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.