DISASTER MANAGEMENT Level of Disaster Level 1 Local assistance Level 2 Regional assistance Level 3 National assistance TRIAGE To sort

ort out (French) Method of ranking sick or injured people according to the severity of their sickness or injury in order to ensure that medical and nursing staff facilities are used most efficiently; assessment of injury intensity and the immediacy or urgency for medical attention. is a process of prioritizing patients based on the severity of their condition so as to treat as many as possible when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning "to sort, sift or select." TYPES OF TRIAGE SIMPLE TRIAGE Simple triage is used in a scene of mass casualty, in order to sort patients into those who need critical attention and immediate transport to the hospital and those with less serious injuries. This step can be started before transportation becomes available. The categorization of patients based on the severity of their injuries can be aided with the use of printed triage tags or colored flagging . ADVANCE TRIAGE In advanced triage, doctors may decide that some seriously injured people should not receive advanced care because they are unlikely to survive. Advanced care will be used on patients with less severe injuries. Because treatment is intentionally withheld from patients with certain injuries, advanced triage has ethical implications. It is used to divert scarce resources away from patients with little chance of survival in order to increase the chances of survival of others who are more likely to survive. START SYSTEM (Simple Triage and Rapid Treatment) -Refers to a specific triage method to evaluate patient respiratory,

circulatory and neurological function and categorize each of them into four categories. START SYSTEM It uses four colors of survey tape in categorizing patients. The person who is triaging use off the appropriately colored tape and ties it around the patients arm so that other responders know the condition of the patient. A small piece of tape the same color is placed on the side pouch of the belt. The triage officer can then track the number and severity of injury by looking at the pouch or a count of patients and their severity. RED= immediate Red / Immediate - They require immediate surgery or other life-saving intervention, and have first priority for surgical teams or transport to advanced facilities; they "cannot wait" but are likely to survive with immediate treatment YELLOW= observation Their condition is stable for the moment but requires watching by trained persons and frequent retriage, will need hospital care (and would receive immediate priority care under "normal" circumstances). GREEN= wait They will require a doctor's care in several hours or days but not immediately, may wait for a number of hours or be told to go home and come back the next day (broken bones without compound fractures, many soft tissue injuries). BLACK= expectant They are so severely injured that they will die of their injuries, possibly in hours or days (large-body burns, severe trauma, lethal radiation dose), or in life-threatening medical crisis that they are unlikely to survive given the care available (cardiac arrest, septic shock, severe head or chest wounds); they should be taken to a holding area and given painkillers as required to reduce suffering. They require immediate surgery or other life-saving intervention, and have first priority for surgical teams or transport to advanced facilities; they "cannot wait" but are likely to survive with immediate treatment. Their condition is stable for the moment but requires watching by trained persons and frequent re-

triage, will need hospital care (and would receive immediate priority care under "normal" circumstances). They will require a doctor's care in several hours or days but not immediately, may wait for a number of hours or be told to go home and come back the next day (broken bones without compound fractures, many soft tissue injuries). They are so severely injured that they will die of their injuries, possibly in hours or days (large-body burns, severe trauma, lethal radiation dose), or in life-threatening medical crisis that they are unlikely to survive given the care available (cardiac arrest, septic shock, severe head or chest wounds); they should be taken to a holding area and given painkillers as required to reduce suffering. Disaster Triage Principles Never move a casualty backward Never hold a critical patient for further care Salvage life overtime Triage providers do not stop treating patients Never move patients before triage.