Emergency Preparedness, Triage, and Evacuation
Concepts to master
Know triage systems (color-coded and score-based), mass-casualty triage principles, surge capacity, incident command, and evacuation decision-making. Understand that mass-casualty triage prioritizes doing the greatest good for the greatest number, which differs from day-to-day triage that prioritizes the sickest individual. Know the categories: immediate, delayed, minimal, expectant, and deceased.
Evacuation and preparedness
Understand when to shelter in place versus evacuate, how to determine evacuation priority, and the role of transportation assets. Know the phases of disaster management: mitigation, preparedness, response, and recovery. Familiarize yourself with personal protective equipment selection and decontamination principles.
Traps to watch
- Applying everyday "sickest first" triage to a mass-casualty scene where expectant patients are not prioritized for scarce resources.
- Forgetting that scene safety and responder safety precede patient contact.
- Confusing incident command roles; the incident commander does not personally treat patients.
- Missing that decontamination precedes treatment for hazardous material exposure.
Rule of thumb
In a mass-casualty event, ask "who can I save with the resources I have?" rather than "who is sickest?" Scene safety always comes first.
Worked example: At a bus crash with multiple casualties and limited ambulances, a patient with a survivable but non-immediate injury is categorized delayed, while a patient with catastrophic injuries and no realistic survival given available resources is categorized expectant.