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Are your MCI Triage Tags Water Proof?
The concept of START Triage revolutionized how we, the fire service approaches mass casualty incidents which dependent upon where you are from includes an five or more patients. If you pulled up on an accident scene, do you have the necessary tools memorized to ensure saving the maximum number of lives? And if you do have to use the decontamination process, please make sure that your triage tags are water proof. One drill I attended included everyone documenting the appropriate information on the triage tags for a drill. The problem was that after the victims went through gross decon after the initital triage nurse evaluation, the triage tags lost all the data because they were not water proof.
The first triage tags that came out were paper. We were not living in a world of WMD and emergency decontamination when this all started in the 1970's. These were no frills triage tags that still have a place, but not if decontamination or a wet environment is a factor.
Even though START Triage is as simple because all you have to memorize is:
32 CAN DO... or RPM... that's it. Here's the flow chart to explain this:
The second generation of triage tags included a cheat sheet to remind folks of this new concept of 32 CAN DO or START Triage. The problem with these tags was their lack of abilty to resist water. Anything written disappears after going through the decontamination process.
The newest or third generation of Triage Tags include several new features, all designed around dealing with contaminated victims from a NBC+E* incident.
*Nuclear, Biological, Chemical or Explosives Incident
New features include
1. Use of bar codes
2. Cheat sheet reminder for organophosphate poisoning (SLUDGEM). Salivation, Lacrimation, Urination, Defecation, Gastro-Intestinal Distress, Emesis, Miosis)
3. Evidence Collection Tag with corresponding bar code
4. Personal Property Receipt with corresponding bar code
5. Destination Tag with corresponding bar code
6. Morgue Tag
7. Each tag contains the familiar Immediate, Delayed, Minor Tags but these have corresponding bar codes
8. Additional medical information as seen below on the WMD Triage Tag:
Now that you are aware that there are different types of Triage Tags, you can evaluate what you have and specify what you order when you update your MCI Supply Cache. Remember that the older tags are still very useable for MCI's that don't involve emergency decontamination procedures.
I hope this saves you the hassle of doing a drill, having the EMS folks put a lot of effort into coming up with various signs and symptoms written on the Triage Tags only to have the writing completely disappear from the decon showers.
Best of luck!
Mike Schlags
Santa Barbara, CA
mschlags@yahoo.com
The first triage tags that came out were paper. We were not living in a world of WMD and emergency decontamination when this all started in the 1970's. These were no frills triage tags that still have a place, but not if decontamination or a wet environment is a factor.
Even though START Triage is as simple because all you have to memorize is:
32 CAN DO... or RPM... that's it. Here's the flow chart to explain this:
The second generation of triage tags included a cheat sheet to remind folks of this new concept of 32 CAN DO or START Triage. The problem with these tags was their lack of abilty to resist water. Anything written disappears after going through the decontamination process.
The newest or third generation of Triage Tags include several new features, all designed around dealing with contaminated victims from a NBC+E* incident.
*Nuclear, Biological, Chemical or Explosives Incident
New features include
1. Use of bar codes
2. Cheat sheet reminder for organophosphate poisoning (SLUDGEM). Salivation, Lacrimation, Urination, Defecation, Gastro-Intestinal Distress, Emesis, Miosis)
3. Evidence Collection Tag with corresponding bar code
4. Personal Property Receipt with corresponding bar code
5. Destination Tag with corresponding bar code
6. Morgue Tag
7. Each tag contains the familiar Immediate, Delayed, Minor Tags but these have corresponding bar codes
8. Additional medical information as seen below on the WMD Triage Tag:
Now that you are aware that there are different types of Triage Tags, you can evaluate what you have and specify what you order when you update your MCI Supply Cache. Remember that the older tags are still very useable for MCI's that don't involve emergency decontamination procedures.
I hope this saves you the hassle of doing a drill, having the EMS folks put a lot of effort into coming up with various signs and symptoms written on the Triage Tags only to have the writing completely disappear from the decon showers.
Best of luck!
Mike Schlags
Santa Barbara, CA
mschlags@yahoo.com
Replies to This Discussion
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Permalink Reply by rfdjumper on
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We have the 2nd type. You bring up a good point about the ink going bye-bye, I'll have to bring that up in the next discussion I have with "The Man". Thanks
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Permalink Reply by Ben Waller on
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Mike,
For small departments that don't have the funds to buy the START tags, there's a VERY inexpensive option.
Simply buy rolls of red, yellow, green, and black surveyor's tape. That tape is lightweight plastic ribbon, and it does a good job of identifying the patient's triage category.
A sheet, blanket, or blue tarp can substitute for the black tag.
Decontamination identifiers - patient wearing their own clothing = NOT DECONTAMINATED
Naked patient or patient wearing one of those sexy Tyvek re-dress suits = DECONTAMINATED.
This system doesn't give us the same amount of information that a completed START triage tag does, but if your people are trained on the START/RPM system, they can make this work.
After all, the most important two parts of triage are the Contaminated/Decontaminted marking and the triage category color. Everything else is of secondary importance.
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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To be honest Ben, the only way I've seen these is when we received them from our local OES folks. When a jurisdiction is writing the grants for equipment, be sure to include these tags in the language. People are real good about justifying decon shelters and other equipment, just don't forget to add the Triage Tags on the next go around.
Your suggestions as to how to accomplish this using colored tape is certainly an option if you don't have the tags. Departments need to make contact with their local EMS authority and hospitals. These tags work really well and just might be available through Homeland Security Grants.
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Mike,
We carry a 50-tag bundle of START triage tags on every ambulance, with a larger cache of 300 tags, color-coded treatment area tarps, and medical group command vests on our battalion and hazmat rigs. We have also added a bundle of 150 tags on our USAR rig, but we anticipate that USAR rig's tags won't be used for triage much unless we get a mass entrapment from a structural collapse at a place of mass gathering.
START triage tags are a state standard in SC. The EMS unit tags were provided by a state EMS grant and the hazmat tags were provided through a state Homeland Security grant. All 14 of the state COBRA (WMD) teams carry START tags to go with the mass decon systems. We've found that just throwing up a one or two-pumper deluge decon works better than the tents most of the time.
We also have a decon Plan C that states if a mass decon event takes place near the beach, we just have all of the walking wounded go self-decon in the ocean. We can tag them after they get clean in that case - I'm not playing Triage Tag games while surfing in turnout gear or tyvek.
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You know, I live next to the ocean as well and I don't think I've ever heard of that obvious out of the box approach to mass decon. Very original thoughts. ms
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Permalink Reply by T.J. on
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never thought of that befroe Mike, great idea and I'll check into this, we have a county wide trailer that stores all of out mass caulity equipment, so where ever its needed its always ready:)
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Ben, I wanted to re-reply to this to bring alive this post to coordinate making it more readily available for folks reading a post I put together on MCI and the use of triage tags. Your concept of using other non-commercial items for triage is something that everyone needs to at least be exposed to. Not everyone has a mega-budget and your concept just makes things work. Thanks again for sharing. CBz
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