2.
Triage (cont..)
Casualty collection
sites for Levels 1 and 2 triage should be located close enough to
a disaster site to offer quick treatment, but far enough away to be
safe. Important features are:
-
Proximity to the disaster site
-
Safety from hazards and upwind location from contaminated environments
-
Protection from climactic conditions
-
Easy visibility for disaster victims
-
Convenient
exit routes for air and land evacuation
Boston DMAT at Ground
Zero, World Trade Center, New York
3.
Definitive Medical Care
Definitive
medical care generally refers to care that will improve, rather than
simply stabilize, a casualty’s condition, e.g., surgery or other
care provided in a hospital. Requirements for definitive medical care
will vary widely depending on the magnitude and epidemiology of the
disaster.
In
some disasters, local hospitals may be destroyed, or transportation
to medical facilities might not be feasible. In these situations, definitive
care must be brought to the disaster site. Hospital teams with mobile
equipment that can provide a graded, flexible response to the need for
definitive care in disasters are key to a successful disaster medical
response.
4.
Evacuation
Evacuation can be useful in a disaster as a means of “decompressing”
the disaster scene: removing the patients who are consuming the most
resources. Evacuation of seriously injured casualties to off-site medical
facilities not only improves their care, but also allows increased attention
to remaining casualties at the disaster site.
There
are several indications for evacuation in a disaster:
-
To decompress the disaster area
-
To improve care for most critical casualties
-
To provide specialized care to specific casualties, such as those
with burns and crush injuries
There
are also several reasons to delay or defer evacuation of some casualties.
These include:
-
Contaminated casualties
-
Casualties with transmissible diseases
- Unstable
casualties
Modes
of evacuation include:
- Ground
transport
-
Transport by helicopters or small fixed wing aircraft
- Transport
by large fixed wing aircraft
Local
disasters in or around urban centers would employ
transport by ambulance (ground) and helicopter. In largescale
disasters, such as Boston’s Coconut Grove fire in
1942, police cars, taxicabs, and newspaper trucks were
commandeered to bring casualties to hospitals.
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