How do you triage these patients?

[RomeViking09]

For class I am doing a project looking into how working EMTs and Medics would triage these patients Here is the additional Call info: You are dispatched to a college campus for a football bleacher that has caved in. You have at least 30 PTs, 8 ALS and 4 BLS units in route to the scene your the first unit on scene and have started triage above are your first 3 PTs. (I would like to know why you place each PT and your working level {EMT-B, EMT-I, Paramedic, Etc...} and would like at least 10 EMTs and 10 Medics to respond) Thanks

[crotchitymedic1986]

I agree with whoever voted first, being pregnant is not an emergency, but many folks make the mistake of transporting them first before more critical patients, or working a pediatric or adult arrest during an MCI. A tip on triage at an MCI:

(this should make someone mad, but it works). You get on your external radio/PA or yell, "If you are injured and can walk, walk over to this ambulance or green tarp and sit down, some one will be with you shortly". That instantly separates your yellow/greens from most red/blacks --- obviously you will need to triage them to make sure you didnt have a walking red.

[temsp40]

For class I am doing a project looking into how working EMTs and Medics would triage these patients Here is the additional Call info: You are dispatched to a college campus for a football bleacher that has caved in. You have at least 30 PTs, 8 ALS and 4 BLS units in route to the scene your the first unit on scene and have started triage above are your first 3 PTs. (I would like to know why you place each PT and your working level {EMT-B, EMT-I, Paramedic, Etc...} and would like at least 10 EMTs and 10 Medics to respond) Thanks

I have triaged all your patients, and I am wondering what your criteria for triage is, are you working on the "phenomenom" of SMART triage the the military and several other states are using, or are you planning on utilizing some other triage standard. Based on your scenario, the first patient is deemed yellow because of the inability to ambulate. The second patient is green, although she is an OB patient and the final patient begins as red, but my guess is this patient will rapidly deteriorate to a black category. These determinations are made upon initial triage and will be further triaged when they arrive at the treatment areas.

I am a Paramedic in MA.

[brentoli]

The first yellow was due to the fractures, and the elevated pulse/decreased BP.

The second I considered yellow. My reasoning (with out looking at any protocols) is that with being pregnant, and the elevated vitals, she will need to go in and get checked out, but not get mixed in with the walking wounded when they make their mass exodus from the scene.

The third is obviously red. In a low manpower/high patient situation, though, she would probably be black.

[fiznat]

I called the first red because I'm not sure of his volume status. Two long bone fractures and borderline hypotensive with tachycardia sounds like compensated shock to me. I could see calling it yellow also, though.

Second was green. This is an MCI and she's got good vitals and a minor lac. Pretty sure you don't get bumped to yellow just because you are pregnant.

Third is clearly red until she codes.

Edited April 13, 2009 by fiznat

[rock_shoes]

Patient 1: Red. This patients BP in conjuntion with his HR indicate that he may be compensating for volume lost. It is also possible that this patients shock progression is primarily psychosomatic but I don't have CT, X-Ray, or MRI on scene to confirm so off he goes.

Patient 2: Yellow. The Mother herself is a green but I don't have the diagnostic tools reqiured available at a scene like that to check on the unborn.

Patient 3: Black. This patient would have an extremely low chance of survival even if she where the only patient there. Her initial BP isn't even enough to maintain any kind of a perfusion head and death is likely iminent. Don't risk losing your reds to try and save someone like this when you have 30 other patients to worry about.

Edit: Having re-read the scenario you seem to have an unusually great amount of resources available. In those circumstances it would be possible to bump patient 3 up to Red until she arrests.

Edited April 13, 2009 by rock_shoes

[brentoli]

Your poll is no longer worth anything. You had about half of your votes before you changed the scenario. Just FYI.

[RomeViking09]

Your poll is no longer worth anything. You had about half of your votes before you changed the scenario. Just FYI.

Posted them both at the same time in the same post (can't help the posting system)

[Chief1C]

Who the hell voted #1 as a green tag?

We use the Smart Triage/IC system, anyone who cannot ambulate due to injury is automatically a Priority 2 (Yellow Tag).. and I'm gonna go out on a limb, and guess that he ain't going anywhere with an open fracture of a leg.

[rat115]

I had to put that OB pt up to a yellow instead of a green because of the scenario. If she's fallen and her b/p is already a bit high, I'm going to watch her close. THere's a chance of complications with the baby that may not show because of the fall alone.