• It is a process of prioritising patients based on the severity of their condition so as to treat as many as possible when resources are insufficient for all to be treated immediately.
• In case of any disaster where a number of people are affected in the neighborhood, hospital takes the moral responsibility to accept the patients and provide first aid or the basic treatment. The maximum number of patients can be treated is limited to a particular number of which the number of unstable patients requiring life support is limited to a particular number.
• Other elective admission for Oncology patients is stalled until the situation comes to normal.
• Triage shall be initiated whenever faced with a situation of mass casualties.
• If faced with a large number, casualties need to managed priority wise
• The aim is to ‘do the best for the most’

Triaging:

Triaging of the patients is done at the main lobby by any of the doctors who are on duty. During external disasters, patients shall be triaged as Red, Yellow, Green and Black according to the following criteria.

Red

First Priority, Most Urgent, Life-Threatening shock or hypoxia is present or imminent, but patient can be stabilized and if given immediate care, shall probably survive.

Yellow

Second Priority, Urgent, Injuries have systemic implications or effects, but patient is not yet in life-threatening shock or hypoxia, although systemic decline shall ensure, given appropriate care, patient seems able to withstand a 45 to 60-minute wait without risk

Green

Their Priority, Non-urgent, Injuries are localized and without immediate systemic implications, with a minimum of care, patient generally does not deteriorate for up to several hours.

Black

Dead, no distinction can be made between clinical and biologic death in a mass casualty incident, and any unresponsive patient who has no spontaneous ventilation or circulation is classified as dead.

 

• These colored ribbon bands stickers are made available at the E.R room and Front Desk and the ICU.
• The doctors and consultants at all levels and specialities shall act as treating doctors during this situation.
• For detailed procedure on disaster management refer Safety Manual

Methods of triage

Triage can be performed rapidly by assessing

• Airway
• Response to verbal command
• Respiratory rate
• Circulation rate: Pulse rate or capillary return
• Pupillary reaction