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Chemical injuries
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
Casualties on the scene of a chemical disaster will be divided into these four groups according to the chemical and/or other injuries such as mechanical and blast injuries or thermal burns. All persons who have been exposed to hazardous materials and who are asymptomatic at the time of triage should be labelled with a capital C on the triage tag or casualty form and evacuated to a medical facility11. Triage during transport and at the medical facility will again be based on the same principles. It is more likely, however, that by the time the casualties reach the hospital, enough time would have elapsed to permit the appearance of the signs and symptoms indicative for poisoning.
The Use of Field Triage in Disaster and Mass Casualty Incidents: A Survey of Current Practices by EMS Personnel
Published in Prehospital Emergency Care, 2018
Kevin Ryan, Douglas George, James Liu, Patricia Mitchell, Kerrie Nelson, Ricky Kue
Commercially available triage tag designs are intended to allow EMS providers to rapidly track patient flow and clinical data in a compact, efficient tool from point of injury to definitive care. While this is considered the “gold standard” of triage practice, it may not always be feasible for EMS personnel to complete triage tags prior to transport. Other practices that focus less on data collection and only assign a triage category such as simple color-coded triage tape or labels have been suggested (9). Geographical triage, by which casualties are brought to a specific sector of the collection area based on their priority level as designated by a triage officer, has also been described as an efficient alternative to triage systems that heavily rely on tag usage (10,11).
Implementing a Patient Tracking System in a Large EMS System
Published in Prehospital Emergency Care, 2022
Andra M. Farcas, Hashim Q. Zaidi, Nicholas P. Wleklinski, Katie L. Tataris
Our review of the patient tracking system used during planned operational periods and mass gathering events revealed several important findings and opportunities for improvement. Our prehospital system identified four conclusions based on our implementation experience. First, use of a web-based system with barcode identifiers was able to track patients from prehospital to hospital during planned operational days and mass gathering events. Second, the percent of scanned patients increased after the first operational day and remained consistent in subsequent events. Review of the second operational day compared to the first demonstrated improvement in both EMS scanning and hospital scanning of patient transports. There was a higher patient/hour scanned by EMS during the second operational day at 33.5 patients per hour compared to 25.9 patients per hour for the first, as well as a higher percentage of total transports scanned at 96% for the second compared to 88% for the first. There was also a higher hospital scanning percentage with the second operational day at 88% of patients scanned and 100% hospital participation compared to the first scanning percentage of 57% and 89% hospital participation. This highlights the importance of communication and training in any new process or policy to improve compliance for users. While the hospital disposition data were only tracked during the second operational day, the low numbers (37%) may be due to provider unfamiliarity and the delay in time from the initial hospital scan to the time when the disposition is determined for the patient or the additional step in the scanning process. Third, the use of a single patient tracking system between Chicago Fire Department EMS, private EMS providers, and hospitals allowed for a common method of monitoring patient movement in real time through a planned event which allows for improved incident management. The use of a statewide barcoded triage tag for mass casualty incidents also encourages standardization and serves to promote inter-agency collaboration. Finally, while this patient tracking system was used in planned operational days and mass gathering events and the utility of such a patient tracking system is not for every disaster or incident, we believe there is benefit to further research testing this type of system in unplanned events.