Disaster Medicine by David E Hogan

By David E Hogan

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Clearly, the amount of information obtained during this short encounter will depend on the training and experience of the triage officer. This is one of the reasons that triage must be dynamic with repetitive triage evaluations on casualties that are selected to wait for care. Experience has given the triage officer 2. Triage 23 ◗ TABLE 2-2 Clues to Improve Triage Sensitivity Physiologic clues Altered mental status Anxious Apprehensive Pulse examination Soft Nonexpansive Anatomic clues Body region injury Chest Abdomen Amputation Specific measurements Resting tachycardia Systolic pressure <100 mm Hg Pulse pressure <30 mm Hg Resting tachypnea Modified from Burkle FM, Newland C, Orebaugh S, et al.

Casualties arriving dead are recorded (carded) as such, identified by medical informatics, and taken to the morgue or other designated area where they are secured. The figure provided and the discussion in the preceding text demonstrates only a generic set of organizing principles associated with disaster triage at the level of the hospital. Other methods are certainly possible and variations in hospitals will require specific modifications. However, each plan used will retain most of the organizational elements noted.

In general, the more clinical experience the triage officer has the better. In disaster triage, it is the alteration in physiology that should be focused on, not the disruption of the anatomy (7,25,26). ’’ These are lofty words to be sure, but what do they mean in human terms for the casualties presenting to the ED during a disaster? Although it is clearly our intention to benefit the largest number of casualties, and provide the best service to society, we cannot currently be sure that our disaster triage methods are achieving this.

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