Visual 3.1

Unit 3: Disaster Medical Operations

Visual 3.2

Unit Objectives

1. Identify the “killers.”

2. Apply techniques for opening airways, controlling bleeding, and treating for shock.

3. Conduct triage.

Visual 3.3

Identify the “killers”

The “Killers”: Airway obstruction Bleeding Shock (circulation)

Visual 3.4

Respiratory System

Components of a respiratory system: Lung Bronchus Larynx Pharynx Nasal Air Passage Trachea

Visual 3.5

Airway Obstruction

In an unconscious or semi-conscious victim the tongue-which is a muscle- may relax and block the airway.

A victim with a suspected airway obstruction must be checked immediately for breathing and, if necessary, the airway must be opened!

Visual 3.6

Head-Tilt/Chin-Lift

Visual 3.7

Maintaining the Airway

If breathing is not restored on the first try using the Head-Tilt/Chin-Lift method, CERT members should try again. If breathing IS NOT restored,

move on. If breathing IS restored place

a soft object under the victim’s shoulders, then move on.

Visual 3.8

Spinal Precaution

Head, neck and spinal injuries are common during disasters. Used properly the Head-Tilt/Chin-Lift method causes little spinal manipulation because the head pivots on the spine.

Option: Use the jaw-thrust method. Grasp under the jaw and displace it forward.

Visual 3.9

Controlling Bleeding

The average adult has about 5 liters of blood. Losing one liter can result in death.

Visual 3.10

Controlling Bleeding

Arterial Bleeding- Arteries transport blood under high pressure. Bleeding from an artery is spurting.

Venous Bleeding- Veins transport blood under low pressure. Bleeding from a vein is flowing.

Capillary Bleeding- Capillaries also carry blood under low pressure. Bleeding from capillaries is oozing.

Visual 3.11

Controlling Bleeding

Visual 3.12

Tourniquet Usage

Tourniquets are a LAST RESORT option.

In a disaster setting response resources may be delayed. CERT members may have to resort to tourniquet usage to “save life & limb”.

Visual 3.13

Treating Shock

Definition: Shock is a disorder resulting from ineffective circulation of blood. Remaining in shock will lead to the death of

cells, tissues then entire organs The body will attempt to compensate for any

blood loss by:

• Rapid, shallow breathing

• Increased capillary refill >2 seconds

• Failure to follow simple commands

Visual 3.14

Blanch Test (capillary refill)

Visual 3.15

Procedures for Controlling Shock

Visual 3.16

Conducting Triage

Triage is an effective strategy in situations where: Victims outweigh rescuers Limited resources Time is critical

Visual 3.17

Haz Mat Situations

CERT members should leave the scene to avoid harm to themselves, and to reduce the risk of spreading the contamination.

Visual 3.18

The Goal of Triage

Do the greatest good for the greatest number.

Visual 3.19

Triage Categories

Immediate

Injuries jeopardize

“the killers”

Delayed

Injuries do not jeopardize “the killers”

Minor

“walking wounded”

Dead

No life status

Virginia Triage Tag

Visual 3.20

Contaminated Victims

Victims that have been exposed to contaminates in some regions get tagged BLUE. This tag remains with the victim until proper decontamination has been completed.

Visual 3.21

Personal Protection Equipment (PPE)

CERT members must wear all safety equipment to prevent accidental exposure. Helmet Latex gloves* Goggles Particle mask

(N95 or duck-bill)

*allergy caution!

Visual 3.22

Triage Equipment

Ground Tarps

Triage Tape(notice the black is now striped!)

Triage Tags

MCI Trailer

Visual 3.23

Conducting Triage

Step 1: Stop, look, listen, and think Step 2: Conduct voice triage Step 3: Start where you stand Step 4: Evaluate, tag them and move on Step 5: Treat a red tag’s problem immediately Step 6: Document results

• How many victims

• There location

Visual 3.24

S.T.A.R.T. Triage

Visual 3.25

Jump S.T.A.R.T.

Visual 3.26

Performing Triage Evaluation

Airway Position yourself on one side of the victim. Gently shake the victim for response.

• If no response:–Open the airway–Look, listen and feel for breathing–>30 respirations ? (RED TAG)–Not breathing after two attempts

(BLACK)

Visual 3.27

Performing Triage Evaluation

Bleeding All victims are tagged YELLOW unless: Uncontrolled bleeding

• Tag RED

• Hold direct pressure, do not cut-off circulation!

• Use GREEN victims for assistance. Perform a blanch test

• >2 seconds tag RED

Visual 3.28

Performing Triage Evaluation

Mental Status (level of consciousness) Inability to respond to simple commands tag

RED

• Shock?

• Diabetic?

• Drunk?

• Stroke?

• Seizure?

Visual 3.29

Triage Documentation

Come up with a means to track your triage findings and the victims location (if necessary).

• Chart method

• Cloths pins

• Pieces of ribbon

• Hash marks

• Etc……

Visual 3.30

Reverse Triage

Used for MCI lightening injuries. The BLACK tags are treated first. High potential for respiratory arrest High potential for cardiac arrest conversion with a AED

Visual 3.31

Triage Pitfalls

No team plan, organization, or goal Indecisive leadership Too much focus on one injury Treatment (rather than triage) performed

Visual 3.32

“Break” Time !