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Continuous integrated triage - Wikipedia, the free encyclopedia

Continuousintegratedtriage
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Continuousintegratedtriageisanapproachtotriageinmasscasualtysituations.Itisbothefficientand sensitivetopsychosocialanddisasterbehavioralhealthissuesthateffectthenumberofpatientsseekingcare (surge),themannerinwhichahospitalorhealthcarefacilitydealswiththatsurge(surgecapacity),andthe overarchingmedicalneedsoftheevent. Continuousintegratedtriagecombinesthreeformsoftriagewithprogressivespecificitytomostrapidly identifythosepatientsingreatestneedofcare.Itbalancestheneedsoftheindividualpatientsagainstthe availableresourcesandtheneedsofotherpatients.Continuousintegratedtriageemploys: Group(Global)Triage(i.e.M.A.S.S.Triage(http://www.ndlsf.org/common/content.asp?PAGE=347)) Physiologic(Individual)Triage(i.e.S.T.A.R.T.orSimpleTriageandRapidTreatment) HospitalTriage(i.e.E.S.I.orEmergencySeverityIndex(http://www.ahrq.gov/research/esi/)) HoweveranyGroup,Individualand/orHospitalTriagesystemcanbeusedattheappropriatelevelof evaluation.

Contents
1History 2ApplicationandTechnique 3Overviewofcontinuousintegratedtriage 3.1Group(global)triage(masstriage) 3.1.1Ambulatorywithminimalornoassistance(Greentriagearea) 3.1.2Nonambulatoryfollowscommands(Yellowtriagearea) 3.1.3Nonambulatoryandunresponsive/inappropriate(Physiologicaltriage) 3.1.4Physiological(individual)triage(START/JumpSTART) 3.1.4.1Respirations 3.1.4.2Pulse 3.1.4.3Mentation 3.1.5HospitalTriage

History
ContinuousIntegratedTriagewasdevelopedbytheFoundingChairperson,MauriceA.Ramirez,ofthe AmericanBoardofDisasterMedicinebyapplyingthelessonslearnedattheLouisArmstrongInternational AirportinNewOrleans,Louisianafollowingthe2005HurricaneKatrinatoMassCasualtyTriageathospitals andhealthcareinstitutions.

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Continuous integrated triage - Wikipedia, the free encyclopedia

ApplicationandTechnique
UsingaGroup(Global)Triagemethod(i.e.M.A.S.S.Triage(http://www.ndlsf.org/common/content.asp? PAGE=347)),patientsaredividedintoambulatory(green)andnonambulatory(red,yellow&black)triage categories. AmbulatorypatientsaredirectedtoselfdeconshowersandthenprogresstotheGreenTriageholdingareafor retriageusingaHospitalBasedTriagemethodandtreatment. PatientswhoarenotresponsiveareimmediatelyretriagedusingaPhysiological(Individual)Triagemethod (i.e.S.T.A.R.T.orJumpS.T.A.R.T.)modifiedtoincludebehavioraltriageconsiderationspriortodecon. Thosefoundinrespiratoryarrestorpulselessaretaggeddeceasedandnotmovedduetolegalconsiderations. Unresponsivepatientswithcriticalvitalsignsundergoassisteddeconwhilereceivingonlyimmediatelylife sustaininginterventionsthenretriagedagainusingaPhysiological(Individual)Triagemethod(i.e. S.T.A.R.T.orJumpS.T.A.R.T.)modifiedtoincludebehavioraltriageconsiderations. Next,unresponsivepatientswithstablevitalsignsundergoassisteddecon.Afterdeconthesepatientstooare retriagedusingaPhysiological(Individual)Triagemethod(i.e.S.T.A.R.T.orJumpS.T.A.R.T.)modifiedto includebehavioraltriageconsiderations. Finally,nonambulatoryresponsivepatientsundergoassisteddeconfollowedbyretriageusinga Physiological(Individual)Triagemethod(i.e.S.T.A.R.T.orJumpS.T.A.R.T.)modifiedtoincludebehavioral triageconsiderations. Followingassisteddecon,patientsfoundtobeAlert,Oriented,ResponsiveandabletoFollowCommandsbut nonambulatoryaretriagedtotheYellowTriageholdingareaforretriageusingaHospitalBasedTriage methodandtreatment. Followingassisteddecon,unresponsivepatientsaretriagedtoeithertheCritical(red)orExpectant(black) treatmentareasbasedonwhetherornottherearesufficientresourcesavailableatthatmomentintimetotreat thepatientwithoutdenyingcaretotwoormoreotherpatients.

Overviewofcontinuousintegratedtriage
Group(global)triage(masstriage)
Ambulatorywithminimalornoassistance(Greentriagearea) NYHeartClassI GoldCOPDClassI NIHSS0 GCS15 80%ofPatientSurge

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Nonambulatoryfollowscommands(Yellowtriagearea) NYHeartClassIIorIII GoldCOPDClassIIorIII NIHSS1or2 GCS15 16%ofPatientSurge Nonambulatoryandunresponsive/inappropriate(Physiologicaltriage) 4%ofPatientSurge Physiological(individual)triage(START/JumpSTART)

Respirations

NoneDead(Black) <12or>20(Red)NotAgeAppropriateforChild 12to20AgeAppropriateforChild(checkpulse)

Pulse

NoneDead(Black) <60or>100(Red)NotAgeAppropriateforChild 60to100AgeAppropriateforChild(checkmentation)

Mentation

Alert,Oriented,Responsive,Ambulatory (GreenMedical) (GreenMed/Behavioral) Alert,Oriented,Responsive,NonAmbulatory (YellowMedical) (YellowMed/Behavioral) Unresponsiveorcomatose(Resourcebasedtriagedecision) Inadequateresourcestosavepatientwithoutdenyingcaretotwoormoreotherpatients Expectant(Black) AdequateresourcestosavepatientwithoutdenyingcaretotwoormoreotherpatientsCritical (Red) HospitalTriage E.S.I.(Emergencyseverityindex(http://www.ahrq.gov/research/esi/))orotherresourcebasedhospital

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Continuous integrated triage - Wikipedia, the free encyclopedia

triagesystem Retrievedfrom"http://en.wikipedia.org/w/index.php?title=Continuous_integrated_triage&oldid=579030497" Categories: Triage Thispagewaslastmodifiedon28October2013at00:08. TextisavailableundertheCreativeCommonsAttributionShareAlikeLicenseadditionaltermsmay apply.Byusingthissite,youagreetotheTermsofUseandPrivacyPolicy. WikipediaisaregisteredtrademarkoftheWikimediaFoundation,Inc.,anonprofitorganization.

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