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- To sort
- Medical needs and urgency of each individual patient
- Sorting based on limited data acquisition
- Consider resource availability
MILITARY VS CIVILIAN
Military Civilian
Priority is to get as many soldiers back into actions Priority is to maximize the survival of the greatest
as possible number of victims
serious wounds -> the first treatment priority those with the most serious but realistically
salvageable injuries are treated first
In both models, victims with lethal injuries or unlikely to survive even with extensive resource
application are treated as the lowest priority
ETHICAL JUSTIFICATION
Utilitarian rule
- Greater good of the greater number rather than particular good of the patient at hand.
- Justified only because of clear necessity of general public welfare in a crisis
Importance of Resources
- Disaster is commonly defined as an incident in which patient care needs overwhelm local
response resources
- Daily emergency care is not usually constrained by resource availability
Abundant resources relative to demand (R Patient)
*Resources challenged
Secondary Triage
Goal: Identify victims
- Needing life saving treatment, can only be provided in hospital settings
- Need life saving treatment initially available on scene
- With moderate non-life threatening, at risk for delayed complications
- With minor injuries
http://www.bordeninstitute.army.mil/cwbw/CH14.pdf
www.jumpstarttriage.com
Managing MCI
- Loss of lives results from inefficient mobilization of resources
- The community is the first to provide emergency assistance during emergencies and disasters
resulting in large number of injuries
- Attention was given to the training for emergency personnel in first aid or first responders
- First responders were trained to provide victims with basic triage and field care before
evacuation to the nearest health facility
MCI defined as an event resulting in a bumber of victims large enough to disrupt the normal course of
emergency and health care services
- Low impact
- High impact
- Terrorism
The most sophisticated approach, including pre-established procedures for resource mobilization, field
management and hospital reception
Impact Zone Field/Pre-hospital management (utilize resource mobilization) Hospital Reception and
Management
MIC Management
First Responders first medically trained responder to arrive on the scene
Second Responders vital to the restoration of the disaster sites
FIRST RESPONDERS
- Bureau of Fire
- National Security
- Emergency Medical Services
SECOND RESPONDERS
- Skilled construction workers
- Police
- Fire
- Volunteers
- Other responders
Characteristics:
- Incorporates linkages between field and health care facilities through a command post
GOAL: Good of the majority (utilitarianism)
Challenges:
- Availability of resources
- Efficiency of responders
LEGAL BASIS
- Department of Health A.O. 155 2004
o Known as Implementing Guidelines for Managing Mass Casualty Incidents during
Emergencies and Disasters
o Reduce possible loss of life and prevent disability in cases of MCI
o Components:
Operations and Dispathc
Field Management
Safety Measures
Victim Management
- Establish partnerships