Talk:Simple triage and rapid treatment

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[edit] I

I am an Undergraduate Student at the University of Virginia majoring in the Electrical Engineering Field with a minor in Engineering Business. I am currently working with a professor, whose research is in First Responders, researching the ethical aspects of obtaining medical information from patients and having it be applied to everyday life as well as during emergency crisis for my thesis. Sweetdid15

[edit] Instructive section

This was at triage. It can probably be killed outright (this kind of "howto" doesn't really belong in an encyclopaedia), but maybe someone can salvage something?

Only perform triage for two or more injured persons. For a single injury, always perform first aid!
Some form of marking is very helpful to ration care. If you have triage tags—the right solution—immediately available, use them. If you have a marker or lipstick on your person, mark foreheads with "D" for deceased, "I" for Immediate, "DEL" for Delayed or "M" for "minor injuries." Unmarked or untagged persons should be considered unevaluated. If you cannot mark or tag, proceed anyway.
Triage 1: Loudly and authoritatively ask the group to get up and walk to a safe area that you designate. Do not ask them to walk to the sound of your voice. Designate a particular close area. Anyone who can walk does not need immediate life-saving help in a mass casualty situation. However, people can change categories, and the walking wounded are usually the largest category of victim. A person in shock, for example, might start an incident able to walk, and then faint in the walking-wounded area.
Those with minor injuries are your human resources to perform first aid. You will tell them what to do.
If you have not called for help, point at a particular person, and forcefully ask them to call for help. Make eye-contact, and get them to promise to do it. Ask them to call for help using the local emergency telephone number (9-1-1 throughout the United States and most of Canada, 1-1-2 throughout most of the European Union [but 9-9-9 in the UK and 18 in France], 101 in Israel and 000 for Australia).
Triage 2: On each remaining person, check RPM—Respiration, Perfusion, and Mental state. For each person, follow this procedure:
Triage 2R: If a person is not breathing, adjust their head and clear their airway. If that does not restore their breathing, they are beyond your ability to help. Tag them as DECEASED. Do not start CPR as several other persons may die while you are trying to save just one.
If a person is breathing, check the rate. If it is more than twice as fast as yours—more than 30 inhale/exhale cycles per minute—they are entering shock. Mark them IMMEDIATE; have a person with minor injuries lay them down, elevate their feet, and warm them with a blanket or jacket. As soon as you have instructed the walking-wounded care-giver, move on.
Triage 2P: If a person is breathing, but less than 30 cycles per minute, check their perfusion (blood circulation) by pressing and releasing a fingernail, or the ball of a finger, and seeing if it turns pink within two seconds. Use the ball of the finger if they have nail polish. If it's dark, use your flashlight, if you have one on your person. If it's dark and you have no flashlight, you may check for a pulse at their neck. If they are not perfused, tag them as IMMEDIATE.
Checking the fingernail is both faster and more reliable than checking the pulse, if the light permits, and this means you are less likely to mismark a person as "IMMEDIATE."
Triage 2M: If they are breathing and perfused, check their mental state. Ask them their name, and what happened. If they cannot reply, or say something unrelated, ask again, and tell them that you are testing to see if they are mentally confused. If they are confused, it may indicate a brain injury, which is beyond your ability to help. Tag them as "I" or IMMEDIATE for immediate transportation.
If the person is not confused, mark them DELAYED to indicate that they are stable and their transportation to the hospital may be delayed.
Now quickly check the person for bleeding. If a large wound is arterial bleeding, determine the first aid method of treating it, and ask the victim (if they are rational) or a particular person ("YOU, yes YOU...", not "Somebody") with MINOR injuries to perform the care.
Now, go back and repeat the process for the next person. Using this process, a trained responder can evaluate most injuries in less than thirty seconds. Remember, do not give care yourself. Give the care-giving tasks to walking wounded on the scene, so you can be free to evaluate other people.
Triage 3: Evaluate the IMMEDIATE injuries to prescribe first aid. Deputize people with MINOR injuries and bystanders to perform first aid operations, by telling them what to do for each person. There are almost always enough people to perform the needed first aid when given instruction.
Triage 4: Evaluate the DELAYED injuries to prescribe first aid. Recruit the victim to self-treat, or people with MINOR injuries to perform the first aid operations, by telling them what to do for each person.
Triage 5: Train one of the persons with MINOR injuries to watch the other MINOR injuries for signs of shock. As time permits, examine the victim, including the MINOR injury patients for shock. Look for very rapid breathing, more than twice as rapid as yours, and confirm by touching their skin. If they are clammy or cold, or the breathing is sufficiently rapid, they are entering shock. Have them sit down. If they are sitting, have them lay down. If they are lying down and you have no reason to suspect spine injury, have them raise their legs. The object is to raise the blood pressure to their inner organs to prevent oxygen starvation of major tissues, which is one way that shock kills. If possible, try to keep shock victims dry and warm to reduce their need for oxygen. If you have oxygen, and know how to administer it, do so. As you have time, tag walking wounded as "WALKING" and upgrade shock victims to "IMMEDIATE".

[edit] Academic reference

I have not been able to find an academic reference for START. Only recent papers compare it with other triage systems. Does anyone know a good ref. JFW | T@lk 15:31, 8 July 2007 (UTC)

[edit] Cap Refill

Hey, cap refill is a horrible sign, and shouldn't be part of START, could someone please cite a source for checking cap refill? From my experience, and as per the Red Cross First Responder Instructor Manual, page 201, a radial pulse is the correct assessment. purpleidea (talk) 05:48, 17 February 2008 (UTC)