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Public Health EmergenciesBy: Dr. M. Nowak, Assistant Professor
Dr. C. Schmidt, Associate ProfessorDisaster Response Nurses
2014
What is a Public Health Emergency?
Are you Prepared to help?
http://www.youtube.com/watch?v=5PDY7z40BFk
Educational Objectives
Demonstrate START
Practice in Virtual Disaster Scenario
Review Implicatins of Different types of Disasters
1)COORDINATION Is Key
2) “KNOW YOUR LANE”: START, NIMS, fire,police etc.
3) Need More Event Team Preparedness
Lessons Learned In The Field Post 911
Triage is a dynamic process and is usually done more than once. Generally takes 15 Sec/pt.
Common Elements
Pre Disaster Planning
Event
Post Event
What is S.T.A.R.T.?
What & When?
Simple triage and rapid treatment is a triage method used by first responders.
It quickly classify victims during a mass casualty incident.
It is based on the severity of their injury.
Word that comes from an Old French word, meaning sorting, sifting, from trier to sort.
National / Internationally used.
Used with an MCI.
MCI is 5 or more victims.
S.T.A.R.T.
Simple
Triage
And
Rapid
Transport
Example: Bus Accident
Example: 911 Terrorist
Katrina (RN on Bridge)
TRIAGE Categories
RED=Stop/Urgent (Ambulance Light)
Yellow= Caution/Can Wait
Green= Go/Walk
Black box/Black/dead
RACE AGAINST TIME…when seconds count.
RPM…
32 Q
R P M = RED
Nurses Always Have With Them…
Head
Heart
Hands
Remember RPM…
HAZ MAT?
DECON TEAM Directs: Initiate START Triage Primary Deacon Strip & Bag Evidence Tag Patients Initiate Secondary Deacon Secondary Triage Move to Treatment
TABLE TOP SIM LAB
Hands On
Triage Practice (ADULT)
Note there are different triage techniques; START is most commonly used.
Remember
RPM
Traffic Light
32 Q
PRACTICE: Multiple Casualty 7:45 am on a Saturday in August the weather is clear, temperature is 70 degrees. You go with a friend for a
relaxing weekend breakfast at a small local airport. A commuter plane with 40 passengers onboard begins speeding down the runway. As the plane lifts off the
landing gear retracts, suddenly a catastrophic equipment failure causes the aircraft to crash in the
field just west of the airport. Upon impact the plane is torn apart, the debris field is 100 yards long.
WHAT DO YOU DO?
Patient walks over to you andhas an obvious broken arm Respirations are 22 Cap Refill 2 sec. (Radial 88) He is awake, alert, and crying
What Triage Category? GREEN
Patient states he can’t move or feel his legs.
Respirations are 26 Cap refill 2 He is awake and oriented What Triage Category?
YELLOW
Patient is soaked with blood no obvious killer bleed Respirations are 38 Pulse is weak, no radial He is awake
What Triage Category? RED
Patient is face down in the field. Not Breathing Weak Carotid Pulse She is unresponsive What do you do first? What Category?
BLACK
Patient has an open head wound, bleeding controlled
Respirations are 16 Pulse is intact (88) He is unconscious
What Triage Category? RED
Triage Tag Construction
Synthetic paper Water resistant:100 % resistant to all
commonly used decontamination solutions
May be worn while patient is being decontaminated
Rapid Triage (START)
Front Back
This portion of the tag provides a Personal Property Receipt for valuables belonging to victims that may be contaminated.
Place the valuables and the tag into a bag and seal it.
Hints When Using Triage Tags
Before tearing along perforation area of triage tag, fold area that will be affected.
If triage tag is likely get wet, documentation prior to getting wet.
Name/identification placed on the back of Personnel & Property/Evidence Tag
WMD?There is no widely recognized civilian MCI triage tool used in the US for any of the NRBC (radiologic & biologic )agents.
Agent Symbol Identification
Part of the Solution…keeping communities safe
What is MRC?
RN
POD Point of Distribution
MRC= Medical Reserve Corp
ICC= Incident Com
START = 5 More
References
Atlantic County Department of Health MEC Handout. (2007).. Strategic National Stockpile. Meeting Handout
California Fire Chiefs Association Rapid Triage PPT (2009).Retrieved From:www.emsaac.com/meetings/disaster/NewTriageTags1
Disaster Management Systems. (2007). Triage Training PPT retrieved from: http://www.ecifd.org/training/Triage%20-%20Presentation.pdf
Niles, M., McEwen,M. (2007). Community/Public Health Nursing. (4th ed.). St. Louis Missouri: Elsevier-Saunders.
Rapp,J. (2005). Emergency Management Presentation.NJ Emergency Response Unit.ACSNA Meeting Presentation Handout.
NJ Department of Health and Human Services. (2009).Trauma Treatment and Triage:A practical guide for prehospital care.
Figures:Pictures retrieved from google images and sources above.