Basic Level Pre-Course Reading

Chapter 6
Casualty Management
Thinking Question
Describe your local triage model (the system you will be using in your
jurisdiction).
6.1.2 Triage Procedures Involving (Potentially) Contaminated
Casualties
Triage usually begins when first responders arrive on-scene and it is evident that
there are casualties. However, if contamination is suspected, Initial Triage
should take place in the Hot Zone by specialty teams, who are equipped with
PPE.
An unprotected rescuer can begin treatment of a patient only when the
appropriate decontamination measures have been undertaken; therefore, patient
care may have to be delayed until the patient reaches the Cold Zone. Do not
treat contaminated casualties without proper PPE.
6.1.3 Procedures for Transporting Patients from CBRN Sites
• Ideally, transport only decontaminated patients. If a contaminated patient is
transported anywhere, the threat of spreading the contamination to other
people, areas, and facilities may outweigh the benefits to the patient. The
transport of patients who have undergone only Emergency Washdown is a
risk-versus-benefit call.
• Avoid transporting people with no symptoms to the hospital. In many
jurisdictions, Public Health will be responsible for the disposition of these
people.
• Consider using public transit buses or school buses for shelter and transport,
especially for minor injury (green-tagged) casualties. This will preserve
ambulances for the more serious casualties. Paramedics assigned to the bus
can provide ongoing assessment and care.
6.2 First Aid
6.2.1 Directed First Aid
Directed first aid or “Bullhorn First Aid” as it is sometimes called, becomes
necessary when casualties who are (potentially) contaminated cannot be
approached or touched because they will pose a risk to responder safety. As
well, crowd control and coaching will be necessary to prevent contaminated
casualties from leaving the scene. In these situations, casualties may be
directed to administer self-aid.
CBRN First Responder Training Program
54
Basic Level Course