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This weeks’ CERT (Citizen Emergency Response Team) session, taught by CERT Coordinator/ EMT Steve Fickling of the MIFD, concentrated on the principals of medical triage and how to conduct mass triage evaluations. The need for disaster medical operations is based on two assumptions: The number of victims will exceed the local capacity for treatment, and that survivors will assist others and will do whatever they know how to do.

In a disaster, there will be more victims than rescuers and immediate help may not be available for a considerable amount of time. CERT personnel must be able to function quickly and efficiently to save lives. Primarily, there are three phases of death from trauma. Phase 1: Death within minutes as a result of overwhelming and irreversible damage to vital organs. Phase 2: Death within several hours as a result of excessive bleeding and shock. Phase 3: Death in several days or weeks as a result of infection or multiple-system failure from prolonged complications.

The late medical pioneer Dr. Peter Safer M.D., ScD, who invented CPR, did research after earthquakes in Chile, Peru and Italy, which indicated that providing simple medical care could save more than 40 percent of disaster victims in the second and third phases of death from trauma. CERT personnel are trained to provide treatment for life-threatening conditions – airway obstruction, bleeding, and shock – and for other less urgent conditions such as broken bones and small lacerations. The goal of disaster medical operations is to employ simple triage and rapid treatment that provides the greatest good for the greatest number of victims, in the shortest amount of time.

As CERT responds to a major disaster an incident command is set up, and CERT members are dispatched to provide search and rescue to locate and treat any injured persons. Life-threatening conditions are the first priority: airway obstruction, controlling excessive bleeding, and treating for shock. Triage is a French term meaning to sort. During triage the victims are evaluated, sorted by the urgency of the treatment needed, and set up for immediate or delayed treatment. Triage was, in fact, initiated by the military and experience has shown that triage is an effective strategy in situations where there are many more victims than rescuers, resources are limited and time is critical.

The general procedures for triage are to first – protect your self at all times. Stop, look, listen and think before you act. Conduct voice-triage by calling out and instructing anyone who can hear your voice to walk to you. Start from where you stand and follow a systematic route starting with the closest victims and work outward. Evaluate victims and tag them, including the walking wounded. Gather those victims who are unhurt or have mild injuries and are ambulatory to assist your triage. Treat the immediate life-threatening injured first. And lastly, document triage results for effective deployment of additional resources, information on victims’ locations and for a quick number of casualties by the degree of severity.

Next week: Collier Health Dept. RED Plan and Counter Terrorism Planning.