Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness...
-
Upload
marjorie-woods -
Category
Documents
-
view
216 -
download
1
Transcript of Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness...
![Page 1: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/1.jpg)
Mass Casualty Incident (MCI) Triage
Author
Jacob Kopp
National Center for Disaster PreparednessMailman School of Public Health
Columbia University
Date14 April 2011
![Page 2: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/2.jpg)
Outline
• Introductions• Define triage• Review the three most common triage methods• Triage in a military setting• Key takeaways
![Page 3: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/3.jpg)
Introduction
• Jacob Kopp– 10 years pre-hospital medicine
• Military/Civilian• Pre-hospital/Hospital
– MPH candidate, Columbia University– Research Assistant at the National Center for
Disaster Preparedness
![Page 4: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/4.jpg)
What is MCI Triage
• The systematic assessment and categorization of patients by severity and likelihood of survival with available resources, for the greatest number of patients in the shortest period of time.
![Page 5: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/5.jpg)
What is MCI Triage
• Maximizing survivability – In a MCI the emphasis shifts from the
individual to the population. • Triage situations mandate that individual
autonomy be placed secondary to the collective good.
![Page 6: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/6.jpg)
When to MCI Triage
• Three conditions must be met if triage is to be appropriately employed:
– A scarcity of healthcare resources exists;– A healthcare worker assesses each
patient’s medical needs; and,– The triage officer uses a system usually
based on an algorithm or criteria set, to determine a treatment or assign a treatment priority to each patient.
![Page 7: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/7.jpg)
Civilian Triage Models
• Three main models:– SACCO (STM)– START/JumpSTART– SALT
![Page 8: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/8.jpg)
SACCO
– Bill Sacco PhD– Maximize the expected number of survivors – Analysis of respiratory rate, pulse and motor
response adjusted for age and MOI– Explicit; objective – Outcome driven, measured by lives saved – Can be used on a daily basis– Expensive– Not being used by any organizations
![Page 9: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/9.jpg)
SACCO
![Page 10: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/10.jpg)
SACCO
-3 -3 -2
![Page 11: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/11.jpg)
SACCO
Survival Probability Curve for Blunt Trauma
0
0.2
0.4
0.6
0.8
1
1.2
Physiological Score
Su
vri
va
l Pro
ba
bili
ty
slow deterioration
rapiddeterioration
transitional deterioration .09 .15 .23 .35
.98.97.94.90.75
.63.49
.84
RPM: 1 2 3 4 5 6 7 8 9 10 11 12
![Page 12: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/12.jpg)
START
• Simple Triage And Rapid Treatment• Do the greatest good for the greatest number • Used by most pre-hospital professionals• Easy• Not specific; subjective • Can’t be measured • Can’t be reproduced; no formulation of problem
![Page 13: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/13.jpg)
JumpSTART
• The world's first objective tool developed specifically for the triage of children in the multi-casualty/disaster setting.
• Objectives:– Optimize the primary triage of injured children in
the MCI setting– Enhance the effectiveness of resource allocation
for all MCI victims – Reduce the emotional burden on triage personnel
who may have to make rapid life-or-death decisions about injured children in chaotic circumstances
• *Not for daily EMS or hospital triage
![Page 14: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/14.jpg)
Civilian Triage Models
![Page 15: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/15.jpg)
![Page 16: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/16.jpg)
![Page 17: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/17.jpg)
S.A.L.T.
• Sort• Assess• Lifesaving Intervention• Treatment/Transport
• The new National Standard for performing triage.• Developed by a Multidisciplinary committee with a
CDC grant
![Page 18: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/18.jpg)
S.A.L.T.
![Page 19: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/19.jpg)
Military Triage
• TCCC– Tactical Combat Casualty Care– Three phases
• Care Under Fire • Tactical Field Care• Combat Casualty Evacuation
– Subjective triage • DIME
– Delayed– Immediate – Minimal – Expectant
![Page 20: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/20.jpg)
Key Takeaways
• Expect to be overwhelmed• There are three types of patient:
– Those that will die despite every resource;– Those that will survive only with the proper
intervention; and, – Those that will survive without any medical aid
• The hardest part of triage is deciding where the line between delayed and immediate falls
![Page 21: Mass Casualty Incident (MCI) Triage Author Jacob Kopp National Center for Disaster Preparedness Mailman School of Public Health Columbia University Date.](https://reader035.fdocuments.us/reader035/viewer/2022062421/56649ce05503460f949a9bee/html5/thumbnails/21.jpg)
Thank You