Triage 011

Background: 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.

What has already been done: You yelled to the patients, asking them to move and wave, and sorted them into WALKING, WAVING, and NOT MOVING groups. Next, you need to quickly assess the patients to determine what interventions they might need and place the appropriate triage tag. Selecting a disposition in the tablet will end your evaluation of that patient. Then, you will exit that scenario and move on to the next patient. You need to perform this for all patients.

Patient Communication

Patient: Hey, I am here to take care of you.
Response: Thank you.
Location: Head
Patient: Can you tell me your name?
Response: Hayley Learson.
Location: Head
Patient: What happened?
Response: There was a blast… I think I lost my leg. And my side hurts.
Location: Head
Patient: Are you hurting anywhere?
Response: My leg hurts horribly.
Location: Head
Patient: Does your throat hurt or feel tight?
Response: No. But I feel really weak.
Location: Head
Patient: Are you having a hard time breathing?
Response: I feel weak but my breathing feels ok.
Location: Head
Patient: Does your chest hurt?
Response: No. Just my leg.
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. Please don't let me die.
Location: Head

Scoring Details

Change triage type to immediate
Massive Hemorrhage: Place Tourniquet on Left Upper Leg
Massive Hemorrhage: Place Tourniquet on Left Lower Leg
Exam: Ask patient
Airway: Jaw thrust maneuver
Listen for breathing
Head-tilt-chin lift
Exam: Assessment: Check Carotid Pulse Right
Exam: Assessment: Check Carotid Pulse Left
Exam: Assesment: Check Radial Pulse Right
Exam: Assesment: Check Radial Pulse Left
Exam: Assesment: Check Femoral Pulse Right
Exam: Assesment: Check Femoral Pulse Left
Exam: Assesment: Check Pedial Pulse Right
Exam: Assesment: Check Pedial Pulse Left
Exam: Ask patient
Exam: Ask patient to move right leg
Exam: Ask patient to move left leg
Exam: Ask patient to move right arm
Exam: Ask patient to move left arm
Exam: Assessment: Complete TCCC card
Complete NATO Field card
Patient disposition: Medical Evacuation

Scenario Details

Scenario Package
SALT Triage EMS Practice Pack
Learner type
  • preshospital
  • militaryMedic
Patient severity at start
Serious
Patient severity overall
Serious
Duration to complete
<5 minutes
Scenario difficulty
Moderate
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
  • Amputated left leg at knee
  • Groin junctional wound, left side
Pathologies
  • external hemorrhage, left leg
  • external hemorrhage, left kidney
Scoring summary
  • Triage
  • M-Place Tourniquet
  • A-Assess Airway
  • C-Check Pulse
  • H-Assess LOC
  • Documentation
  • Disposition