NREMT EMT 5: Operations - Triage, START/JumpSTART, SALT, Color-Coded Tagging

What This Is: Triage

Triage is a way to quickly sort people in an emergency situation, based on how badly they're hurt and how quickly they need medical help. Imagine you're at a disaster scene with many injured people. You need to decide who to treat first, who can wait, and who needs to be left alone. Triage helps you make those tough decisions.

Key Steps / Core Facts

• START/JumpSTART: A simple triage system that uses color-coded tags to quickly identify patients. (JumpSTART: Sort, Triage, Airway, Breathing, Circulation, Disability, Exposure, and Transport)
  • Why it matters: Helps EMS teams quickly identify patients who need immediate care.
  • Example: A patient with a severe head injury needs to be tagged red (immediate care).
• SALT: A triage system that uses color-coded tags to identify patients. (Sort, Assess, Life-threatening, Treatment)
  • Why it matters: Helps EMS teams quickly identify patients who need immediate care.
  • Example: A patient with a severe head injury needs to be tagged red (immediate care).
• Color-coded tagging: Using colored tags to quickly identify patients who need immediate care (red), delayed care (yellow), or no care (green).
  • Why it matters: Helps EMS teams quickly identify patients who need immediate care.
  • Example: A patient with a severe head injury needs to be tagged red (immediate care).
• Assessing patients: Quickly checking patients for vital signs, injuries, and other conditions.
  • Why it matters: Helps EMS teams identify patients who need immediate care.
  • Example: A patient with a severe head injury needs to be assessed for breathing and circulation.
• Prioritizing patients: Deciding which patients need immediate care, delayed care, or no care.
  • Why it matters: Helps EMS teams allocate resources effectively.
  • Example: A patient with a severe head injury needs to be prioritized for immediate care.
• Communication: Clearly communicating with patients, families, and EMS teams about triage decisions.
  • Why it matters: Helps prevent misunderstandings and ensures patients receive the right care.
  • Example: A patient's family needs to be informed about the triage decision.
• Documentation: Keeping accurate records of triage decisions and patient care.
  • Why it matters: Helps EMS teams track patient care and make informed decisions.
  • Example: A patient's medical record needs to be updated with triage information.
• Red flags: Warning signs that indicate a patient needs immediate care.
  • Why it matters: Helps EMS teams quickly identify patients who need immediate care.
  • Example: A patient with a severe head injury has a red flag (severe bleeding).
• Triage teams: Trained teams that perform triage in emergency situations.
  • Why it matters: Helps ensure accurate and efficient triage decisions.
  • Example: A triage team is deployed to a disaster scene.
• Triage tools: Equipment and resources used to perform triage.
  • Why it matters: Helps triage teams make accurate and efficient decisions.
  • Example: A triage team uses a triage tag to identify a patient.
• Triage protocols: Standardized procedures for performing triage.
  • Why it matters: Helps ensure consistent and accurate triage decisions.
  • Example: A triage team follows a standardized protocol for triaging patients.

What Laypeople Can Do

• Stay calm: Remain calm and focused in an emergency situation.
• Assess the scene: Quickly check the area for hazards and potential dangers.
• Call 911: Call emergency services if you're in the United States.
• Provide basic care: Offer basic care, such as CPR or first aid, if you're trained to do so.
• Follow triage instructions: Follow the instructions of triage teams and EMS personnel.

Common Mistakes

• Mistake: Failing to prioritize patients based on their condition.
  • Fix: Use a triage system, such as START/JumpSTART or SALT, to quickly identify patients who need immediate care.
• Mistake: Not communicating clearly with patients, families, and EMS teams.
  • Fix: Clearly communicate triage decisions and patient information to prevent misunderstandings.
• Mistake: Not documenting triage decisions and patient care.
  • Fix: Keep accurate records of triage decisions and patient care to ensure informed decision-making.

Quick Practice Scenarios

1. You're at a disaster scene with many injured people. A patient is lying on the ground, bleeding severely from a head wound. What should you do first?

Answer: Call 911 and alert the triage team to the patient's condition.

1. You're at a concert and a person collapses. What should you do first?

Answer: Check for danger (oncoming traffic, fire) and then shout and tap their shoulder to try to rouse them.

1. You're at a hospital and a patient is being triaged. The triage team tags the patient red (immediate care). What should you do first?

Answer: Alert the EMS team to the patient's condition and prepare for immediate care.

Last-Minute Exam Cram

• Agonal breathing is NOT normal breathing – start CPR.
• Normal blood pressure: 90-120/60-80 mmHg.
• Normal heart rate: 60-100 beats per minute.
• Normal respiratory rate: 12-20 breaths per minute.
• SAMPLE: Size, Age, Mechanism, Allergies, Past medical history, Last meal.
• OPQRSTI: Onset, Provocation, Quality, Region, Severity, Timing, Insurance.
• CPR compression depth: at least 2 inches – like pushing down a soda can.
• CPR compression rate: 100-120 compressions per minute – like a metronome.
• Triage tag colors: red (immediate care), yellow (delayed care), green (no care).
• Triage team roles: leader, recorder, and triage officer.
• Triage tool: triage tag, triage chart, or triage app.
• Triage protocol: standardized procedure for performing triage.
• Red flags: severe bleeding, severe head injury, severe burns, or severe respiratory distress.