Professional Documents
Culture Documents
Triaje Sieve
Triaje Sieve
space
space
a 3
standard tool for mass casualty triage
m ,process
oin apolicy
for both Health Response
a d a
Teams and Ambulance
This policy
a
supersedes the i c
Services
l.previous
mass casualty incident.
of Triage Label
t o r i z
(PD2005_482). g m
a u
Replaces Doc. No. Triage a
a s @
r g a r g Medical Disaster Plan - Use of Casualty Labels [PD2005_482]
e s caAuthor Branch
i xa vNSW Health Emergency Management Unit
D , a hcontact NSW Health Emergency Management Unit 02 8396 5012
o
Branch
Tor Applies to Local Health Districts, Government Medical Officers, NSW Ambulance
Service, Public Hospitals
Audience Health Response Teams under the disaster management Medical
Services Supporting Plan
Distributed to Public Health System, Government Medical Officers, NSW Ambulance
Service, Ministry of Health
Review date 04-Jul-2014
Policy Manual Patient Matters
File No.
Status Active
Director-General
space
This Policy Directive may be varied, withdrawn or replaced at any time. Compliance with this directive is mandatory
for NSW Health and is a condition of subsidy for public health organisations.
POLICY STATEMENT
PURPOSE
This policy specifies the use of Mass Casualty Triage Pack - SMART Triage Pack in a
mass casualty situation to denote the priority for treatment under the Medical Service
Supporting Plan (GL2010_011).
MANDATORY REQUIREMENTS
This policy sets the requirements of the use of the SMART Triage Pack for casualty
triage process, documentation in the field and when patients are immediately
r g a s
a
transported to hospital. The SMART Triage Tags become part of the patient’s medical
V
records.
h ix a 5 .1
1 A
z (PD2009_080).
In Local Health Districts, the SMART Triage Packs are to be stored
.2
and formed
8 4
part of
4 9
the Health Response Team Medical Equipment list requirement 8 .
9
In Ambulance Services of NSW, the SMART0Triage 46Packs areIP : 8stored in the
a 3 in mass o m , incident.
to be
Ambulance vehicles for first responders’
a d a use
a i l. c casualty
t o ri z gm
IMPLEMENTATION
a u
aimplemented a @
s Local Health Districts and Ambulance Services
This policyg
ainr 2011. ixava
will be r g across
s c
De o, ah
of NSW
In Local Health Districts, each Health Response Team Medical Equipment Kit requires
two Mass Casualty Triage Packs. Ambulance Service of NSW has purchased one
Smart Triage Pack and additional SMART triage Tags for each Health Response Team
Equipment Kit in Local Health Districts. Local Health Districts will be responsible to
replace all old triage labels by the 31st December 2011 and for future replacement.
De o, ah
or
ATTACHMENTS
T
1. Mass Casualty Triage Pack - SMART Triage Pack - procedures
PROCEDURE
CONTENTS
1 BACKGROUND ...................................................................................................................... 1
1.1 Triage Process ................................................................................................................ 1
1.2 Australian Standard Mass Casualty Triage Labels (Tags) .............................................. 1
a d a a i l .c
t o r iz gm
a a u a s @
g
ar ixava r g
s c
De o, ah
Tor
PROCEDURE
1 BACKGROUND
1.1 Triage Process
Triage was first introduced in military context as a system of sorting the casualties for
medical treatment in the field. In recent decades, the triage concept has been adopted
and implemented in the disaster medical management and emergency departments.
In the context of medical management in a mass casualty situation, the aims of triage are
not only to deliver the right patient to the right place for optimal treatment, but also to ‘do
the greatest good for greatest number’ with the valuable medical resources at the scene
which should not be diverted to treating an irrecoverable condition.
r g a s
1.2 Australian Standard Mass Casualty Triage Labels (Tags) a V
a
A h ix 4 5 .1
In early 2010, the SMART Triage Tags were approved as an
9 1 z
Australian
8 .2mass
standard
8 .
9 4 64 IP: 8
casualty triage label by the Council of Ambulance Authorities (CAA) following
a 3 0
consultation with jurisdictional Health Departments.
,
mcasualty
The SMART Triage Tags provide a a
d standard tool for.c
i l o
mass triage process for
both Health Response Teams
r i z a
and Ambulance
g m a
Services in a mass casualty incident.
a u
These tags also provide, o
t for the firststime,
@ a national consistency for mass casualty triage
g a
tags across Australia
r allows
a r g a
inter-operability.
The s a
c TriageixTags v
a meet world’s best practice and have been tested and evaluated
D e SMART
a h
for
o ,
Australian conditions. The system was used during major incidents including the 2005
Torbombings.
London
Easy access to
contents
TM
Photo source: SMART TAG
PROCEDURE
r ga s
V a
h ixa 5 .1
1 z A 8 .2 4
9
64 IP: 8 8 .
94
a 30 o m ,
a d a a i l. c
t ori z gm
a au a s @
g
ar ixava r g
s c
De o, ah
Tor
The SMART Triage Tag has a prominent priority numbering and matching colour system1
on the tag (Table 1). A separate Black colour triage tag is used for deceased persons.
