Triage and Moving Victims
Emergency triage during disaster with multiple victims
First aid rescuers are sometimes presented with horrific scenes of natural or manmade disasters that leave a havoc of multiple victims with injuries ranging from mild to life-threatening. You may encounter emergency situations where there will be more than one injured person. Being able to prioritize and classify the extent/seriousness of the situation and the injuries and being able to selectively care for victims with much serious injuries and progressively caring for the less serious ones is a process known as triage.
An in-depth but quick assessment is essential in caring for multiple victims from a disaster. Ask all able and walking victims to get up and move to a specific area where they will be attended to later. Victims who are able to get up and walk normally have no life-threatening injuries are classified as “walking wounded”.
It is very crucial to identify who needs life-saving treatment immediately and which ones can be delayed. Check motionless victims first since they are the ones who cannot verbalize their condition and they are the ones who are generally in a much serious condition. Check for breathing and if the victim is not breathing, open the airway and if possible place the victim in the recovery position. Secondly, check for profuse bleeding among serious injured victims and if possible enlist the help of bystanders to assist in giving direct pressure to help control bleeding.
Once you have tended to the needs of the severely injured victim, you can then proceed checking and giving care to victims with less serious injuries. You will usually be relieved of your responsibilities once emergency medical personnel arrive to handle the situation.
Classify victims according to the following care and transportation priorities.
- Immediate care: Victims needing prompt care and transport to a medical facility as soon as possible.
- Severe burns
- Breathing difficulties
- Profuse and uncontrolled bleeding
- Delayed care: Care and transport can be delayed up to a maximum of 1 hour.
- Minor extremity burns
- Back injuries with/without suspected spinal cord injuries
- Bone or joint injuries with/without significant bleeding
- Minor closed fractures
- Minor wounds
- Walking wounded: Care and transport can be delayed up to 3 hours.
- Dead: Victim is obviously lifeless and no signs of life and is unlikely to survive with the type or extent of the injuries.
A victim should not be moved until he/she is ready for transport to a medical facility or if there is an immediate danger such as:
- Fire or danger of fire
- Explosives or other hazardous materials
- Impossible to safeguard and secure the victims from environmental hazards
- Impossible to gain access to other victims in the event who needs lifesaving care (CPR) such as a motor vehicular crash.
The major danger in moving a victim quickly is the possibility of worsening the existing injury. For a victim on the ground, carefully pull the victim in the direction of the long axis of the body to provide as much protection to the spinal region. Several methods exist for moving victims:
- Ankle drag
- Shoulder drag
- Blanket pull
- Human crutch
- Cradle carry
- Fire fighter’s carry
- Piggyback carry
- Two person assist
- Extremity carry
- Two-handed seat carry
All injured parts should be steadily stabilized before and during moving. If rapid transportation is not needed, it will be a feasible option to practice moving a same size non-injured victim first before moving the actual victim.