伤情评估和战场伤员分类江-培训课件.pptVIP

Triage Sieve Simple triage and rapid treatment (START) triage algorithm Triage is only a “snapshot” of how the casualty is at the time of assessment． In order to identify changes in the casualty’s condition，the triage sieve must be repeated at each link of the evacuation chain. It is important initially not to try to predict how a casualty may deteriorate, this will lead to over-triage（a higher than necessary triage category）and can overwhelm the system with P1 and P2 casualties. Triage for treatment Limited time and personnel resources may prohibit a more detailed triage assessment other than that given by the triage sieve. When possible, the Triage Sort can be used to refine the triage sieve decisions． Triage sort uses the respiratory rate, systolic blood pressure and Glasgow Coma Scale，to numerically score the casualty from 0 to 12 and give an indication of priority for evacuation and/or the need for further intervention． This score has a proven direct relationship to outcome from severe injury. Physiological variable Measured value Score Respiratory rate 10-30 4 ? 30 3 ? 6-9 2 ? 1-5 1 ? 0 0 Systolic blood pressure 90 4 ? 89-76 3 ? 75-50 2 ? 49 1 ? 0 0 Glasgow coma scale 15-13 4 ? 12-9 3 ? 8-6 2 ? 5-4 1 ? 3 0 Priorities are assigned as: P1(T1) 1-10 P2(T2) 11 P3(T3) 12 P1 Hold(T4) 1-3 Dead 0 The overlap in scores allows for the seriously injured to be placed in either category,depending on number of casualties and resources available of evacuation. Evacuation will be delayed when the number of casualties outstrips available transport. In this situation，the greater time spent with the casualty will allow additional anatomical assessment of injuries. Where the primary determined by physiology does not match the anatomical severity of injuries, the priority can be upgraded． Example: A soldier loses his left leg in a landmine incident.Immediate first aid is effective in stopping hemorrhage.He is transported to the