1
The blue colour corner of the SMART Triage Tag is referred as fourth priority (Expectant). The Expectant
priority refers to casualty whose condition is so severe that they cannot survive despite the best available
care and whose treatment would divert medical resources from salvageable patient who may then be
compromised. This category (Blue – Expectant priority) is not used in NSW; however it is used in some
jurisdictions in Australia.
PROCEDURE
YELLOW 2 Second Priority (Urgent) Casualties who require definitive treatment within
four to six hours.
GREEN 3 Third (Delayed) Priority Less serious casualties who do not require
treatment within the above times.
1 z A .2 4
medical practitioner. These are labelled and left
8
9
64 IP: 8 8 .
undisturbed, in situ, and Police Forensic Services
a 30 o m ,
Forensic Medicine in mass casualty incidents).
a d a a i l. c
While there is no longer a r
t o z
i to use multiple
need mtriage tags to reflect patient’s changes in
gprovides
a u
condition and priorities.
a The
a
SMART s @Tag documentation for recording patient
a g
changes inrcondition.
v a g
r Total score 10 or less is equal to Priority 1. The time
For example
e s c
of condition changes
i x a
should be recorded using 24hours time recording method.
D , a h
r o
To
PROCEDURE
Before the patient is transferred to definitive health care facility, the Ambulance Loading
Point Officer will complete and remove the transport tag (at the side of the SMART Triage
Tag) for records. This documentation enables the tracking and accounting of the
casualty’s movement.
Transport Tag
r g a s
V a
The SMART Triage Tag will be attached with patient who is then A h a
ix to the45.1
transferred
definitive care destination.
9 1 z 8 . 8 .2
9 4 64 IP: 8
a 30Chart om,
2.2 Triage Sieve and Casualty
a d aCount
a i l .c
A double sided card witht oanr z triage sieve
iadult gmprocess and the casualty count chart is
a u
a TriagergPack
attached to the SMART a @
swith an elastic band. The card is also made from the
g
ar material
same waterproof
c v a the triage tags.
as
s
e chart provides
h x a
ia quick reference of the triage sieve process and a casualty count
DThe
record isra , a
odocument that can be used by Ambulance First Responders and Health
To Team to track the number of casualties and the clinical acuity.
Response
PROCEDURE
r ga s
V a
h ixa 5 .1
1 z A 8 .2 4
9
64 IP: 8 8 .
94
a 30 o m ,
a d a a i l. c
t ori z gm
a au a s @
g
ar ixava r g
s c
De o, ah
Tor CHILDREN RANGE
FROM 3KG/50CM
TO 32 KG /140CM
TM
Photo source: SMART TAG
TM
Photo source: SMART TAG
2
Hodgetts, T., J. Maconochie, C. & Smart, C (1998). Paeditric triage tape. Pre-hospital Immediate Care
2:155-159.
3
Sandell, J. M. & Charman, S.C (2009). Can age-based estimates of weight be safely used when
resuscitating children? Emergency Medicine Journal 2009;26;43-47.
PROCEDURE
The unique identifier number of the victim’s SMART Triage Tag is required to be
a s
documented on the CBR Tag. The completed CBR Tag is to be inserted in the front clear
r g
plastic pocket of the SMART Triage Tag.
V a
h ixa 5 .1
1 z A 8 .2 4
9
64 IP: 8 8 .
94
a 30 o m ,
a d a a i l. c
t ori z gm
a au a s @
g
ar ixava r g
s c
De o, ah
Tor
CBR TAG STAYS WITH
CASUALTY
THROUGHOUT
DECONTAMINATION
TM
Photo source: SMART TAG
3 Training
The Mass Casualty Triage Pack has been incorporated in the Major Incident Medical
Management and Support (MIMMS) course and Ambulance training programs. Updated
training will be provided for existing trained health and ambulance personnel.
A train the trainer course has been conducted for relevant ambulance clinical educators,
health services disaster coordinators and nominated health and ambulance services
personnel, to ensure that the training process is undertaken across NSW Health.
4
The term ‘WMD” used in the SMART Triage Pack or Education Pack, should be referred as “CBR”.
“WMD’ is a term used in USA but not in Australia. In Australia, the term “CBR” is used instead.
PROCEDURE
Education packs were distributed to the relevant health and ambulance services for
training purposes.
1 training DVD
1 training course presentation
1 Training Manual
8 Triage Exercise Cards
Triage sieve and Casualty Count
Paediatric SMART Tape
SMART Triage Tag
r g a s
Deceased Tag
V a
CBR Tags
h ix a 5 .1
Light stick
1 z A 8 .2 4
9
64 IP: 8 8 .
9 4
a 30 o m ,
4 Supplier Details
a d a a i l. c
t ori z gmhas appointed a distributor within Australia
a
The manufacturer, TSG
a u s @
Associate Company
a
g
ar ixava
for future orders. r g
s c
e distributoraishMidmed and the company details are:
DThe o,
o r
T Address -
Postal
PO Box 508
Morningside QLD 4170
PH – 07 3348 9155