2017 has been a year filled with disasters. Disaster generally means mass casualty situations. Mass casualty means someone has to triage/sort the victims. Hospitals now conduct mass casualty training as well as drills for active shooter lock down. Until you actually have to respond to this situation it is hard to know how you would react. Would you know how to triage victims in the chaotic situation of a mass casualty. When I served in the Army Reserve we trained annually for mass casualty situations since we were capable for quick deployment to a large disaster area.
The first step in a mass casualty situation is triage. The best response to mass casualty is founded on the principle of triage. Triage is the system of sorting and prioritizing casualties based medical needs and resources. The priority is different for the military environment than in civilian situations.
Triage helps to establish order in a chaotic environment. Nursing assessment skills will be helpful in the triage process. To provide the greatest good to the greatest number it is important to understand how to triage victims. Triage takes into account time, distance, and capability. As casualties move within the system triage will be a constant process .
As an Army nurse I had to understand that triage for the military is different than for the civilian population. The military goal is to get as many soldiers back into action as possible. When triaging civilian population the goal is to maximize the survival of the greatest number of victims as possible. So someone with the least serious wounds will be treated first by the military medical team. As a civilian I would see that the person with the most serious but realistically salvageable injuries would be treated first.
Making the hard decision
- Red -Life threatening but treatable injuries requiring rapid medical attention.
- Yellow -Serious injuries that are stable enough to wait for medical treatment
- Green -Minor injuries that can wait for longer periods of time for treatment
- Black -Dead or still with life signs but injuries are incompatible with survival in austere conditions
Triage is a process that is done more than once. Victims are reassessed frequently and their status may change if they begin to deteriorate.
The Travel Nurse in Mass Casualty
Mass casualty situations can occur anywhere and at anytime as we have seen. When you travel from city to city and facility to facility you need to know what is your role. What if you are in a situation where mass casualty crisis happens? Do what you have been trained to do as a nurse. You move from victim to victim assessing where you can do the most good until EMS arrives.
In today’s world the likelihood of either being a victim or being the first of the scene is more likely in your career as a nurse. I myself have never been a victim but have been on the scene of a mass shooting shortly after it occurred. Stay up to date with training and be aware of the resources in the city where you are assigned.
You need to be aware of what is your hospital, clinic, nursing home or home health agency is doing to prepare to help if your community has a mass casualty situation. Do you know what your role is? Who would you call if first on the scene? Can you go in and at a local facility on short notice?