patients to determine who is To sort patients to determine who is

the most critical and who is less criticalthe most critical and who is less critical Need to do the greatest good for the Need to do the greatest good for the

greatest numbergreatest number Disaster triage is Disaster triage is notnot routine daily routine daily

triage where you do the best for each triage where you do the best for each individualindividual

Other Important Considerations: Incident Commandor Charge Nurse

See as much as you can in 30 seconds

Process what you see and hear

THINK- Don’t Panic Paint as accurate a

picture as you can with your report

Your first 5 minutes will determine how the incident will go: Remember that

emotions are contagious

FIELD

HOSPITAL

WORKING TOGETHER

Other Important Considerations: Scene Safety – Field and ED

Other Important Considerations: Incident Command

When EMS calls with multiple patients from one incident, consider activating the Multiple Patient Plan for Region X

What resources do you need to activate to recruit to the ED?

Where are your guidelines for the hospital disaster plan? Check the notebooks by

the EMS radio

Other Injury Considerations:Other Injury Considerations:Injuries from BlastsInjuries from Blasts

Primary Blast Injury Lungs, intestine and

tympanic membrane most severe

Secondary Injury Most common type of

injury seen Tertiary injury

From the blast wind and propels victim

Other Injury Considerations:Other Injury Considerations:Crush InjuriesCrush Injuries

Review: Incorporating Review: Incorporating pediatrics into planningpediatrics into planning

1. Equipment1. Equipment Jump Bag with pediatric Jump Bag with pediatric

sized equipment/suppliessized equipment/supplies 2. Triage2. Triage

Method to the madness Method to the madness and not just kids firstand not just kids first

3. Decontamination 3. Decontamination ConsiderationsConsiderations 4. Drills/ Exercises4. Drills/ Exercises

Utilize children or dolls, Utilize children or dolls, mannequins, soda bottles, mannequins, soda bottles, etc with scenariosetc with scenarios

After a critical event, rescue workers often struggle to get back to their daily lives and deal with their experience.

““Handling It”Handling It” It can be difficult to It can be difficult to

“bounce back” after a “bounce back” after a traumatic eventtraumatic event

Difficulty copingDifficulty coping Difficulty feeling back to Difficulty feeling back to

normalnormal

But….But….

No one should feel No one should feel alone in this process alone in this process or that one has to get or that one has to get thru this completely on thru this completely on their owntheir own

There are resources out There are resources out there to help…there to help…

Access mental health resources/professionals that Access mental health resources/professionals that are available through your employer/organizationare available through your employer/organization

The American Psychological Association Help The American Psychological Association Help CenterCenterhttp://helping.apa.org

Substance Abuse and Mental Health Services Substance Abuse and Mental Health Services Administration’s (SAMHSA) Administration’s (SAMHSA) Mental Health Services Mental Health Services LocatorLocator Information available at: Information available at: http://www.mentalhealth.samhsa.gov/databases/

Mental Health ResourcesMental Health Resources http://www.luhs.org/depts/emsc/

Adapt……Adapt……

And Serve

References and References and AcknowledgementsAcknowledgements

The The Pediatric Disaster Triage: Utilizing the JumpSTART MethodPediatric Disaster Triage: Utilizing the JumpSTART Method training module was developed training module was developed through assistance from:through assistance from:

1. AHRQ Decontamination of Children video1. AHRQ Decontamination of Children videoahrqpubs@ahrq.govahrqpubs@ahrq.gov

2. Children’s Memorial Hospital, Chicago2. Children’s Memorial Hospital, Chicago3. Hopkins J and Jones C, 3. Hopkins J and Jones C, Disturbing Legacy of Rescues: SuicideDisturbing Legacy of Rescues: Suicide, USA Today 9/22/2003, USA Today 9/22/20034. Illinois EMSC 4. Illinois EMSC Pediatric Disaster Preparedness GuidelinesPediatric Disaster Preparedness Guidelines

http://www.luhs.org/emsc5. Newport Beach Fire & Marine Rescue and Hoag Hospital for the use of START triage5. Newport Beach Fire & Marine Rescue and Hoag Hospital for the use of START triage

www.start-triage.com6. Lou Romig, MD (Miami Children’s Hospital) for use of JumpSTART Triage materials6. Lou Romig, MD (Miami Children’s Hospital) for use of JumpSTART Triage materials

http://www.jumpstarttriage.com7. Paula Willoughby DeJesus, DO, MHPE (Assistant Commissioner, Chicago Fire Department) for 7. Paula Willoughby DeJesus, DO, MHPE (Assistant Commissioner, Chicago Fire Department) for

provision of several photographsprovision of several photographsFunding Sources• Illinois EMSC and Assistant Secretary for Preparedness & Response (ASPR) Hospital

Preparedness grant funding supported in part the development of this training module.• The Chicago Department of Public Health and a Health Resources & Services

Administration (HRSA) Hospital Preparedness grant supported development of the original training module in 2007.