Mass Casualty Triage Scenario

What tool should you use when you must quickly triage many casualties?

When deploying into a hazardous zone to complete TST, how many personnel should be allocated to each group, as a minimum?

You deploy as a pair so the other person can act as a spotter. There are two teams. You progress into the reception to start triaging patients. Immediately to your right you see your first patient. They are alert and screaming in agony. They have a catastrophic bleed to their right leg and unable to walk. What should you grade them as?

Do you require to do any treatment on this patient before moving on to the next?

You quickly put on a CAT tourniquet which stops the bleeding and move onto your next patient. Your next patient is alert but seems confused with no signs of severe bleeding or penetrating trauma to the trunk. They have quite a bad head injury and you suspect this is causing a confused answer when you ask if they can walk, you don’t think they can from first impressions. What should you grade them as?

You complete triage of the foyer and meet back with the second team. They have triaged 1 P1 patient and 2 P2 patients. You move into a long corridor with rooms either side, you both take a side each and work your way down the corridor. One of the rooms you knock, a patient answers. They state they have been stabbed in the abdomen but were able to run back to their room and lock it. They can still walk. What should you grade them as?

They also have another person in the room who is uninjured, you grade them P3. You bandage the first patient to stop the bleeding. The area is safe and there is a short walk to the casualty treatment area, but you should tell them to stay in the room and wait for a secondary team to come collect them?

They can walk so you tell them to make their way back through the reception and to your team outside in the cold zone as you know it is safe. You notify your team lead of this. You continue and find a door open with one patient on the bed. The bed is blood soaked and the patient is unconscious. The patient is not breathing. Do you start CPR?

You mark the patient with a ‘Not Breathing’ tag and move on to search other rooms. You hear over your radio that a secondary team have arrived and are going to start retrieving patients that you have already triaged. In a major incident, where would they retrieve them to?

Once at the CCS, what triaging tool can be used as a more advanced way of triaging patients?

Your team leader is asking for you to confirm how many patients you have currently triaged so they can let the secondary team know how many they need to collect. How many patients have you triaged?

You add the additional 4 patients the other advancing team have triaged in the corridor to report back to your team leader. You have reached the end of the corridor and come to a set of stairs. You can hear a lot of commotion on the floor above. Do you continue up the stairs so you can continue triage and treatment?

You haven’t had any update from police to suggest the next floor is safe, so you stay in your position and update your team leader. They reply to say the police have the assailants isolated to one room on the first floor. They are unsure where, but you can proceed with caution. They also state that more resources are ready to deploy into the ground floor. You now have plenty of resources to extricate and triage patients, should you suggest revisiting the ‘Not breathing’ patient and potentially now reconsider starting resuscitation?

The team leader agrees and deploys another team to deal with the ‘Not breathing’ patient. As you proceed and reach the top of the stairs, you hear a gunshot. Shortly after you here over the radio one assailant has been shot and the others have surrendered and been arrested. The police see you at the end of the corridor and call you forward to treat the shot assailant. He has one shot in the right side of his upper chest with one exit wound on his back. For penetrating chest wounds, which of the following work well in managing the injury?

The second triaging team have worked their way up the corridor and find no more patients. All assailants are accounted for and police state they did not progress any further into the hotel from this point so now deem the scene as a cold zone. You have an extrication sled with you and decide to quickly extricate the patient rather than wait for further equipment to make it to you to continue treatment at the scene. You hand over your patient to enhanced critical care based at the CCS. What handover tool may be more appropriate?