Basic Level Pre-Course Reading

Chapter 6
Casualty Management
6. CASUALTY MANAGEMENT
After completing this chapter, participants will be able to:
• explain triage procedures for contaminated patients and procedures for patient transport;
• explain effective self-aid and directed first-aid for exposure to CBRN materials;
• describe the medical support for responders;
• describe the potential impact of the public’s reactions to a CBRN incident, on emergency services;
• describe the potential impact of a CBRN incident on emergency responders; and
• describe ways of managing stress before, during, and after a CBRN incident response.
The importance of a planned multi-agency response underlies a discussion in this
chapter of the issues governing triage, first-aid, and medical treatment for large
numbers of casualties of a CBRN incident. The equally serious challenge of providing
needed support for responders in a highly stressful environment is also discussed.
6.1 Triage
CBRN incidents require additional skills and protocols to deal with the complexity of the
event. An understanding of triage and first aid is a requirement for all agencies. In the
event of a mass casualty incident, personnel from all agencies will need to assist with
casualty management. Agency cross-training fosters, not only a better understanding of
others’ roles, but also the ability to respond more safely and effectively.
During a CBRN incident, responders must not contaminate themselves while attempting
to treat exposed or contaminated casualties. One of the main themes of this training
program reinforces the idea that first responders with Basic level CBRN training will not
intervene in a CBRN incident due to safety concerns. However, EMS will be triaging,
treating, and transporting casualties after the CBRN agent has been identified and after
their safety has been assured through decontamination procedures and/or donning
personal protective equipment.
EMS and other medical staff must have a thorough knowledge of triage and treatment
priorities specific to a CBRN incident. Police and fire services should be prepared to
adopt a supportive role to assist EMS as required.
6.1.1 Mass Casualty Triage
In mass casualty situations the goal is to “treat the greatest number for the
greatest good.” The material presented in this chapter is meant to expand on
existing Mass Casualty Incident (MCI) protocols.
CBRN First Responder Training Program
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Basic Level Course