Managing the Scene (1 of 2) --

Managing a scene with multiple patients can be frustrating and difficult. These steps will help you systematically triage and treat each patient. They also will give you information to help you determine the number and types of additional rescue personnel, equipment and transport vehicles you need to manage the crisis.

It is important to recognize that you are not abandoning patients by assigning them the Delayed or Minor categories. They are being directed to the rescuers or facilities that have been assigned to handle those patients. The rescuers who are managing the Minor and Delayed patients will be reassessing them and will re-assign them to the Immediate category if they deteriorate.

_____ VIDEO _____
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[A disaster scene can be trying for the most sophisticated rescue team.
START helps rescuers know where they are needed most.]

Immediate - Red

When you arrive at an emergency where someone has used the START triage system, your first priority is to find and treat the IMMEDIATE patients. These patients are at risk for early death - usually due to shock or a severe head injury. They should be stabilized and transported as soon as possible.

_____ VIDEO _____
(Microsoft Windows Media Player needed.)
Click here to download.
[Firefighter shares hints on rapidly triaging patients.]

Delayed - Yellow

Patients who have been categorized as DELAYED are still injured and these injuries may be serious. They were placed in the DELAYED category because their respirations were under 30 per minute, capillary refill was under 2 seconds and they could follow simple commands. But they could deteriorate. They should be reassessed when possible and those with the most serious injuries or any who have deteriorated should be top priorities for transport. Also, there may be vast differences between the conditions of these patients. Consider, for example, the difference between a patient with a broken leg and one with multiple internal injuries who is compensating initially. The second patient will need much more frequent re-assessment.

Minor - Green

Patients with MINOR injuries are still patients. Some of them may be frightened and in pain. Reassure them as much as you can that they will get help and transport as soon as the more severely injured patients have been transported. Any of these patients also could deteriorate if they had more serious injuries than originally suspected. They should be reassessed when possible.

Deceased - Black

Check with your local protocols about whether patients marked DECEASED should be moved. Some systems don't want patients moved until a coroner is on scene, unless they are interfering with rescue attempts.

The mnemonic RPM will help you categorize each patient.
(Using RPM) NEXT PAGE