In the case of disaster there is a good chance of mass casualty.
A mass casualty is defined as any event where your medical resources are inadequate for the number and severity of injuries incurred.
If you choose to help, your goal is to do the greatest amount of good for the greatest number of people whilst keeping rescuers safe.
Assess the situation as per normal; Must Read - Immediate First Aid – Critical First Aid – Assess the SituationMass Casualty Critical Assessment
Quickly assess and ‘tag’ each patient. You can tag with numbers or colors. There is no international standard, but the following are well recognized (US Standard):
1 or Red: highest priority. Probable loss of life or limb if immediate medical care is not given.
2 or Yellow: needs medical care but can wait 2 to 4 hours. Patient may enter Red over time.
3 or Green: minor injuries. Referred to as the “walking wounded”. Can help with other patients.
4 or Black: no chance of saving. Do not initiate CPR unless the cause is lightning.
Depending on your situation and/or resources, tags that would otherwise be red or yellow may become black. Lack of advanced medical care is a big factor here.
Fix critical problems quickly if possible, but do not spend very much time on any one patient, preferably under 30 seconds.
Tell each patient who you are and that you are there to help. Stay calm and re-assure them.
Mass Casualty Primary Assessment Flow Chart
Open airway if necessary:
If victim begins breathing once the airway is restored, tag red.
If patient’s respirations are too slow or fast, tag red.
If airway is open but they are not breathing, tag black.
If breathing is normal, check pulse and perfusion:
If there is no pulse or capillary refill takes longer than 2 seconds, tag red.
If pulse is present and capillary refill is normal, move to mental status:
If patient is unconscious or disorientated, tag red (explosions may cause temporary hearing loss, which is different from disorientation).
If they can follow commands but are unable to get up, tag yellow.
If they follow commands and can get up, tag green.
While doing the above, consider the following:
Elevate legs if there are signs of shock.
If there is any doubt as to the category, always tag the highest priority triage level, e.g., not sure between yellow and red? Tag red.
Once you have identified someone as level 1/red, tag them and move immediately to the next patient unless you have major bleeding to stop.
Only administer CPR if you have sufficient resources.
Protect the spine only if resources are available.
Stop severe bleeding, (use a bystander if available). If bleeding doesn’t stop, tag Red.
Once critical assessment and tagging has been completed, move patients in order of priority to a safe area for further treatment and secondary exams; Must Read - Secondary Exam.