EMS Triage Curriculum 004

Waving: Triage a responsive patient with moderate injuries (leg fracture) who requires DELAYED category assignment (YELLOW tag)

You are a First Responder on duty one night when there is an explosion near a factory! A large propane tank just exploded near an employee break area with approximately 25-30 employees in the vicinity! You estimate between 15 and 20 people were injured. The uninjured employees have evacuated and declared the area safe. You radioed for assistance, and additional ambulances and five more paramedics/EMTs will arrive in about 5 to 10 minutes. You need to quickly triage patients using the Sort-Assess-Life-Saving-Interventions-Treatment (SALT) protocol. You have an Advanced First Aid Kit that includes Triage Tags.

There is a Level II Trauma Center approximately 10 minutes away by ground, and a Level I Trauma Center about 60 minutes away by ground. You do not have air medical evacuation options due to weather conditions. The ambulance crews in your region have ventilators but do not carry blood products.

Patient Communication

Patient: Hey, I am here to take care of you.
Response: Thank you. I can't walk.
Location: Head
Patient: Can you tell me your name?
Response: Matthew Marcus.
Location: Head
Patient: What happened?
Response: There was an explosion. I got thrown and landed on my leg.
Location: Head
Patient: Are you hurting anywhere?
Response: My leg hurts really bad. I think it's broken. My hand hurts too.
Location: Head
Patient: Does your throat hurt or feel tight?
Response: No. My throat feels fine.
Location: Head
Patient: Are you having a hard time breathing?
Response: No. I can breathe normally.
Location: Head
Patient: Does your chest hurt?
Response: No, just my arm and shoulder.
Location: Head
Patient: Did you pass out (lose consciousness)?
Response: No. I didn't pass out.
Location: Head
Patient: Do you have any numbness or weakness?
Response: No. Just pain in my leg.
Location: Head
Patient: Does your head hurt?
Response: No. My head feels normal.
Location: Head
Patient: Does your neck hurt?
Response: No, I don't think so
Location: Head
Patient: Does your back hurt?
Response: No, I don't think so
Location: Head
Patient: Does your abdomen hurt?
Response: No, I don't think so
Location: Head
Patient: Do you have any allergies?
Response: No, I don't have any allergies
Location: Head
Patient: Do you take any medications?
Response: No, I don't take any medications
Location: Head
Patient: Do you have any medical problems?
Response: No, I don't have any medical problems.
Location: Head
Patient: Have you ever had any surgeries?
Response: No, I've never had any surgeries.
Location: Head
Patient: When did you last eat or drink something?
Response: I drank some water about an hour ago.
Location: Head
Patient: Do you smoke, drink, or use recreational drugs?
Response: No. I don't use any of those.
Location: Head
Patient: I'm going to take care of you.
Response: Thank you, it hurts so bad
Location: Head

Scoring Details

Change triage type to delayed
Exam: Ask patient
Airway: Jaw thrust maneuver
Listen for breathing
Head-tilt-chin lift
Patient disposition: Medical Evacuation

Scenario Details

Scenario Package
SALT Triage EMS Curriculum
Learner type
  • preshospital
Patient severity at start
Serious
Patient severity overall
Serious
Duration to complete
5-10 minutes
Scenario difficulty
Standard
Environment
POI
Equipment
  • Bandage
  • Combat Application Tourniquet (1)
  • Combat Application Tourniquet (2)
  • Trauma Shears
  • Blanket
  • FoilBlanket
  • Nasopharyngeal airway
  • Chest Seal Package
  • Packing Gauze
  • Gloves
  • Eye Guard
  • Non-Adherent Dressing
  • Decompression needle
  • Radio
  • Marker
  • Triage Tag (Minimal)
Available medications
Injury type
  • Open fracture of the right thigh with visible bone
  • Right lower hand burn
Scoring summary
  • Triage
  • A-Assess Airway
  • Disposition