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EAHA DM 2.2: Mass Casualty Incidents - Captions

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    (English captions by Trisha Paul, University of Michigan.)
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    In this session, we shall talk about mass
    casualty incidents.
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    A mass casualty incident is any incident where
    the number of injured overwhelm the capabilities
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    of the first arriving units.
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    They usually involve trauma but could be acute
    radiation, biological weapons, or poisoning
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    from alcohol.
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    It could be bomb blasts, it could be transportation
    crashes.
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    They involve road traffic injuries, collapsed
    buildings, which are occurring every day.
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    Three things are particularly important in
    lessening injuries and deaths in mass casualty
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    incidents.
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    One is immediate search and rapid triage.
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    Two, immediate first aid treatment.
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    And three, transport to the nearest medical
    centre.
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    Read the story on the bus collision.
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    What things went wrong in that scenario?
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    After the incident, it is important to be
    composed; search and rescue should be done
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    methodically.
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    Stop, look, listen, and think, and call for
    help!
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    Choose a team leader.
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    Usually security personnel are needed to secure
    the incident site, Zone 1 or Ground Zero as
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    it is called in court.
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    Wear protective gadgets including gloves and
    helmet.
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    Select a medical incident commander to manage
    triage, treatment and transport, the 3Ts.
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    These are very important in mass casualty
    incidents.
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    Triage, treatment, and transport the patient.
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    Some ambulances are able to sustain lives
    that require advanced support.
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    Call for an ambulance.
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    Triage is a French term meaning pick and sort,
    or select and categorize.
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    It involves: classifying victims in order
    to assign priorities for medical care and
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    transportation, urgency of the case handling
    to increase victims' likelihood of survival.
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    The aim is to provide the greatest good for
    the greatest number of people injured.
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    Triage categories.
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    Triage uses agreed colors to communicate amongst
    personnel.
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    Triage ribbons or cards can be used, although
    in resource constrained countries, you may use
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    other coding systems.
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    It tells intervention teams the priority level
    with which to handle each affected person.
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    This is an example of a color coded triage
    card.
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    Triage categories include those injured or
    affected persons that need immediate care,
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    those that need delayed care, those that need
    minor care, and those that can be classified
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    as deceased.
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    The Red Coded are first priority at the mass
    casualty incident.
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    Immediate care should be started.
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    They have a compromised airway, or are in
    shock, and need immediate resuscitation.
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    The Yellow Coded are the second priority.
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    Urgent care is needed.
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    They can deteriorate to Red category in a
    short time.
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    They are in impending shock.
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    The Green Coded are the third category and
    include all walking wounded.
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    Care can come later.
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    However, they need monitoring for any sign
    of deterioration.
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    The Black Coded are either dead or hopelessly
    wounded.
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    They should not take priority time and resources.
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    Concentrate on those that can be saved.
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    How To Triage.
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    Begin by assessing all non-moving patients
    where they lie.
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    Use START Triage.
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    START, meaning Simple Triage And Rapid Treatment,
    where treatment here refers to first aid treatment
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    and follow up treatment.
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    Triage can be performed by any individual
    including non-health workers.
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    Because of the scarcity of manpower, all who
    can should participate in triage.
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    Triage Techniques: We consider three main
    aspects: respiration, blood circulation, and
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    consciousness.
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    Under respiration, we check: Are they breathing?
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    And if they are breathing, what are their
    breaths per minute?
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    These are important criteria that can help
    us decide whether someone needs immediate
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    care or delayed care.
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    Under Blood Circulation, we check: Is there
    a pulse?
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    If there is a pulse or if there is no pulse,
    how is the perfusion of blood into the tissues?
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    Three, Consciousness.
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    Are they conscious?
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    Or, what is their Mental status?
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    All these 3 areas of assessment should take
    less than one minute per patient.
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    Checking for Respiration.
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    If there is no respiration or they are not
    breathing, open the airway and clear the airway
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    by stretching the neck and clearing anything
    that may be in their mouth.
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    If there is still none, label as black.
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    If the respiration is restored, label as red.
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    If the respiration rate was initially present
    and the breathing rate was above 30 beats
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    per minute or a visibly faster rate, label
    as red.
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    However, if the breathing rate is below 30
    in the initial breathing, then go to the next
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    stage of assessment and that is the circulation,
    or the perfusion.
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    Blood circulation is the same as perfusion.
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    Check if the radial pulse is present, and
    if it is not present, or the capillary refill
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    is greater than 2 seconds, label as RED.
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    If the radial pulse is present and normal
    or the capillary refill is less than or equal
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    to 2 seconds, then that means that circulation
    is ok.
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    For some patients, if they have passed the
    respiration test and they have also passed
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    the circulation test, we need to check the
    mental status.
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    If the mental status cannot follow simple
    commands, then they are unconscious or have
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    an altered level of consciousness.
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    These are labeled as Red.
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    If they can follow simple commands on their
    first or previous test, that is respiration,
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    circulation, then label as Yellow if they
    are unable to walk or Green if they are walking.
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    This is the summary algorithm.
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    Take time to look at it.
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    Summary.
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    Triage is the single most important decision
    involving management of mass casualty incidences.
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    Triage evaluation involves airway and breathing,
    that is, respiration, checking the circulation,
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    and checking the mental status.
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    However, after the Triage, the Triage teams need to
    hand over the serious cases to the first aid
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    treatment teams. Later on, we shall look,
    in another session, we shall look at first
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    aid treatment. Medical facilities are encouraged
    to develop mass casualty plans for their facilities
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    based on operating capacity and resources.
    District committees and local authorities
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    should identify key players in search and
    rescue and in first aid.
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    Thanks for listening.
Title:
EAHA DM 2.2: Mass Casualty Incidents - Captions
Description:

This is a remix of 2.2: Mass Casualty Incidents narrated by Roy William Mayega (Makerere University). The original video (without captions) can be found at http://www.youtube.com/watch?v=uFnKgBUlOoU. This video is part of a learning module from the East Africa HEALTH Alliance called Public Health Emergency Planning and Management for Districts. The full module and the video transcript can be accessed at http://openmi.ch/disaster-mgmt. Copyright 2009-2019 Roy Mayega (Makerere University). The video, transcript, and module are all shared under a Creative Commons Attribution (CC BY) 3.0 License: http://creativecommons.org/licenses/by/3.0/.

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Video Language:
English
Duration:
10:09

English subtitles

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