Professional Documents
Culture Documents
hammad
2 DaRRaN
TRIAGE
• PRIORITAS I (MERAH)
1. Sumbatan jalan nafas / distress pernafasan.
2. Luka tusuk dada
3. Hipotensi / syok
4. Perdarahan pembuluh nadi
5. Problem kejiwaan serius
6. Tangan dan kaki terpotong dengan perdarahan
7. Combustio TK II > 25 %
8. Combustio TK III > 25 %
• PRIORITAS II (KUNING)
1. Combustio TK II / TK III > 25%
2. Patah tulang besar
3. Trauma thorak /abdoment
4. Laserasi luas
5. Trauma bola mata
• PRIORITAS III (HIJAU)
1. Contusio dan laserai otot ringan
2. Combustio TK II < 20 %(kecuali daerah muka dan tangan)
• PRIORITAS 0 (HITAM)
1. Henti jantung kritis
2. Trauma kepala kritis
3. Radiasi tinggi
TRIAGE PADA BENCANA / MUSIBAH
MASAL
19 September 2019
START TRIAGE
• Simple
• Triage
• And
• Rapid
• Treatment
Dasar : - respirasi
- sirkulasi
- status mental
START
• Tindakan penyelamatan
- sumbatan jalan nafas
- perdarahan hebat
• Tidak lebih dari 60 detik
RAPID ASSESSMENT TRIAGE
METODE START
( SIMPLE TRIAGE AND RAPID TREATMENT )
0. Awal
1. Airway
2. Breathing
3. Circulation
4. Kesadaran
19 September 2019
0. AWAL
19 September 2019
Penderita terdekat Masih bernafas ??
Tidak bernafas buka airway
Tetap tidak bernafas : Hitam
Bila kembali bernafas : Merah
Bernafas spontan Tahap berikutnya
19 September 2019
Napas spontan
> 30 x / menit : Merah
< 30 x / menit : Tahap Berikut
19 September 2019
Capillary refill
Gelap capillary refill sulit dinilai, periksa nadi pergelangan tangan
19 September 2019
Tidak dapat mengikuti perintah : Merah
Dapat mengikuti perintah : Kuning
19 September 2019
BAGAN ALIR “START”
Bisa jalan ?
Ya Cedera Ringan Hijau
Tidak Ya
Pasien
Bernafas 30 lebih 30 kurang
Buka Airway 30 x/ menit
Meninggal Urgen
HITAM MERAH PERFUSI
Periksa Kesadaran
Tidak Ada
Nadi Radialis/
Kapilari refile
Kontrol Periksa
Pendarahan Kesadaran
Tidak Ya
Urgen Mengikuti Tertunda
MERAH Perintah KUNING
Kategori HIJAU
merah
Kuning
Hitam
Pemilahan Korban Masal dalam Kategori Disaster (Triage in Overwhelming
Multiple Casualty Incident)
SAVE START
Korban
massal
kategori
disaster
Secondary Assesment of Victim Endpoint
imediate
unsavegeable Delayed
save
Pemilahan Korban Masal dalam Kategori Disaster (Triage in
Overwhelming Multiple Casualty Incident)
24
Forensik/
Hitam
Km Jenazah
R. Resus.
Merah ICU
Orange
ICCU
PICU/ Perina
Admini- ReTriase / R. OK
Pasien UGD
R. Tindak / Monitor
strasi Triase RS
IW
Kuning Kebidanan
Hijau Pulang
R. Tunggu 25
Triage cannot be organised ad hoc.
It requires planning:
• Security
• Convergence reaction = relatives, friends &
the curious (especially the armed ones)
Triage involves a dynamic equilibrium between needs
and resources.
• Nursing groups
Discuss afterwards.
Triage is a dynamic process:
• Include basic
information
• Short-form
• Clear
• Concise
• Complete
Triage Documentation
Reality check
What really happens!
During post-triage
evaluation:
decided to use plastic
sleeve to hold the
documentation.
The triage process:
• Sift
• Sort
• the dead
• the uninjured
Sort
Categorise the most severely injured based on:
WW in the field
(GSW, mine, blast)
100 wounded
30 - 40 % 60 - 70 %
No surgery Hospital care
• Category I 5 - 10%
• Category II 25 – 30%
• Category IV 5 - 7%
Triage in Monrovia 2003
3 June – 22 August
• Total patients triaged = 2588
• Operations = 1433
0
20
40
60
80
3.06
7.06
11.06
15.06
19.06
23.06
27.06
1 July
5.07
three peaks
9.07
13.07
Date
17.07
Patients triaged by date:
21.07
25.07
29.07
2.08
6.08
10.08
14.08
18.08
22.08
Summary of triage theory & philosophy:
sorting by priority