First Responder EMS Curriculum for Training Centers in Eurasia

in the absence of airway problems, extremity injuries, or back injuries. These are patientswith serious injuries but no immediate life threat. The lowest priority patients are thosewith minor injuries as well as patients who are already dead or expected to die despiteinterventions.Upon arrival at a mass casualty incident a command post should be set up, dispatchnotified, and a triage officer designated. The centralization of operations will reduce theduplication of labor and increase the efficiency of the operation.Patient triage is a continuous process because patients that are initially of low priority candeteriorate. Different systems have different ways of approaching the patient evaluation,but it is important that a method is chosen by the system as opposed to leaving it up to theindividual.One simple way to rapidly triage is as follows:1. Identify the walking wounded by asking everyone who can move under his or herown power to move to a specified location. These are low-priority patients untilfurther evaluation.2. Assess the respirations of all patients who could not walk. If the patient is notbreathing, open the airway. If still not breathing, this patient is dead, so move on. Ifrespirations are above 30 or labored, this patient belongs to the immediate category.Patients with respirations below 30 are placed in the delayed category.3. Assess circulation. Any patient who is breathing but does not have a palpable radialpulse is tagged in the immediate category.4. Assess mental status. Patients with adequate respirations and perfusion who can’tfollow simple commands are triaged to the immediate category.This system is a stepwise system, and the steps must be performed in order.9. Application of Content Materiala. Procedural (How)None identified for this lesson.b. Contextual (When, Where, Why)The First Responder will apply knowledge of EMS operations throughout his/her career.Gaining access to patients and complex extrication require special skills that are not partof the focus of this lesson. For the purposes of this lesson, the important points aresafety and the medical aspects of the process.10. Student Activitiesa. Auditory (Hearing)1. Students will listen to tapes of dispatchers talking to callers and dispatchingproviders.b. Visual (Seeing)1. Students will look at actual equipment (preferred) or audiovisual materials aboutambulance equipment.2. Students will view audiovisual materials depicting an ambulance run.228 First Responder EMS Curriculum/AIHA, July 2002