TRIAGE AND DISASTER MANAGEMENT
Triage and Disaster ManagementDefinition of TriageDerived from
French word, trier which means to sort.A method of quickly
identifying victims who have immediately life-threatening injuries
and who have the best chance of surviving.System of priorities to
maximize the number of survivors.
Triage during disasterMass-casualty or multi-casualty
incidentInvolves more than one victimAim :Sort the victims in order
of severityBased on their medical needBased on the available
resources Provide the best outcome for the greatest number of
patients
Disaster triage vs emergency department triage :During a
disaster with limited resources, victims with little or no chance
of survival are not resuscitated. 5s RuleSafety assessmentAssess
the scene for safetySelf-protecting measures
Scene size upSize of the scene areaType of incidentEstimate the
number of patientsSeverity of injuriesThe access route
Send information Information regarding the scene size upRequest
for assistance and additional resourcesSetting up sceneSafe and
sheltered location to move the patientsObtain triage ribbon to mark
the patientsConsider scene access and egress
START triage process Simple Triage And Rapid Treatment To allow
rapid assessment of respiration, perfusion and mental status
(RPM).
START triage scaleColourCategory RedPatients who need immediate
care and transport as soon as possible. YellowPatients whose
treatment and transportation can be temporarily delayed. Green
Patients whose treatment and transportation can be delayed until
last. BlackPatients who are already dead or have little chance for
survival.Red First priority, very urgentYellow Second priority,
urgentGreen Third priority, walking wounded, non urgent Black
Negligible chance of survival 8START STEP 1Can the patient walk ?
NOYESGreen / MinorEvaluate respiration STEP 2START STEP
2Respiration present?YESNOOpen airwayNo respirationsRespirations
Black / Deceased> 30/minEvaluate perfusion STEP 3Red /
Immediate< 30/minRed / ImmediateSTART STEP 3PerfusionAbsent
Radial PulsePresent Radial PulseControl HemorrhageEvaluate mental
statusSTEP 4Red / ImmediateSTART STEP 4Cant Follow Simple
CommandsMental statusCan Follow Simple CommandsRed /
ImmediateYellow / Delayed
Definition of DisasterIncident that occur in a sudden manner,
complex in nature, resulting in the loss of lives, damages to the
property or the environment as well as affecting the daily
activities of local community. Requires the handling of resources,
equipment, frequency and extensive manpower from various agencies
as well as effective coordination. National Security Council (NSC)
Directive 20 1997Types of DisasterNatural disaster such as floods
and landslideAccidents involving transportation Collapse of high
rise buildingsMajor fire incidentsAir and environmental disasters
such as hazeIndustrial disasters such as explosion and emission of
hazardous materialsPolicy and MechanismUnder the National Security
Council, an organisation was formed to manage on scene incident in
major disasters on land. Disaster Management and Relief Committee
that was established at Federal, State and District level. Disaster
Operation Control Center at each level : Monitor the progression in
term of search, rescue and relief efforts to the victims. On scene
post (at the incidence scene)Commander : PoliceDeputy commander :
Fire and Rescue DepartmentRoles:To assess, manage and coordinate
all search and rescue efforts at the incident scene. Request
assistance at higher level (if required). To appoint officers and
personnel from Royal Malaysia Police (RMP) and other agencies as
responders to disaster management. Communicate with the Disaster
Operation Control Center.
Agencies roles at disaster site RolesAgencySearch and rescue
Police, Fire and Rescue Department, SMART, Army Health and medical
Emergency Medical Service, Malaysia Red CrescentSecurity control
Police, RELA, Army Support Local authorities, TNB, TELEKOMMedia
Information and broadcasting departmentWelfare Welfare
departmentSMART Special Malaysia Disaster Assistance and Rescue
Team19
