EMS Triage Curriculum 003

Not moving: Triage a non-responsive, non-breathing patient requiring life-saving interventions (airway, hemorrhage control, needle decompression) for IMMEDIATE categorization (RED 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: The patient is having a hard time talking
Location: Head
Patient: Can you tell me your name?
Response: The patient is having a hard time talking
Location: Head
Patient: What happened?
Response: The patient is having a hard time talking
Location: Head
Patient: Are you hurting anywhere?
Response: The patient is having a hard time talking
Location: Head
Patient: Does your throat hurt or feel tight?
Response: The patient is having a hard time talking
Location: Head
Patient: Are you having a hard time breathing?
Response: The patient is having a hard time talking
Location: Head
Patient: Does your chest hurt?
Response: The patient is having a hard time talking
Location: Head
Patient: Did you pass out (lose consciousness)?
Response: The patient is having a hard time talking
Location: Head
Patient: Do you have any numbness or weakness?
Response: The patient is having a hard time talking
Location: Head
Patient: Does your head hurt?
Response: The patient is having a hard time talking
Location: Head
Patient: Does your neck hurt?
Response: The patient is having a hard time talking
Location: Head
Patient: Does your back hurt?
Response: The patient is having a hard time talking
Location: Head
Patient: Does your abdomen hurt?
Response: The patient is having a hard time talking
Location: Head
Patient: Do you have any allergies?
Response: The patient is having a hard time talking
Location: Head
Patient: Do you take any medications?
Response: The patient is having a hard time talking
Location: Head
Patient: Do you have any medical problems?
Response: The patient is having a hard time talking
Location: Head
Patient: Have you ever had any surgeries?
Response: The patient is having a hard time talking
Location: Head
Patient: When did you last eat or drink something?
Response: The patient is having a hard time talking
Location: Head
Patient: Do you smoke, drink, or use recreational drugs?
Response: The patient is having a hard time talking
Location: Head
Patient: I'm going to take care of you.
Response: The patient is having a hard time talking
Location: Head

Audio Triggers

This is not the correct spot to place an NDC. Please try again.
Good job! This is the right spot to place an NDC.
Good job! This is the right spot to place an NDC.

Scoring Details

Change triage type to immediate
Massive Hemorrhage: Place Tourniquet on Left Upper Leg
Exam: Ask patient
Airway: Jaw thrust maneuver
Listen for breathing
Head-tilt-chin lift
Head-tilt-chin lift
Move the patient into a sitting position
Roll patient into recovery position
Airway: Jaw thrust maneuver
Airway: Place Nasopharyngeal Airway
Place Chest Seal Front Right
Breathing: Needle Decompression right side placement
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: Ask patient
Perform sternal rub
Exam: Assessment: Complete TCCC card
Complete NATO Field card
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
  • Amputated left leg at knee
  • Chest wound (anterior right)
  • Facial burn
Pathologies
  • airway obstruction
  • external hemorrhage, left leg
  • pneumothorax, open, right
Scoring summary
  • Triage
  • M-Place Tourniquet
  • A-Assess Airway
  • A-Airway Intervention
  • R-Treat Pneumothorax
  • H-Assess Neuro/LOC
  • Documentation
  • Disposition