Nurse Roles in Impact Response

Disaster Triage: START Triage

-Simple Triage And Rapid Transport

Triage
● Is a French word which means "to sort"
● Triage is used when there are many more victims than responders
● Usually, resources are limited
● Do the greatest good for the greatest number

General Procedures for Triage

● Stop, look, listen, think and be aware of the surroundings before the
execution
● Do the voice triage for minimizing the patients left in the field (For those
who can hear me, walk towards me for interventions and help)
● Assign somebody who can respond to voice triage
● Remember that not all the Walking wounded are tagged as Green.
● Re-evaluate the Walking wounded

Triage Tag
● Can be a simple ribbon, coloured tape or complicated card, this used to
denote the category of the patient, and is a part of the medical record.
● Is usually left at the chest of the patient or upper arm so it is easy for the
Transport Team to locate.

MINOR - Any injuries can be treated with first aid. (Green)

DELAYED - Injuries requiring medical treatment, but not life threatening, okay to
delay care. (Yellow)
IMMEDIATE - Life threatening injuries requiring rapid treatment. (Red)
DECEASED - Morgue/Dead. (Black)
Interventions
● Airway Control
○ Jaw Thrust Maneuver / Head Tilt, Chin Lift Maneuver
● Bleeding Control
○ Direct Pressure & Pressure Bandages
○ Elevation of wound above heart
○ Pressure Points (Brachial Arm, Femoral Leg)
● Treatment for Shock
○ Elevate Feet, Open Airway
○ Maintain body temperature
Examples
1. Presents with a severe chest injury and absent respirations despite an attempt to
open the airway twice. Black
2. Patient has flail chest secondary to blunt force, > 30 RR, <2, does not obey
command. Red
3. Walked towards you when called, broken arm, > 30 RR, >2 cap refill, wiggles
toes. Green
4. Has an open deformity in lower extremity, > 30RR, >2 cap refill, squeezes hands.
Yellow
Mass Casualty Incident
• A mass casualty Incident (MCI) is an incicent where the number of patients
exceeds the amount of healthcare resources avallable. This number varies widely
across the country, but sometimes having 4 patients and more is already
considered an MCI.

Mass Casualty Incident

● Set-up a Collection area for patients & Treatment area for responders
● Deploy Triage Team, and prepare Extrication Team to deploy
● Line-up ambulances & orient Transport Team of patients that would board
the ambulance
● If available, tap an Ambulance Bus for Rapid Augmentation in the MCI